Twenty Britons are beginning 45 days of self-isolation in the UK after being evacuated from a cruise ship hit by hantavirus.
They are isolating at Arrowe Park Hospital in Merseyside, after their chartered flight from Tenerife landed at Manchester Airport on Sunday. They will stay there for 72 hours, before being asked to self-isolate for a further 42 days at home.
Professor Robin May, chief scientific officer at the UK Health Security Agency (UKHSA) told the BBC that all of the evacuees are "healthy and asymptomatic".
Three people have died following the outbreak on the MV Hondius, including two whom the World Health Organization has confirmed had hantavirus.
Two British nationals, who are being treated in the Netherlands and South Africa, also have confirmed cases.
A British-US dual national is currently in quarantine in Nebraska, according to Matthew Ferreira of the US Health and Human Services department.
Meanwhile, an American and French national who returned to their home countries after leaving the ship have also tested positive for the virus, according to local authorities.
A Spanish national who was on board the ship also provisionally tested positive for Hantavirus, Spanish Health Minister Mónica García announced, with the result due to be confirmed late on Monday.
On Monday evening the final six passengers who had been still onboard disembarked from the ship, alongside some members of the crew.
The vessel then left Tenerife for the Netherlands where the last 26 crew will leave and the boat will be disinfected.
Most strains of hantavirus, a group of viruses carried by rodents, do not pass from person to person, but the Andes strain identified in a number of people who had been on the Dutch cruise ship does.
Twenty-two British nationals had been still aboard the ship when it docked in the Canary Islands on Sunday. Two were dual nationals, with one heading to the US and one to Australia.
Some could be seen clad in blue protective gear as they were bussed from the Granadilla de Abona port to Tenerife South Airport.
They were tested for hantavirus before getting on the flight.
"The UK Government has worked with international partners to ensure the safe return of all remaining British nationals on board the MV Hondius, with passengers now safely transferred to Arrowe Park Hospital," the UKHSA said in a statement.
Twenty British nationals along with one German national, who is a UK resident, and one Japanese passenger, are now being monitored at the hospital.
After their time in hospital, May said they will likely spend the rest of their isolation period in their homes, adding that decision would be made on a "case-by-case basis".
Speaking to BBC Breakfast on Monday morning, he said "we may need to update" the period of isolation "depending on what the science tells us".
May said throughout that period, they will continue to support the passengers "very closely".
"Not just with testing, but also for the very large emotional turmoil this will obviously have – it's going to be a very stressful period for them and their families," he said.
The support will include clothes and supplies, he said, as many had to leave behind all but essential belongings when they were evacuated.
May also reiterated that the risk to those not directly linked to the cruise is "extremely low indeed", and that the process of testing and contact tracing is still ongoing.
Janelle Holmes, CEO of Wirral University Teaching Hospital Trust, which oversees Arrowe Park Hospital, said the former passengers will be screened and continuously assessed when they arrive there.
They will be housed in self-contained flats with access to phones so they can call friends and relatives.
A specialist team will be on site throughout their quarantine to support them.
"What we've learnt from past experience is they're going to be absolutely shattered. They've probably felt quite traumatised by the whole experience so the thing for us to do is to make sure that they're here, they're safe, they're welcome," Holmes said.
She added that if passengers develop symptoms, they will be taken to Royal Liverpool University Hospital, which houses the regional Tropical and Infectious Diseases Unit.
They will not be allowed to take public transport when they leave Arrowe Park for a period of self-isolation at home.
A joint statement from emergency services in the North West and Wirral Council said the hospital is "operating completely normally" and "visitors and staff should continue to come to the hospital with complete confidence".
"This is a planned, controlled and carefully managed arrangement. Hantavirus is not spread through everyday social contact and there is no reason for local residents to be concerned," it said.
On Sunday, Foreign Secretary Yvette Cooper thanked those "who worked around the clock to get passengers from MV Hondius back to the UK by special flight this evening with public health protections in place".
As well as the confirmed cases, there are also two suspected cases, including a British man who is on the remote Atlantic island of Tristan da Cunha. He is currently in a stable condition and in isolation.
A team of six British Army paratroopers and two medical clinicians have parachuted onto the island to help its two-person medical team provide care to the man and the island's other residents.
It is the first time the UK military has parachuted in medical personnel to provide humanitarian support, according to the MoD.
Meanwhile two Britons are voluntarily self-isolating at home in the UK, having disembarked the vessel at St Helena on 24 April alongside dozens of other passengers before the first case of hantavirus was confirmed.
MV Hondius began its journey on 1 April in Ushuaia, Argentina, with about 150 passengers and crew from 28 countries reported to have initially been aboard.
Many of those still aboard the ship disembarked on Sunday for repatriation to their home countries.
In a video statement released by operator Oceanwide Expeditions on Monday, the captain said the past few weeks have been "extremely challenging", and praised the patience, discipline and kindness shown on board the vessel.
Jan Dobrogowski said the crew's thoughts were "with the ones that are now longer with us".
With additional reporting by Dominic Hughes
