A first group of passengers, all Spanish nationals and none displaying symptoms of infection, disembarked from the ship into small boats as the vessel approached the Port of Granadilla in Tenerife, Spain’s health ministry said.

Spanish officials said the passengers would be transported in sealed military buses directly to Tenerife’s airport before being flown aboard a government aircraft to Madrid for hospital evaluation and quarantine measures.

Authorities said all passengers would undergo testing by Spanish health officials before onward transport. Foreign nationals are expected to be repatriated in stages using specially arranged flights coordinated by their respective governments rather than commercial air services.

The European Centre for Disease Prevention and Control, or ECDC, classified all passengers and crew as high-risk contacts as a precautionary measure in rapid scientific guidance issued late Saturday. The agency said symptomatic passengers should receive priority medical evaluation and testing upon arrival and may either remain isolated in Tenerife or be medically evacuated home depending on their condition.

Thirty crew members are expected to remain aboard the vessel, which will later sail to the Netherlands for disinfection operations, according to Spanish authorities.The ship departed waters off Cape Verde earlier this week after the World Health Organization and the European Union requested Spain coordinate the evacuation effort following confirmation of the outbreak.

WHO Director-General Tedros Adhanom Ghebreyesus arrived in Tenerife on Saturday alongside senior Spanish ministers to oversee preparations for the ship’s arrival and passenger transfer operations.The WHO said eight people aboard the vessel had fallen ill, including three fatalities involving a Dutch couple and a German national.

Six infections have been laboratory confirmed, while two additional cases remain under investigation.Hantavirus is primarily transmitted through exposure to infected rodents, though health officials say limited person-to-person transmission can occur in rare circumstances.

The WHO has assessed the risk to the wider global population as low while describing the threat to passengers and crew aboard the vessel as moderate.Spanish authorities said evacuation operations were expected to continue throughout the day under strict biosecurity protocols at Tenerife’s Port of Granadilla.

A limited hantavirus outbreak linked to an international cruise ship has intensified scrutiny of the United States’ public health preparedness, as scientists and global health officials warn that staffing reductions, laboratory disruptions and political disputes over infectious disease research may undermine responses to future outbreaks.Health experts say the current outbreak remains controllable, with transmission still largely confined to close contacts of infected individuals.

However, the incident has exposed broader concerns about whether public health agencies retain sufficient testing capacity and operational flexibility to respond rapidly if a more dangerous pathogen emerges.According to officials at the World Health Organization, investigators are increasingly focused on evidence suggesting limited human-to-human transmission among individuals who had prolonged close contact with infected patients.

The outbreak has drawn comparisons to a similar hantavirus cluster in Argentina between late 2018 and early 2019, when 34 people tested positive and 11 died. WHO officials said current transmission patterns appear consistent with those earlier cases, including infections involving close family members and healthcare workers.

Maria Van Kerkhove said investigators believe transmission likely occurred between the first infected patients and several close contacts, including a physician who treated patients aboard the cruise ship where the outbreak was first identified.WHO infection prevention specialist Abdirahman Mahamud said aggressive contact tracing, quarantine measures and rapid isolation protocols remain central to containing the outbreak.

He said lessons learned during the Argentina outbreak demonstrated that transmission chains can be interrupted through coordinated public health action.Authorities are now attempting to track passengers from 12 countries, including the United States, who disembarked before the outbreak was identified and later returned home. Epidemiologists said tracing those individuals and anyone they may have contacted while symptomatic remains a critical component of containment efforts.

William Hanage said international coordination may prove more complicated than in previous outbreaks because the passengers dispersed across multiple jurisdictions governed by different public health authorities.Hanage said aggressive contact tracing and quarantine measures would likely be necessary to prevent wider transmission, though he noted that political resistance to such interventions following the Covid-19 pandemic could complicate implementation.

The outbreak is unfolding as US public health infrastructure faces mounting operational and political pressures. Scientists and health officials say laboratory staffing reductions and administrative pauses have already disrupted testing capacity for multiple infectious diseases.According to infectious disease specialist Rochelle Titanji, laboratories responsible for hantavirus testing have experienced staffing cuts, while some federal testing programs have been temporarily suspended.

States currently cannot send samples to the US Centers for Disease Control and Prevention for orthopoxvirus testing, including tests related to mpox, because that division has been paused temporarily, Titanji said. She also noted that federal laboratories can no longer conduct certain diagnostic testing used to determine the specific parasite responsible for leishmaniasis infections.

In April, rabies testing at the CDC was also halted temporarily, according to health officials familiar with the disruptions.At the same time, virology research in the United States has become increasingly politicised. The White House recently issued an executive order restricting certain forms of virus research, while the National Institutes of Health implemented broad funding reductions affecting related scientific work.

US lawmakers have also introduced legislation targeting what they describe as “gain of function” research, a term used in debates surrounding experiments that modify pathogens to study transmissibility or virulence.The debate has intensified amid continuing political disputes over the origins of Covid-19. Although many scientists maintain that available evidence strongly supports zoonotic spillover from animals to humans as the most likely origin of Sars-CoV-2, investigations into possible laboratory-related scenarios continue.

Researchers involved in virology and pandemic studies have increasingly faced subpoenas, investigations and public political scrutiny linked to those debates.Hanage said the current political environment risks weakening scientific preparedness for future outbreaks by discouraging research into zoonotic spillover events.“We should be investing in doing more to understand how these spillover events take place,” he said, adding that current policy trends were moving in the opposite direction.

