Dozens of passengers and crew from countries around the world have been evacuated from a cruise ship at the centre of a deadly hantavirus outbreak.
British people were among those taken off the ship as part of a two-day operation which began on Sunday in Tenerife. They were put on chartered flights back to the UK, where they will enter hospital quarantine in Merseyside.
Spanish passengers wearing blue plastic ponchos and hair coverings had already been taken off the vessel by medical teams in hazmat suits after being screened for the infection. They were then taken by coach to Tenerife airport.
The ship arrived in the Canary Islands in the early hours of Sunday carrying 146 people, after three people died of the virus and eight more became ill.
No one else onboard the vessel had symptoms, but passengers and crew had been confined to their cabins in the last few days to help halt the spread of the virus, which is transmitted only through very close contact.
They were each being screened for hantavirus, which can cause flu-like symptoms leading to respiratory arrest and death in some cases.
The 19 passengers and three crew from the UK were to be flown into quarantine at Arrowe Park hospital in Wirral.
Separate flights have been arranged for those from elsewhere to repatriate passengers and crew to their home countries.
The Spanish government and the World Health Organization (WHO) have said they will not come into contact with people in Tenerife.
Fourteen Spanish citizens touched down at Madrid airport on Sunday evening, the government confirmed.
Flights carrying passengers from the UK, the Netherlands, Germany, Belgium, Greece, Canada, Turkey, France, Ireland and the US followed.
Authorities said a Dutch refuelling plane would pick up any passengers who had not yet been evacuated on Monday.
The last scheduled flight would be to Australia with six people, departing on Monday afternoon.
The government of the Philippines, the country with the most people on board, confirmed that of the 38 Filipino crew, 24 were stewards and hotel staff. The latter were being transferred to the Netherlands on two flights from Tenerife and will begin their quarantine in the Netherlands.
A spokesperson said the remaining 14 staff were deck and engine operatives, part of the essential crew remaining on board to bring the ship to port in Rotterdam.
Those who have been evacuated were being asked to isolate for 42 days from their point of potential exposure, which for most of the passengers would be many days ago.
The MV Hondius is anchored slightly offshore of the southern commercial port of Granadilla. Passengers have been taken to the dock in groups of five to 10 by a small boat only when planes were on the asphalt ready to receive them, the president of the Canary Islands, Fernando Clavijo, said.
Flights to some countries were yet to be arranged as authorities scrambled to get planes in place on Sunday.
Winds off the coast of the island were expected to pick up from Monday, meaning any people whose flights had not been arranged may be stuck onboard.
Authorities have sought to make clear that the virus, though serious, would not result in another pandemic.
However, the director general of the WHO, Dr Tedros Adhanom Ghebreyesus, was asked at a press conference in Tenerife late on Saturday night whether allowing passengers to travel all over the world and relying on them to self-isolate with no oversight could cause further outbreaks.
“Based on our assessment, what you have said is not going to happen,” he said.
Some crew will stay onboard, going on to pick up supplies at Santa Cruz port in the north of Tenerife and then returning the ship to the Netherlands, where it is from.
At the port Javier Padilla Bernáldez, Spain’s health secretary, said PCR diagnostic testing was not being carried out on the ship and instead those onboard were having their temperatures taken and had filled out a health survey designed to identify hantavirus symptoms.
He said the UK and US had asked for further testing onboard the MV Hondius, which had been refused, but the countries had been told they could test passengers on the plane as soon as it left the airport.
Countries are carrying out their own health checks, which for some, such as the UK and Spain, involve PCR testing. He said the European Commission and the European Centre for Disease Prevention and Control were “trying to achieve a certain degree of coordination, and not a high variation among the different countries”.
“But every country has its own confidences,” he said.
The polar cruise ship arrived at the Canary Islands after spending days stranded off the coast of Praia, the capital of Cape Verde. Local authorities would not allow the ship to dock amid fears of a wider outbreak overwhelming the healthcare system of the small island nation.
Fears of a new pandemic were unfounded, the WHO said, because hantaviruses did not spread as quickly as Covid-19 and treatment was highly effective if the virus was caught quickly enough.
However, a broad incubation period, lasting between a few days and eight weeks, means infected people might have the opportunity to pass on the virus before any symptoms become apparent.
For this reason, the WHO is putting together an international coordinated response, particularly in tracing those who left the vessel since the onset of the outbreak more than a month ago.
Several countries have come together to solve the logistical challenge of tracing people who have been in close and prolonged contact with 29 people who disembarked on 24 April in the remote southern Atlantic island of St Helena.
Two British people are self-isolating in the UK because they could have been exposed to the virus before getting off about a month ago. Neither has symptoms.
A specialist army team and medical personnel have been parachuted on to the British overseas territory of Tristan da Cunha with medical aid and equipment, the Ministry of Defence has said, after a British national disembarked on to the island, where they live, with a suspected case of hantavirus.