Some human-to-human transmission may have occurred on board the cruise ship hit by a hantavirus outbreak that has left three people dead and several others ill, the World Health Organization (WHO) said Tuesday.

“We do know that some of the cases had very close contact with each other and certainly human-to-human transmission can’t be ruled out so as a precaution this is what we are assuming,” Dr. Maria Van Kerhove, WHO’s Director for Epidemic and Pandemic Preparedness and Prevention, told reporters.

What is hantavirus and how does it spread?

Almost 150 people, including 17 Americans, remain stranded on the MV Hondius that is currently off the coast of West Africa.

The ship, operated by tour company Oceanwide Expeditions, left Ushuaia, Argentina last month on a voyage across the Atlantic Ocean, stopping off at some of the world’s most remote islands. But along the way, several passengers fell sick with a rapidly progressing respiratory illness, the company said.

Seven cases of hantavirus, a rare disease typically caused by contact with infected rodents’ urine, faeces or saliva, have been identified so far. Two of those are confirmed and five suspected, WHO said Monday.

Three people – a Dutch couple and German national – have died while one British national remains in intensive care in South Africa, though Van Kerkhove said his condition is improving.

Two other people suffering from hantavirus symptoms remain on board the ship, though their medical evacuation is currently underway, Van Kerkhove said.

“The risk to the general public is low,” Van Kerkhove emphasized. “This is not a virus that spreads like flu or like COVID. It’s quite different.”

This is a developing story and will be updated.