In the early weeks of the COVID-19 pandemic, health officials struggled to impress upon the public the grave risks associated with the disease, as well as how easily it could spread.
Now, six years later, public fears have surrounded another type of virus that has killed and sickened passengers on a Dutch-flagged cruise ship, including four Californians who were exposed to the virus and recently returned to the United States. This time however, officials are taking a very different approach to messaging surrounding the deadly Andes virus — a type of hantavirus.
While officials and infectious disease experts have been quick to note the seriousness of the rodent-borne disease, they have also stressed key differences between hantavirus and COVID-19. Namely, that this virus is far less transmissible.
Public alarm over the illness began to grow following reports that three passengers died aboard the stricken vessel, MV Hondius. Worries grew further over the weekend when officials announced that 18 U.S. cruise passengers had disembarked and were returning home.
On Monday the California Department of Public Health said during a media briefing that four Californians had been exposed to the virus, but none had contracted it. Three of them were cruise ship passengers, while the fourth was a Sacramento resident who was on a plane with an infected person in South Africa.
As of now, all four individuals lack symptoms and appear healthy, according to Dr. Erica Pan, director of the California Department of Public Health.
One passenger, a Santa Clara resident, disembarked the cruise before the outbreak was recognized and returned to California, she said.
“This person was reported to our department last week and is being monitored by the local public health department where they live,” Pan said. “The other two passengers disembarked over the weekend in the Canary Islands and have been flown” to a bio-containment facility at the University of Nebraska Medical Center.
The individuals in Nebraska are undergoing a health assessment, and federal authorities will determine when they can return to California.
Of the total U.S. cruise ship passengers, sixteen boarded a medical repatriation flight arranged by the U.S. government to Nebraska and have remained there as of Monday, including one person who tested “mildly” positive for hantavirus — that person is staying in biocontainment at the University of Nebraska Medical Center.
Two other passengers, one of whom is showing symptoms of the virus, traveled to Atlanta and are staying in a biocontainment facility at Emory University.
That brings the total number of cases of hantavirus to nine, seven laboratory confirmed and two probable cause, including three deaths.
It’s reasonable for people to be concerned about this latest outbreak, said Dr. Nicole Iovine, chief medical epidemiologist and an infectious disease expert at the University of Florida Shands Hospital. Photographs of healthcare personnel in full personal protective equipment assisting cruise passengers are likely to spark recollections of the pandemic.
Even though this is not an easily transmitted disease, it is transmissible and has a high mortality rate, Iovine said. U.S. Centers for Disease Control and Prevention officials said 38% of people who develop respiratory symptoms from hantavirus may die from the disease.
“So it’s reasonable for the medical personnel to take maximal precautions so that they don’t contract it,” Iovine said. “It’s not a reflection of [the virus] being extremely contagious.”
In the U.S., hantavirus cases occur year-round and are transmitted via the urine, feces and saliva of wild rodents.
The Andes virus, a strain of the disease that’s endemic to Argentina, similarly passes from the exposure of wild rodent particles. Infected humans can transmit the virus to other people.
Unlike other infectious respiratory illnesses, hantavirus “infects cells very deep in the lungs, so it’s not as easily transmitted then when someone is speaking or coughing,” Iovine said.
COVID-19 transmission occurred when an infected person breathed out droplets and very small particles that contained the virus. Other humans could then inhale the particles or come into contact with them on the surface of objects.
“That’s one of the reasons that makes it much more difficult to transmit person-to-person, and is the reason why this is just not going to turn into a pandemic,” she said.
Experts say person-to-person transmission of the virus occurs only with close and prolonged contact. The hantavirus outbreak is rare but it’s not unusual for a viral outbreak to occur in a cruise ship, where people are packed in and close to each other, said Dr. Afif El-Hasan, member of the American Lung Assn.’s national board of directors.
“From an infectious disease standpoint, that is one of the most difficult and challenging situations and one where it’s more easy to catch something versus other situations,” El-Hasan said.
Experts including Scott Pegan, professor of biomedical sciences at the University of Riverside, say the average American’s risk of contracting the disease — if they aren’t within close proximity of an infected individual for a prolonged period — is really low.
Pegan acknowledged it’s confusing to the public when a health incident like this occurs because “they hear ‘this is a really bad disease.’”
“At certain levels, we should worry about it because we don’t want to be interfacing with this virus,” he said.
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