An American and a French national who have returned to their home countries having left a cruise ship hit by a deadly outbreak of hantavirus have tested positive, authorities say.

The US health department said a second American national on the repatriation flight had also shown mild symptoms, adding that both passengers had travelled back in "biocontainment units out of an abundance of caution".

French Health Minister Stéphanie Rist said a woman was isolating in Paris and her health was deteriorating, with 22 contact cases traced.

More than 90 passengers of the MV Hondius ship, currently docked in Spain's Canary Islands, are being repatriated.

Three passengers - a Dutch couple and a German woman - have died after travelling on the vessel. Two of them are confirmed to have had the virus.

Hantaviruses are usually carried by rodents, but human transmission of the Andes strain - which the World Health Organization (WHO) believes was contracted by some of the Dutch ship's passengers while in South America - is possible.

Symptoms can include fever, extreme fatigue, muscle aches, stomach pain, vomiting, diarrhoea and shortness of breath.

Officials say the risk of a major outbreak is very low.

In its statement early on Monday, the US Department of Health and Human Services said all 17 US citizens on the flight will "will undergo clinical assessment" at a medical facility in Nebraska.

Seven other US passengers had already returned and are being monitored in their home states.

A British national who resides in the US was evacuated along with the 17 American passengers.

Before the American case was confirmed, WHO head Tedros Adhanom Ghebreyesus warned that the decision by the US not to follow his organisation's guidelines over the hantavirus outbreak "may have risks".

The WHO has recommended 42 days of isolation for those leaving the MV Hondius.

But Dr Jay Bhattacharya, the acting head of the US Centers for Disease Control (CDC) said he did not want to cause public panic, insisting that human-to-human transmission was rare and it should not be treated like the Covid virus.

Cruise ship passengers were pictured wearing blue gowns, bouffant caps, and medical face masks as they disembarked on Sunday at the port of Grandilla de Abona in Tenerife.

There were five French nationals sailing on board the vessel.

On Sunday, a plane carrying 20 British nationals arrived in the UK.

The passengers flew into Manchester Airport on a chartered flight from Tenerife and were taken to Arrowe Park Hospital in Wirral, Merseyside, to isolate for 72 hours. None of them have reported symptoms.

Two other British nationals with confirmed cases are now being treated in the Netherlands and South Africa.

Ukraine said four of its citizens would remain on board the MV Hondius as part of the crew to ensure the ship's transfer to the Netherlands. Upon arrival, the foreign ministry said, they would be expected to quarantine at a medical facility.

Another Ukrainian national was expected to leave the ship as part of the partial crew evacuation on a flight to the Netherlands.

At present, no signs of illness have been recorded among the Ukrainians, the ministry added.

An elderly Dutch man was the first passenger who died on board the MV Hondius on 11 April. He had earlier developed symptoms - but is considered a probable case as no tests have been carried out.

His wife - a 69-year-old woman - left the ship on the island of St Helena on 24 April and flew to South Africa. She died two days later in a clinic in Johannesburg.

A German woman died on board the cruise ship on 2 May.

The two women are both confirmed cases.