Note: The newshounds at FluTrackers are following media reports (see thread) of a hantavirus outbreak aboard a cruise ship (MV Hondius, bound from Ushuaia in Argentina to Cape Verde), where 2 or 3 passengers have reportedly died, and several more are apparently infected.
While details are scarce, I've prepared a backgrounder on the virus, and what we currently know about today's events.
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Hantaviruses - which are carried by rodents in many parts of the world - are contracted by humans primarily through the inhalation or ingestion of aerosolized rodent feces, urine, saliva. While relatively uncommon, some of these viruses have demonstrated limited human-to-human transmission.
Some - like Europe's Puumala Virus - produce relatively mild illness, while others like North America's Sin Nombre Virus and the South American Andes Virus can carry a high fatality rate.
In 2019 we closely followed an unusually large outbreak in Argentina where over a period of 3 months, a total of 29 laboratory-confirmed cases of Hanta Pulmonary Syndrome (HPS), including 11 deaths - were reported in Epuyén, Chubut Province.
The WHO DON report stated:
The index case had environmental exposure prior to symptom onset on 2 November, and subsequently attended a party on 3 November. Six cases who also attended the party experienced the onset of symptoms between 20-27 November 2018.
An additional 17 cases, all of whom were epidemiologically-linked to previously confirmed cases, experienced symptom onset between 7 December 2018 and 3 January 2019 (Figure 1). Potential human-to-human transmission is currently under investigation.
In that outbreak, the incubation period ran from 8 to 31 days. The CDC notes incubation can run anywhere from 1 to 5 weeks, and some studies have suggested up to 8 weeks.
Hantavirus in humans is almost always a dead-end infection, but in recent years the Andes virus (ANDV) has garnered a reputation for being a bit of an outlier.Following the above outbreak, the NEJM published “Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina, which warned: ANDV Epuyén/18−19 strain shows a facility (R>2) for sustaining continuous chains of transmission if no control measures are enforced.
While we don't know if this hantavirus is the ANDV Epuyén/18−19 strain, the fact that it appears to have infected 5 or 6 passengers is a concern.
The ship in question (HV Honidus) reportedly carries up to 174 passengers, and 74 crew, and departed Argentina in early April. This ship appears to have been on a `polar exploration cruise', then proceeding on to South Africa and Cape Verde.
While we don't have a solid timeline, according to media reports, in late April a 70 y.o. passenger died on board, and his 69 y.o. wife subsequently fell ill (she reportedly died in a Johannesburg hospital).
A third passenger has reportedly died (unconfirmed), and 3 more passengers are supposedly sick (1 hospitalized in Johannesburg),while two are in isolation awaiting the next port.
Given this is Sunday, there's very little in the way of official confirmation of these reports. Hopefully we'll get more details in the next day or two.
While more cases are possible - with appropriate control measures, this outbreak should be manageable - although the long incubation period will certainly complicate matters.
For more on hantaviruses, you may wish to revisit:
Two Recent Studies On the Host Range of Hantaviruses In the United States
EID Journal: Experimental Infection of Peromyscus Species Rodents with Sin Nombre Virus
MMWR: A Little Bit Of Seoul (Virus)
