Canada, the Netherlands, the UK, Turkey, ⁠Ireland, and the United States will be the next countries to evacuate citizens from the MV Hondius, Spanish health officials said.

It comes after Spanish and French nationals were evacuated on charter flights earlier on Sunday.

Passengers have begun evacuating from a cruise ship hit by a hantavirus outbreak, as Britons on board prepare to be flown home to isolate at the UK’s initial Covid quarantine site.

The MV Hondius arrived in Tenerife on Sunday morning, with Spanish authorities beginning evacuations of the ship by nationality.

The UK Health Security Agency (UKHSA) said 22 British passengers and crew will be transferred to an isolation facility at Arrowe Park Hospital on the Wirral, Merseyside, after being repatriated to the UK on a chartered flight.

Spanish authorities said on Sunday that no passengers on the ship were showing symptoms of the virus, with 14 Spanish nationals who formed the first group to be evacuated from the vessel being flown to a hospital in Madrid.

French passengers will leave the ship next, followed by nationals from Canada, the Netherlands, the UK, Türkiye, Ireland and the US.

Cruises are sold as floating holidays, but they are also useful for understanding public health. Cruise ships are carefully designed places where many people live, eat, relax and move through the same shared spaces for days at a time. They show how easily illness can spread when people are packed into a single interconnected environment.

Think of a cruise ship as a temporary city at sea. It has restaurants, theatres, lifts, cabins, kitchens, water systems and indoor gathering spaces. That is great for convenience, but it also means that once an infection gets on board, it can move through the ship in ways that are hard to stop.

The Diamond Princess outbreak is perhaps the best-known example. During the 2020 COVID outbreak, 619 passengers and crew tested positive for the disease. Researchers found that the ship conditions made the novel coronavirus spread more easily. Their modelling suggested that public health measures, such as isolation and quarantine, prevented many more cases, but it also showed that an earlier response would have further limited the outbreak.

Norovirus (the so-called vomiting bug) is the infection most closely linked to cruise ships. In a review of previously published studies, researchers found 127 reports of norovirus outbreaks on cruise ships, with many linked to contaminated food, contaminated surfaces and person-to-person spread. A more recent report from the US also showed that norovirus can spread very rapidly from person to person on a cruise ship.

This helps explain why ships such as Celebrity Mercury, Explorer of the Seas and Carnival Triumph have become familiar names in outbreak reports. These were not unusual in some special way; they were simply settings where shared dining, close contact and frequent movement through common areas allowed infection to spread fast.

In interviews with The Associated Press, two Spanish passengers — speaking on condition of anonymity because of fears they’ll be ostracised once on land — said that despite the outbreak, their days aboard have passed with relative tranquility.

Some people are bird-watching, and others are gathering in common areas to read or attend talks, while wearing masks and social distancing. Both passengers told AP they’re worried about how they’ll be treated in Spain and once home.

“We’re scared by all the news that’s coming out, by how people are going to receive us, by how people see us,” one said. “We’re just normal people. We’ve heard that this is a millionaires’ cruise, and it’s the complete opposite of reality. And we’re scared by this.”

All Spanish evacuees on board a flight to Madrid are asymptomatic, the country’s health ministry has confirmed.

In a post on X, health minister Monica Garcia wrote: “The 14 Spaniards board the plane bound for Gómez Ulla. They have been evacuated in small groups, in UME bubble buses, with disinfection processes and personal protective equipment in every phase of the transfer.

“External Health confirms that all of them are asymptomatic.”

The wider public health threat from the outbreak remained low, director-general Tedros Adhanom Ghebreyesus insisted, adding that the WHO was aware of reports of other patients, with more possible due to the incubation period for the virus.

It comes as passengers disembark the virus-stricken ship to return to their home countries, where many will be asked to isolate.

You can read more about each affected country below: