Keeping Tabs on Hantavirus; MA Auto-Enrollment; Mel Gibson’s Ivermectin Influence

The following is a transcript of the podcast episode:

Rachael Robertson: Hey everybody, welcome to MedPod Today, the podcast series where MedPage Today reporters share deeper insight into the week’s biggest healthcare stories. I’m your host, Rachael Robertson.

To kick us off this week, Kristina Fiore will update us on what we know about the hantavirus outbreak tied to a cruise ship. Then Joyce Frieden will tell us about how Medicare officials are considering a plan to auto-enroll some patients into Medicare Advantage plans or accountable care organizations. After that, Charley Bankhead joins us to talk about research quantifying the impact of Mel Gibson talking about ivermectin on Joe Rogan’s podcast.

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Robertson: Passengers aboard a small cruise ship that experienced a hantavirus outbreak have been brought back to the U.S. Most of them are being monitored for symptoms in a national quarantine unit in Nebraska. But other passengers disembarked the ship in mid-April and returned to the U.S. before the outbreak was known. MedPage Today broke that story, and Kristina Fiore is here to tell us more.

So Kristina, how did you find out about these other passengers who returned earlier?

Kristina Fiore: So we have a lot of good infectious disease and public health sources that we made both during COVID and in the early days of the Trump administration, when people were losing their public health jobs. We stayed in touch with those sources over the years, and they’ll come to us sometimes when there’s important public health information that they believe the public should know about.

One source was very concerned about the potential gravity of the situation. It sounded like there were several people who had come back to the U.S., but were just out and about in the community without any monitoring, even though they had potentially been exposed to a hantavirus that could transmit person-to-person. So it wasn’t clear how many people there were, or if the states where they lived were able to track them down. I would say it took a good 24 hours to really solidify the story. We kept checking in with those sources, and over time, the picture became clearer as to just how many people were being tracked down and where they lived. And once my sources had a clearer picture, we decided to run with the story. And at the time, we said there were seven people living in Arizona, California, Georgia, Texas, and Virginia. And that information has held up over time.

Robertson: So states are monitoring those seven people, but some states are monitoring others as well. Who are those people and where are they?

Fiore: Yeah, that’s right. So officials have been contact tracing people who are on a flight from the remote island of St. Helena to Johannesburg, South Africa. That’s because the widow of the first person who died of hantavirus, unbeknownst to anyone at the time, was on that flight, and she was symptomatic, and she died not long after they had landed. We know of at least nine people from that flight who are in the U.S. now: one in California, two in New Jersey, two in Maryland, one in Minnesota, and three in Kansas. So the total number of people who are being monitored in the U.S. is about 34 – seven previously disembarked, nine air travel, and 18 who were repatriated from the ship earlier this week.

Editor’s Note: After this episode was recorded, MedPage Today learned of two more air travel passengers in Washington state who were being monitored, bringing the total to 36. However, the CDC reported a total of 41 people being monitored.

Robertson: What does quarantine look like for all of these people?

Fiore: That’s a good question. We know that the folks who were repatriated from the cruise ship were flown to our only national quarantine facility at the University of Nebraska Medical Center (UNMC). Sixteen people remained there, while two were flown on to another national biocontainment facility at Emory University in Atlanta. One person had symptoms, though they’ve since tested negative, and the other person was their partner.

Of the 16 in Nebraska, one was moved to the biocontainment unit because he had at least one positive test result even though he remains asymptomatic. He’s actually an oncologist who was on board the expedition, but had helped out when the ship’s doctor became sick, so he was particularly at risk of exposure. The other 15 will be assessed, and officials keep saying that they will have the option to serve out their quarantine at home, but that will only be after a significant assessment to make sure that they can do so safely and that they have access to critical care should the need arise. I think that one of the doctors from UNMC put it perfectly: if it were me, I would choose to stay in quarantine right here because it gives me the best chance of survival should I develop this illness.

As for the other 16 people who are currently doing home quarantine, according to CDC guidance, anyone who was aboard that ship as of April 6, the day the first passenger died, is high risk and should really curtail their contact with the outside world — no medical appointments, no travel, work from home. Hopefully people are abiding by those rules and submitting to surveillance by local public health authorities in the interest of keeping us all safe and making sure that this doesn’t spread to others.

The difficult part is that the recommended quarantine is 42 days, and that’s the upper limit of the incubation period for hantavirus, or the strain of the hantavirus called the Andes virus. Most people will develop the disease sooner than that, within a week or two, maybe three, but it’s a really long incubation period, and that does make this all a bit trickier to manage.

Robertson: Yeah, hopefully this burns out quickly. Thanks, Kristina.

Fiore: Yeah, I definitely hope so. Thanks, Rachael.

Robertson: Growing numbers of first-time Medicare enrollees are choosing Medicare Advantage plans, but enrollment may not be increasing fast enough for some Trump administration officials. The Centers for Medicare and Medicaid Services (CMS) is reportedly considering automatically enrolling new beneficiaries in either Medicare Advantage plans or something called an accountable care organization or ACOs. Joyce Frieden is here to tell us more.

