A hantavirus outbreak aboard the cruise ship MV Hondius has reached 11 confirmed and suspected cases, with three deaths reported, health officials announced Tuesday. The latest case involves a Spanish passenger who was evacuated from the ship and is now in quarantine at a military hospital in Madrid.

The outbreak began with a Dutch couple who health officials believe were first exposed to the virus while visiting South America before boarding the cruise. The couple, who had taken a bird-watching tour that included a stop at a garbage dump where they may have encountered infected rodents, later died from the infection. Argentina's health ministry said it will dispatch scientific experts to investigate the landfill and other locations the couple visited.

Evacuation of all 87 passengers and 35 crew members from the MV Hondius was completed Monday night in Tenerife, Canary Islands. Personnel in full protective gear escorted passengers to shore in a carefully coordinated operation. Two aircraft carried Dutch, Australian, New Zealand, and Filipino nationals to the Netherlands, where they were placed in quarantine. The ship is now sailing back to the Netherlands for cleaning and disinfection.

Passengers described the experience as emotionally challenging. Jake Rosmarin, an American passenger, said the situation became "more scary when we found out that Cape Verde authorities weren't allowing us to dock." He and other passengers are now in quarantine at medical facilities, including a hospital in Nebraska.

World Health Organization Director-General Tedros Adhanom Ghebreyesus said there is currently "no sign that we are seeing the start of a larger outbreak," but warned that more cases could emerge given the virus's long incubation period of one to eight weeks. The WHO has advised returning passengers to remain in quarantine for 42 days. Health authorities report this is the first known hantavirus outbreak on a cruise ship. While hantavirus typically spreads through rodent droppings and is not easily transmitted between people, the Andes strain detected in this outbreak may spread between humans in rare cases.