The World Health Organization is trying to coordinate a response to a worsening situation aboard a Dutch cruise ship. 

Three people died and at least four other people are infected due to a hantavirus outbreak on the MV Hondius. The vessel, anchored off Cabo Verde since May 4, was denied permission by authorities there to dock, citing the need to protect its population. Authorities say there will be no contact between passengers and the country.

The Dutch government has agreed to lead the repatriation of two seriously ill crew members and one deceased passenger to the Netherlands, as containment efforts continue.

Meanwhile, Cape Verdean officials are awaiting approval from the Netherlands and the UK for an air ambulance requested for some passengers.

The outbreak was reported to the WHO following a cluster of severe respiratory illnesses among the 147 passengers and crew on board.

Most passengers remain on board under strict precautionary measures, including isolation and continuous medical monitoring, according to the ship's operator, Oceanwide Expeditions.

"At the present time, there are no additional symptomatic cases, but the situation is being closely monitored," according to WHO epidemiologist, Maria Van Kerkhove. 

Oceanwide disclosed the issue likely began unfolding on April 11 following the death of one passenger. 

Hantavirus is marked by fever, gastrointestinal symptoms, and rapid progression to pneumonia and acute respiratory distress.

As investigations continue, response measures include case isolation, medical care, evacuation of critically ill patients, and laboratory testing are in force.

Hantavirus is typically transmitted through contact with infected rodent urine, feces, or saliva. While human-to-human transmission is rare, it has been documented in outbreaks involving the Andes virus hantavirus strain, according to the WHO, which currently assesses the global risk as low.

(Story compiled with input from wire reports)