A French woman infected in the deadly hantavirus outbreak on a cruise ship is critically ill and being treated with an artificial lung, a doctor at the Paris hospital caring for the sickened passenger said Tuesday. The outbreak has now reached 11 total reported cases, nine of which have been confirmed.

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Dr. Xavier Lescure, an infectious disease specialist at Bichat Hospital, said the woman is on a life-support device that pumps blood through an artificial lung, providing oxygen and returning it to the body. He called it “the final stage of supportive care.”

The MV Hondius is now sailing back to the Netherlands for cleaning and disinfection after all passengers and many crew members were evacuated. Three people on the cruise died, including a Dutch couple health officials believe were first exposed to the virus while visiting South America.

World Health Organization Director General Tedros Adhanom Ghebreyesus said there is no sign of a larger outbreak, but more cases may appear due to the virus's long incubation period. He advised returning passengers to quarantine for 42 days.

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A Spanish passenger tested positive and is in quarantine at a military hospital in Madrid. Argentina’s health ministry will send experts to investigate the outbreak's origin, focusing on a garbage dump where the Dutch couple may have been exposed to infected rodents.

Hantavirus usually spreads from rodent droppings and is not easily transmitted between people. However, the Andes virus detected in this outbreak may spread between people in rare cases. Symptoms include fever, chills, and muscle aches, appearing one to eight weeks after exposure.

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Twelve employees at a Dutch hospital are in preventive quarantine after improperly handling bodily fluids from an infected passenger. The hospital said the risk of infection is low.