The Hague: The World Health Organization (WHO) has confirmed a second case of hantavirus infection identified on a vessel in the Atlantic Ocean, bringing the total number of confirmed cases on board to two, Dutch cruise ship operator Oceanwide Expeditions said in a statement. 

The newly confirmed case was a Dutch female passenger who died on April 27, the operator said.

About 150 people remain on board following the deaths of a Dutch couple and a German national, as well as two crew members falling ill. Another confirmed hantavirus passenger, a British national, has left the vessel and is receiving intensive care in Johannesburg, South Africa, it said.

"Two crew members on board continue to present acute respiratory symptoms, one mild and one severe. Both require urgent medical care," the statement said.

"These crew members are of British and Dutch nationality. At this time, no other persons with symptoms have been identified," Xinhua news agency reported.

Hantaviruses are a group of viruses carried by rodents that can cause severe disease in humans. Infection typically occurs through contact with infected rodents or their urine, droppings, or saliva, while human-to-human transmission is rare.

Human Hantavirus infection is primarily acquired through contact with the urine, faeces, or saliva of infected rodents or by touching contaminated surfaces. Exposure typically occurs during activities such as cleaning buildings with rodent infestations, though it may also occur during routine activities in heavily infested areas. Human cases are most commonly reported in rural settings, such as forests, fields, and farms, where rodents are present, and opportunities for exposure are greater.

HPS is characterised by headache, dizziness, chills, fever, myalgia, and gastrointestinal problems, such as nausea, vomiting, diarrhoea, and abdominal pain, followed by sudden onset of respiratory distress and hypotension. Symptoms of HPS typically occur from 2-4 weeks after initial exposure to the virus. However, symptoms may appear as early as one week and as late as eight weeks following exposure.