The long wait to return home has just become a little longer for a group of Australians stranded on a cruise ship struck by a deadly hantavirus outbreak.
A French woman and an American tested positive for the virus on Monday as Australia and other nations scrambled to repatriate their citizens from the luxury liner anchored off Spain's Canary Islands.
The four Australian citizens, one permanent resident and a New Zealand national who were expected to fly out of Tenerife for Perth must now detour via the Netherlands.
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After leaving about 6.20pm on Monday, (3.20am Tuesday AEST), they're now expected to spend up to 48 hours transiting though the European nation under strict protocols before flying on.
Even that is just the beginning as after landing at RAAF Base Pearce near Perth later this week they'll immediately be transferred to the nearby Bullsbrook Centre for National Resilience.
Hantavirus will be listed under the Biosecurity Act before they arrive, and an order will be made for them to quarantine for three weeks.
Health Minister Mark Butler said while the virus was "very, very rare" with human-to-human transmission "rarer still", he's taking a "precautionary approach".
"As we move into that three-week period we will be seeking further advice," Butler said, adding that the incubation period for the virus is 42 days.
"I do make no apology for the fact this is one of the stronger approaches you'd see around the world."
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The WHO recommends a 42-day quarantine period. UK passengers will be asked to isolate for up to 45 days but public health specialists will assess whether they can do that at home or somewhere else.
The US has only said that the uninfected passengers will be taken to the National Quarantine Unit for assessment and monitoring.
Personnel in full-body protective gear and breathing masks escorted the travellers from ship to shore in Tenerife as planes arrived to fly out passengers from more than 20 countries in an evacuation effort continuing on Monday.
Three people have died since the outbreak began, and five people who left the ship earlier were infected.
One of 17 American passengers evacuated from the ship and flown to Nebraska also tested positive for the hantavirus but was not showing any symptoms, and another had mild symptoms, US health officials said late on Sunday (Monday AEST).
It was the first-ever case of a hantavirus outbreak on a cruise ship, according to Maria Van Kerkhove, WHO's director of epidemic and pandemic preparedness.
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Health officials say risk to public is low
Hantavirus usually spreads from rodent droppings and is not easily transmitted between people. But the Andes virus detected in the cruise ship outbreak may be able to spread between people in rare cases.
Symptoms — which can include fever, chills and muscle aches — usually show between one and eight weeks after exposure.
WHO Director-General Tedros Adhanom Ghebreyesus said on Sunday that the general public should not be worried about the outbreak.
"This is not another COVID. And the risk to the public is low. So they shouldn't be scared, and they shouldn't panic," he said.
Kerkhove said WHO was recommending passengers' home countries "have active monitoring and follow-up, which means daily health checks, either at home or in a specialised facility".
– Reported with Associated Press
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