Passengers from hantavirus ship arrive in US; 3 people in biocontainment

In a press briefing in Omaha on Monday morning, federal and Nebraska officials corrected the HHS statement, saying that the US has repatriated 18—not 17—people, which includes 17 US citizens and one person who is a dual British/US citizen. The passengers range in age from late 20s to late 70s–early 80s. On the flight to Omaha, two were flown in special biocontainment units “out of an abundance of caution.” That includes the one person who tested “mildly positive,” and a second person who had symptoms. For now, the definition of symptoms is “liberal,” including anything as minor as nasal congestion, officials said in the press briefing. The quarantine period for those exposed to hantavirus is 42 days from their exposure date. The 18 people will be monitored carefully for the life-threatening infection, with the 15 in quarantine undergoing detailed risk assessments. Depending on various factors, some in the quarantine unit may be able to return home before the 42-day period. These factors include, among many things, their assessed exposure and risk levels as well as their access to care at home. People who develop hantavirus infections require high-level care. Thus, if people do not live close to health facilities with intensive care units or advanced life-support technology, namely ECMO (extracorporeal membrane oxygenation), they would likely be advised to stay in Omaha. Andes hantavirus is a rare infection in humans, and the vast majority of cases are acquired via exposure to rodents or inhaling particles from their droppings, urine, or bodily fluids. However, the Andes virus is the only hantavirus known to, in even rarer cases, spread from human to human, which appears to have been the case on the Hondius. Rodents have not been reported on the ship. Cruise ships—where a mix of people from various places live in confined settings with communal facilities—are known to enable wide and rapid spread of viruses. While this is the first time an Andes virus outbreak with likely human-to-human transmission has occurred on a ship, no other features of the outbreak appear out of line with what’s known about the virus’s spread or disease. The virus transmits human-to-human amid close, prolonged contact with a symptomatic case. The virus is generally not known to transmit easily or from asymptomatic people. For more information about the outbreak and Andes virus, check out our explainer. In addition to the 18 people returned to the US this weekend, six other American passengers on the Hondius had disembarked the ship in April before the outbreak was identified. They are being monitored by state health officials.