Public health specialists also expressed concern over legal restrictions adopted in many US states following the Covid-19 pandemic. More than half of US states have enacted laws limiting the authority of public health officials to impose quarantines, recommend masks or enforce certain emergency health measures.Some states have also restricted vaccine requirements for schools and limited the authority of schools to suspend in-person operations during future outbreaks.

Titanji said the relatively limited hantavirus outbreak was already exposing potential weaknesses in outbreak coordination and public compliance. She warned that a more severe pathogen with higher transmission rates or mortality could create substantially greater risks.Despite the United States formally beginning withdrawal procedures from the WHO, the country remains connected to the International Health Regulations framework and continues receiving technical updates and outbreak information from the organisation.

Mahamud said collaboration between WHO officials and US institutions remained active and transparent during the current outbreak response.WHO director-general Tedros Adhanom Ghebreyesus said the outbreak illustrated the continuing importance of international coordination mechanisms during infectious disease emergencies.

He urged both the United States and Argentina to reconsider decisions to leave the WHO, warning that gaps in international cooperation create opportunities for viruses to spread more easily across borders.

The World Health Organization (WHO) says countries across the Eastern Mediterranean are steadily strengthening systems to detect and respond to respiratory diseases, even as conflict, displacement and political instability continue to strain public health infrastructure.

In a feature released on April 17, WHO described the Eastern Mediterranean Region (EMR) as one of the most complex operating environments for infectious disease preparedness. The region comprises 22 countries and more than 700 million people, with frequent outbreaks ranging from seasonal influenza to zoonotic infections and other respiratory illnesses with epidemic potential.

WHO data show that more than half of these countries are affected by prolonged crises, including armed conflict and humanitarian emergencies, resulting in large-scale population displacement that complicates surveillance and service delivery.The region’s geographic position along major migratory bird pathways and international travel corridors gives it added importance in global influenza monitoring.

Viruses detected in EMR countries are routinely shared with international networks, contributing to global risk assessments and informing seasonal vaccine composition through the WHO-led Global Influenza Surveillance and Response System.WHO attributes much of the region’s progress to the implementation of the Pandemic Influenza Preparedness Framework, adopted in 2011 to improve global readiness for influenza pandemics.

At the time of its introduction, surveillance coverage and laboratory capacity across the EMR varied significantly, and most countries lacked formal vaccination policies. Through the framework’s Partnership Contribution funding mechanism, 11 countries, including Afghanistan, Iran, Iraq and Egypt, received sustained financial and technical support to develop core capacities, while additional countries benefited indirectly.

By 2025, WHO reports that 18 of the 22 EMR countries were regularly submitting influenza data to regional and global platforms, including EMFLU-2, FluNet and FluID. These systems are supported by an expanding network of sentinel surveillance sites that provide epidemiological data.

At the same time, 18 countries had established functioning National Influenza Centres, with at least 14 routinely sharing virus samples with WHO collaborating centres under GISRS.Despite operational challenges linked to insecurity and resource limitations, WHO said laboratory and surveillance functions remained active across most of the region.

This continuity was tested during the COVID-19 pandemic, when countries adapted existing influenza systems to incorporate SARS-CoV-2 testing. WHO described this transition as a catalyst for broader integration, accelerating the shift from single-disease monitoring to multi-pathogen surveillance.

According to WHO, 21 EMR countries now operate integrated sentinel surveillance systems capable of tracking influenza, COVID-19, respiratory syncytial virus and other respiratory pathogens simultaneously.

These systems are designed to enable earlier detection of outbreaks and support more timely public health responses.WHO officials also highlighted efforts to strengthen workforce capacity through regional training programmes in epidemiology, laboratory diagnostics and outbreak investigation.

These initiatives have supported the adoption of genomic surveillance techniques, allowing for more detailed analysis of circulating viruses and improving risk assessment capabilities.The organisation said that lessons learned during the COVID-19 pandemic informed the development of a regional operational strategy focused on community protection under the PIP framework.

This strategy is aligned with broader global mechanisms, including the International Health Regulations (2005) and WHO’s Health Emergency Preparedness and Response framework. It is intended to guide the use of funding, support evidence-based policymaking and improve resilience at the community level.Countries that have invested in influenza preparedness infrastructure have also been able to apply these systems to other respiratory threats.

WHO cited responses to Middle East respiratory syndrome (MERS), avian influenza and emerging pathogens as examples of how established surveillance and laboratory networks can be leveraged beyond their original scope.Investment priorities have evolved over time, moving from the establishment of basic surveillance systems to improvements in quality, integration and advanced capabilities such as genomic sequencing.

WHO said regional technical teams have played a role in strengthening virus characterisation and ensuring that data generated in the EMR contribute effectively to global decision-making processes.The framework has also supported countries in generating national-level evidence on disease burden and vaccine effectiveness. WHO noted that Iraq has formally adopted a national influenza vaccination policy, while Tunisia, Lebanon and Jordan are in the process of developing similar frameworks.

These policy developments reflect varying national priorities, with some countries focusing on innovation and system integration and others concentrating on maintaining essential services in fragile settings.WHO emphasised that tailored approaches remain critical given the diversity of conditions across the region. Targeted support, adapted to individual country contexts, is seen as key to strengthening health systems and ensuring continuity of surveillance and response activities.

Looking ahead, WHO said continued alignment with global strategies, including the Global Influenza Strategy and ongoing discussions around a Pandemic Agreement, will be necessary to sustain progress.

The organisation highlighted the importance of long-term investment and regional collaboration in maintaining preparedness gains and mitigating the risk of cross-border disease transmission.