So Joyce, what exactly are Medicare officials thinking about doing?

Joyce Frieden: Well Rachael, currently, if you become eligible for Medicare, but don’t choose a particular plan, the government automatically enrolls you in what’s called traditional fee-for-service Medicare. Under the traditional program, enrollees pay a monthly premium. This year it’s a minimum of $202, but it can be up to twice as much, depending on your income. And in exchange, you can see any doctor that accepts Medicare. That payment covers hospital care, but doesn’t include a Medicare Part B drug plan, which you have to pay for separately, and you would still face additional co-pays unless you also buy a Medicare supplemental policy.

But under what Medicare officials are now considering, if you don’t choose a plan, you will automatically be enrolled in either a Medicare Advantage Plan run by a private insurance company, which includes doctor and hospital care and sometimes includes a drug benefit as well, or you could be assigned to an ACO, which is a group of doctors that contracts with Medicare to provide all of your care for a specified amount.

Robertson: What are health policy experts and members of Congress saying about this idea?

Frieden: Well, you might not be surprised to hear that opinions are divided. Republicans argue that Medicare Advantage, with its smaller physician networks and stricter prior authorization rules, can save the Medicare program money. But a report by the Medicare Payment Advisory Commission, better known as MedPAC, in March 2026 found that Medicare paid $76 billion more for Medicare Advantage patients in 2025 than it would have if those same patients had been enrolled in traditional fee-for-service Medicare.

Healthcare consultant Tom Campanella says it’s a good idea overall, but precautions must be taken because “if [it] means we’re denying needed and appropriate services, that’s a bad thing. So there needs to be some form of guardrails or user-friendly transparency,” especially in terms of posting patient outcomes.

But Tricia Neuman, who heads up Medicare policy at KFF, has a lot of questions. For example, how would Medicare select which plan to enroll the beneficiary in, and will any consideration be given to helping someone keep their current doctors? And would the assignment process give preference to insurers with certain characteristics such as zero-premium products, a certain plan type, like HMO or PPO, or plans with relatively high star ratings? Keep in mind that this is only an idea at this point, and no decisions have been made according to Medicare officials.

Robertson: And I know you will be keeping tabs on the story. So thank you so much for updating us on what’s been happening so far.

Frieden: You’re welcome, Rachael.

Robertson: In January of 2025, actor Mel Gibson appeared on the Joe Rogan Experience podcast, and among other topics, talked about how three close friends had allegedly been cured of stage IV cancer by treatment with ivermectin and benzimidazole. The podcast has been viewed an estimated 60 million times. That led to a study examining the potential impact of Gibson’s comments on prescriptions for combination ivermectin-benzimidazole. Charley Bankhead is here to tell us more about the study that was recently published in JAMA Network Open.

Charley, how did researchers go about looking at the impact of Gibson’s comments?

Charley Bankhead: The researchers used a large U.S. medical record database to identify anonymous patients who had at least one prescription for ivermectin-benzimidazole from January through July of 2025 — the 6 months following Gibson’s podcast experience. They compared those numbers with prescription rates for the same months in 2024. A separate analysis focused on ivermectin-benzimidazole prescriptions for patients with cancer diagnoses.

The primary objective was to see whether the prescription rates change after Gibson’s appearance on the podcast. The researchers also wanted to know more about the patients who received prescriptions for the combination treatment.

Robertson: What were the key findings?

Bankhead: Overall, monthly prescription rates for ivermectin-benzimidazole doubled from 2024 to 2025. The rates increased by more than two and a half times among patients with cancer diagnoses. The data showed that patients who received ivermectin-benzimidazole prescriptions for cancer were more likely to be white men younger than 65 living in the South — characteristics that have been associated with podcast audiences.

Robertson: What did the researchers consider the take home messages from the study?

Bankhead: They were particularly concerned by the increase in prescriptions among patients with cancer. The findings could indicate that patients with serious life threatening conditions might be delaying or even rejecting proven therapies in favor of an unproven treatment like the ivermectin-benzimidazole combination. The researchers called for a concerted effort to counter misinformation that can drive patients away from evidence-based care. The research was another indicator that people with large platforms hold influence.

Robertson: Well, thank you for your reporting on this, Charley.

Bankhead: Thanks for inviting me.

Robertson: On the measles front, there were 49 new cases last week, and 30 the week before. Arizona and Utah still have outbreaks going on, and a new outbreak in Pennsylvania had nine cases last week. South Carolina, on the other hand, is finally done with its outbreak. Check out our measles map for more details on where cases are and how it’s changing,

And that’s it for today. If you like what you heard, leave us a review wherever you listen to podcasts, and hit subscribe. If you haven’t already, we’ll see you again soon.

This episode was hosted and produced by me, Rachael Robertson. Sound engineering by Greg Laub. Theme music by Palomar. Our guests were MedPage Today reporters Kristina Fiore, Joyce Frieden, and Charley Bankhead. Links to their stories are in the show notes.

MedPod Today is a production of MedPage Today. For more information about the show, check out medpagetoday.com/podcasts.