Relatives of Britons on board a cruise ship anchored off the coast of Panama have expressed their fears after the cruise line confirmed four passengers had died on board.

Holland America Line said in a post on its Facebook page that more than 130 people aboard the Zaandam had reported flu-like symptoms, and two people have tested positive for coronavirus.

The statement said: “Holland America Line can confirm that four older guests have passed away on Zaandam.

“Our thoughts and prayers are with their families and we are doing everything we can to support them during this difficult time.”

The Zaandam cruise ship arrives at the bay of Panama City
The Zaandam cruise ship arrives at the bay of Panama City (Arnulfo Franco/AP)

It did not identify the cause of death.

The ship, which had been turned away from other ports and is now being denied passage through the Panama Canal, was receiving medical supplies and medical personnel from another Holland America ship, the Rotterdam, and the company planned to begin transferring healthy passengers to that ship.

“Priority for the first guests to transfer will be given to those on Zaandam with inside staterooms and who are over 70,” the statement said.

There are 1,243 guests and 586 crew on board the Zaandam.

Late Friday, the Panama Maritime Authority said in a statement that 401 passengers not showing symptoms of the virus would be transferred to the Rotterdam.

It said medical supplies were being delivered to the Zaandam until midnight and then the shipments would resume on Saturday.

The Zaandam cruise ship is anchored shortly after it arrived at the bay of Panama City
The Zaandam cruise ship is anchored shortly after arriving at the bay of Panama City (Arnulfo Franco/AP)

The Panama Maritime Authority “deeply regrets these deaths, as well as the complex situation the passengers and crew of the Zaandam cruiser go through”, the statement said.

The authority’s administrator, Noriel Arauz, said earlier in the day that no-one on either ship would be allowed ashore in Panama, which the Health Ministry said had 786 coronavirus cases, with 14 deaths, as of Friday.

The Zaandam departed Buenos Aires, Argentina, on March 7.

The ship was trying to get to Fort Lauderdale, Florida, after being denied permission to dock at its original destination of San Antonio, Chile, a week ago.

The cruise line said no-one had been off the ship since March 14 in Punta Arenas, Chile.

On March 22, when a number of passengers began reporting flu-like symptoms, the ship instituted protective measures, including telling everyone to self-isolate in their cabins, the cruise line said.

On Thursday, all passengers and crew received masks and instructions on how to use them.

Panamanian navy police navigate near the anchored Zaandam cruise ship
Panamanian navy police navigate near the anchored Zaandam cruise ship (Arnulfo Franco/AP)

Neil Bedford said his parents, Kim and Chris Bedford, from Bradford, England, left on March 4 for a flight to Argentina and boarded the ship three days later.

“They were enjoying their time,” he told the Associated Press in a Twitter message.

But on March 15, it was announced that the cruise was over and they were turned away from several countries.

Mr Bedford said: “The meals are delivered to their rooms three times during the day. I’m not sure if they are left outside for them to collect or if someone brings them into the room. The captain is making announcements once a day but everyone seems to be getting frustrated as it’s constantly bad news.”

His parents are both in their sixties.

“They are just growing increasingly concerned with what will happen to them,” he wrote.

“There is a new ship alongside them, the Rotterdam, which the healthy will be evacuated to, but they will need testing first before that can happen. They are becoming terrified of being stuck onboard the ship.”

Hayley Pillai Johnson, a medical student at Cambridge University, also posted on Twitter, asking questions about her grandfather and his wife.

“We just want them home,” she wrote in a message.

Her grandfather, Sethy Pillai, is a 90-year-old retired doctor.

His wife, Hazel Pillai, is 75 and has diabetes.

They are from Oxfordshire and Ms Pillai Johnson spoke to them on Friday via WhatsApp as they were quarantined in their room.

“They are scared now they have heard of the four deaths and never thought this would happen,” she wrote.

“My grandma has a non-dry cough but no temperature, so has been counted in the ‘symptom category’. My grandpa feels tired and scared but is fine.

“Holland America needs to get all guests off this cruise, test them and go from there. We are worried sick about them, especially as the route through Panama Canal has not yet been confirmed and neither has the docking at Port Everglades.”

The Zaandam had planned to pass through the Panama Canal en route to Florida, but after being inspected by Panamanian authorities, the request to use the canal was denied, said canal administrator Ricauter Vasquez.

The Health Ministry “did not give permission”, Vasquez told reporters on Friday.

“The ship is in territorial waters but has to remain isolated.”

The Zaandam cruise ship, left
The Zaandam cruise ship, left (Arnulfo Franco/AP)

It was not immediately clear where either ship would go.

The Rotterdam had not requested permission to pass through the Panama Canal.

There are four doctors and four nurses on the Zaandam, according to the cruise line statement, while the Rotterdam had two doctors and four nurses aboard.

Holland America Line had announced on March 17 that it was voluntarily suspending its cruise operations for 30 days “due to the continued port closures and travel restrictions surrounding Covid-19 and in an abundance of caution”.

At that point, the company said none of its passengers or crew had tested positive for the virus.

The Seattle-based cruise line is owned by Miami-based Carnival Corp.