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The World Health Organization (WHO) said on Friday that eight people have fallen ill in a hantavirus outbreak linked to a cruise ship, including three deaths.

Of these cases, six have been confirmed through PCR testing as infections caused by the Andes virus, a type of hantavirus, while two remain probable cases.

The outbreak was first reported on May 2 when the ship had 147 passengers and crew on board, while 34 others had already disembarked earlier.

Four patients are currently receiving treatment in hospitals in South Africa, the Netherlands, and Switzerland, while one suspected case transferred to Germany tested negative.

The Centers for Disease Control and Prevention (CDC) said it is closely monitoring the situation involving U.S. citizens on board the vessel and is preparing to evacuate American passengers on a government medical repatriation flight to Omaha, Nebraska.

According to cruise operator Oceanwide Expeditions, there are 17 U.S. citizens among those on board the ship.

The vessel departed Cabo Verde on May 6 and is en route to Spain’s Canary Islands, where passengers are expected to disembark.

The WHO assessed that the risk to the global population remains low, but the risk to passengers and crew on the ship is considered moderate. It also suggested that the first case may have been infected before boarding, possibly during travel in Argentina or Chile, with further transmission likely occurring onboard.

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