Spain discharges first hantavirus patient as updated protocol allows release with positive blood PCR
A 70-year-old man, the first passenger from the MV Hondius to test positive for hantavirus, has been discharged from a Madrid hospital after meeting new clinical criteria, while a second confirmed case has developed a mild fever.
The first Spanish passenger to contract hantavirus during the outbreak aboard the MV Hondius cruise ship has been discharged from Madrid's Hospital Gómez Ulla and returned home, the Ministry of Health confirmed on Thursday. The 70-year-old man had been isolated in the hospital's High-Level Isolation and Treatment Unit (UATAN) since 11 May, a day after the vessel docked at the port of La Granadilla in Tenerife.
Discharge criteria updated
His release follows an updated protocol approved on Thursday by the Public Health Commission. Under the new rules, confirmed cases can be discharged once they have been symptom-free for at least three days and have returned two negative PCR tests from urine and oropharyngeal swab samples, taken at least 48 hours apart. The protocol explicitly acknowledges that a blood PCR may remain positive after clinical recovery.
The most recent studies on the Andes strain of hantavirus show that detection of viral RNA in blood can persist for a prolonged period after clinical recovery. For this reason, discharge criteria are not based exclusively on a negative blood PCR, but on the absence of symptoms and negative results from biological samples more directly related to possible virus shedding, such as urine and oropharyngeal exudate.
Six-month follow-up
Because viral genetic material can linger in the blood without posing a demonstrated transmission risk, discharged patients who still test positive via blood PCR will undergo clinical monitoring for six months. Monthly blood samples will be taken until the test turns negative. The protocol also recommends that recovered patients avoid unprotected sex for at least four months after symptom onset, given the virus's ability to persist in semen for extended periods.
Second case develops symptoms
The second confirmed case, who entered the UATAN asymptomatic on 25 May, has developed a low-grade fever (febrícula) in recent hours. He will be subject to the same discharge criteria once his condition improves. The other 12 passengers from the MV Hondius, considered close contacts, remain asymptomatic and in individual rooms at the Gómez Ulla hospital.
Quarantine timeline for contacts
Those 12 contacts are expected to complete their hospital quarantine around 6 or 7 June if they remain negative, at which point they can continue isolation at home. The maximum quarantine period is 42 days, ending on 21 June. At the 28-day mark, if they are still asymptomatic, they may finish the quarantine at home. A final sample will be taken at the end of the period and analysed by the National Centre for Microbiology; only a negative result will allow them to resume normal activity.
- MV Hondius docks at La Granadilla port, Tenerife; passengers disembark.
- First passenger (70-year-old man) tests positive and enters UATAN at Hospital Gómez Ulla.
- Second passenger tests positive and enters UATAN, initially asymptomatic.
- Public Health Commission approves updated discharge protocol. First patient discharged. Second patient develops low-grade fever.
- Expected date for 12 asymptomatic contacts to transition from hospital to home quarantine.
- Maximum 42-day quarantine period ends for all contacts.
Two women in Barcelona and Alicante who shared a flight with one of the deceased passengers from the outbreak are also completing the 42-day quarantine under the same conditions.
