Department spokesperson Foster Mohale said the four individuals in the province were identified through contact tracing after possible exposure linked to the ship.
“Four linked contacts were identified as possibly exposed and are being monitored as a precautionary measure,” Mohale said.
News24 reports that one of the individuals is exhibiting symptoms, including a fever and a sore throat.
The Minister of Health, Dr Aaron Motsoaledi, said that of the 62 people who may have come in contact with the virus, 42 have already been traced.
South African airline Airlink issued a customer notice that passengers on its flight 4Z132 from St Helena to Johannesburg on 25 April 2026 are being traced.
Contact tracing is continuing around the world as cruise ship passengers return home.
Three people — a Dutch couple and a German national — died in the outbreak on the MV Hondius.
Reuters reports that, in total, five people are confirmed to have contracted the virus, with another three suspected cases, the World Health Organisation (WHO) said.
Hantavirus is usually spread by rodents, but can, in rare cases, be transmitted from person to person.
All passengers who disembarked in St Helena in the South Atlantic Ocean, where the ship made a stop on 24 April, have been contacted, the ship's operator said.
This included people from at least 12 countries, among them seven British citizens and six from the US. The first confirmed case of hantavirus in this outbreak came in early May.
The WHO repeated that the risk to the general public was low, even if the Andean strain of the virus, found in several victims, can, in rare cases, be transmitted among humans.
"This is not coronavirus, this is a very different virus," Maria Van Kerkhove, WHO director of epidemic and pandemic management, told a press conference.
"This is not the same situation we were in six years ago."
The WHO said it was working on step-by-step guidance for when the dozens of passengers remaining on the ship, which is sailing to the Canary Islands, arrive there on Saturday or Sunday, disembark and travel home. None of these passengers currently has any symptoms.
The United States' Centres for Disease Control and Prevention said it was closely monitoring the situation, adding that the risk to the American public was extremely low at the time. The US CDC has classified the outbreak as a "level 3" emergency response, ABC News reported.
President Donald Trump told reporters on Thursday he had been briefed on the hantavirus and expressed hope that it was under control.
"It's very much, we hope, under control," Trump said.
Asked whether Americans should be concerned about any spread of the virus, Trump replied: "I hope not." He also said, without elaborating, that a report on the virus was expected on Friday.
The Georgia Department of Public Health said it was monitoring two asymptomatic residents who had returned home after disembarking from the cruise ship.
The Arizona Department of Health Services said it was monitoring one resident, who was also on the ship, and was not symptomatic. According to the New York Times, California was monitoring several residents who had been on the ship.
Officials in Texas said that two residents who were passengers on the ship had returned to the US before the outbreak was identified.
One French citizen has been in contact with a person who had fallen ill but was not showing symptoms, officials said.
Singapore has isolated and is testing two residents who were onboard, the Communicable Diseases Agency (CDA) said.
The ship's operator, Oceanwide Expeditions, said it was working to establish details of all passengers and crew who embarked and disembarked on various stops since March 20.
The Dutch couple who died, and who are believed to be the first hantavirus cases of this outbreak, boarded on 1 April.
Dutch airline KLM said it had taken the Dutch woman off a plane in Johannesburg on 25 April due to her deteriorating medical condition. She died before she could reach the Netherlands.
According to broadcaster RTL, a KLM stewardess who had been in contact with her has been admitted to a hospital in Amsterdam after showing possible hantavirus symptoms.
Crew and passengers who helped the Dutch woman are being called daily for health checks, Dutch authorities told public broadcaster NOS.
Three patients were evacuated from the ship on Wednesday. Two have been admitted to a hospital in the Netherlands, while another was transferred to Germany for medical care.
Martin Anstee, an expedition guide, was one of the two evacuees in hospital in the Netherlands, according to Sky News, and told them he was "doing OK" but "there are still lots of tests to be done".
The Düsseldorf University Clinic, treating the German evacuee, said she was not a confirmed case but rather a contact and was undergoing tests.
In Switzerland, a man who travelled on the cruise ship and was admitted to a hospital tested positive for the infection, officials said.
A Danish citizen who was aboard the Hondius has returned home and has been advised to self-isolate as a precaution, Danish health authorities said.
In Canada, officials said that two Canadians on the cruise returned home before the outbreak was identified, and another Canadian was on the same flight as a symptomatic person. All three are currently asymptomatic.
Reuters, the news and media division of Thomson Reuters, is the world's largest multimedia news provider, reaching billions of people worldwide every day.
Go to: https://www.reuters.com/
