A Spanish passenger evacuated from the cruise ship at the centre of a hantavirus outbreak has tested positive for the virus, Spain’s Ministry of Health has announced, with the World Health Organization (WHO) confirming 11 cases, including three people from the cruise who have died.

The man who was confirmed infected on Tuesday is one of more than 120 passengers and crew members evacuated from the Dutch-flagged MV Hondius, whose fate has caused international alarm after the passengers’ deaths.

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A military hospital in Madrid is quarantining 14 Spaniards who were removed from the ship on Sunday, with all but one testing negative for the hantavirus.

“The patient who provisionally tested positive for hantavirus yesterday has been confirmed as positive,” the Health Ministry said. “Yesterday the patient had a slight fever and minor respiratory symptoms, although at present he is stable and without any evident clinical deterioration.”

The WHO said nine of the 11 confirmed cases involved the rare Andes variant of the virus, which usually spreads among rodents but is transmissible between humans and has no vaccine or treatment.

After evacuating its 87 passengers and 35 crew members, the cruise is now sailing back to the Netherlands, where it is expected to be thoroughly cleaned and disinfected.

“These numbers have changed little over the past week thanks to the governments of multiple countries and partners,” said Tedros Adhanom Ghebreyesus, the WHO director-general.

“At the moment, there is no sign that we are seeing the start of a larger outbreak,” he said. “But of course the situation could change, and given the long incubation period of the virus, it’s possible we might see more cases in the coming weeks.”

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Meanwhile, a Dutch hospital quarantined 12 of its staff members for six weeks as a preventive ⁠measure after blood and urine samples of a ⁠hantavirus patient from the cruise were improperly handled.

In a Paris hospital, a French woman evacuated from the ship remained in intensive care in a stable condition. The French government was holding two hantavirus-related emergency meetings on Tuesday, Prime Minister Sebastien Lecornu said.

The WHO has advised returning passengers to stay in quarantine, either in their homes or in hospitals, for 42 days, saying countries may handle the monitoring of their nationals returning from the ship without symptoms in different ways.

Health authorities say this is the first hantavirus outbreak on a cruise ship. While there is no cure or vaccine, the WHO says early detection and treatment improve chances of survival.