At least some of the 18 American cruise ship passengers potentially exposed to the hantavirus will be allowed to leave a quarantine facility on Monday, after nearly three weeks in isolation.
But federal officials have said that the passengers should remain at their homes and under constant surveillance by law enforcement or public health workers for another three weeks — an approach that greatly exceeds typical public health protocols.
“Apparently the C.D.C. wants some kind of local guard or person to watch over the individual to ensure that they don’t leave their home,” said Steven Hyman, a lawyer representing two passengers who are New York residents, citing information provided by his clients.
It appeared earlier this week that Mr. Hyman’s clients might be prevented from leaving the National Quarantine Unit in Nebraska, the only federally funded facility of its kind. But late Friday, Dr. James McDonald, the New York health commissioner, said they would return home on a noncommercial flight, and could isolate in their residences until June 22.
He did not address whether they would be subject to round-the-clock monitoring by state authorities.
Federal health officials did not reply to questions about the release conditions, but the Department of Health and Human Services said that the “C.D.C.’s top priority has been the health and safety of the returned U.S. passengers and American communities.”
It remains unclear how many of the passengers will leave the Nebraska facility on Monday. At least some — including a third passenger from New York, according to Dr. McDonald — have expressed a desire to remain in the quarantine unit for the virus’ full 42-day incubation period in case they develop symptoms. None have so far.
The 18 passengers were among a group of Americans on a cruise ship that became the center of a global hantavirus outbreak this month. After being repatriated from the Canary Islands on May 11, they have been housed in federally funded facilities for observation, though none appear to have the disease.
In a call on Wednesday evening, officials from the federal Centers for Disease Control and Prevention initially asked states to post a law enforcement officer outside the passengers’ homes if they left the facility, according to several people briefed on the details who were not authorized to speak publicly. The agency revised the plan, calling for 24/7 monitoring by a health worker, after state officials raised questions about cost and authorization.
The Trump administration’s restrictions have far exceeded those that U.S. health officials used to successfully contain a 2018 hantavirus outbreak.
At least two of the cruise passengers were issued federal orders by Jay Bhattacharya, the interim C.D.C. director, to remain at the quarantine center in Omaha through at least Sunday, the end of the 21-day period during which people are most likely to develop symptoms.
The orders came after the two had made plans to return to their home states to self-isolate, as officials had originally suggested they could do after initial testing. They came as a surprise to many public health experts, who said the administration’s protocols ran counter to the philosophy of Dr. Bhattacharya and the health secretary, Robert F. Kennedy Jr., who have advocated medical freedom and more limited restrictions for disease containment.
Other Americans who departed the cruise before the outbreak was detected, or who were in close contact with a passenger who later died, have been allowed to quarantine at home.
And during the 2018 outbreak of the same type of hantavirus, dozens of people who might have been exposed were allowed to stay at home and monitor themselves for potential symptoms for 42 days. None became ill.
Round-the-clock monitoring of people who may have been exposed to hantavirus is “not standard at all,” said Caitlin Rivers, an epidemiologist and professor with the Johns Hopkins Bloomberg School of Public Health.
She added that allowing people to quarantine at home with check-ins from health workers would be reasonable to contain a pathogen like the hantavirus. “But going a step further, to 24/7 on-site monitoring — I’ve never heard of that, and I don’t think it’s needful,” she said.
Hantavirus is a rare family of viruses carried by rodents. The World Health Organization has identified the Andes subtype, which can be transmitted between people who have had close contact, as the one that affected the cruise passengers.
The ship on which the outbreak emerged, the Dutch-registered MV Hondius, began its journey in Argentina in early April. Three passengers later died from the virus, and several others became ill or tested positive. So far, according to the C.D.C., no cases of Andes virus have been confirmed in the United States as a result of the outbreak.
Sixteen people began quarantines in the Omaha unit on May 11. Two more began their quarantines in Atlanta, but have since joined the others in Nebraska, making a total of 18.
At least seven other Americans who departed the cruise ship earlier and took commercial flights back to the United States have mostly been monitored at home, with daily check-ins from local health workers, either virtually or in person. There appeared to be no clear explanation for the divergent protocols, Dr. Rivers said.
“There seem to be different rules, or different handling, of the passengers who had previously disembarked, compared to the passengers who were made to stay at the National Quarantine Unit,” she said.
Jacey Fortin covers a wide range of subjects for The Times, including extreme weather, court cases and state politics across the country.
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