These States Are Watching for Potential Hantavirus Cases

Some people who may have been exposed to a hantavirus that can transmit from human to human returned to the U.S. before the outbreak aboard a cruise ship was known.

This includes seven Americans who disembarked the ship on the remote island of St. Helena on April 24. MedPage Today broke that story last week.

It also includes at least nine Americans who were on the same plane from St. Helena to Johannesburg as the widow of the first cruise ship passenger who died. That woman was symptomatic during the flight, and died not long after landing in South Africa.

State health officials have contacted these people and have advised them to quarantine as best they can, with home monitoring and daily symptom and fever checks. According to CDC’s interim guidance, they are all high risk, as they were either on the ship as of April 6, when the first patient died, or were seated close to the symptomatic passenger on the plane.

They’ve been asked to delay nonessential medical care, skip travel plans, and work from home.

There are also 18 passengers from the ship who were recently repatriated; 16 of them are at the University of Nebraska Medical Center in Omaha, while two were flown to a biocontainment unit at Emory University in Atlanta after one developed symptoms. That person has since tested negative for the disease. The other person was their partner.

Of the 16 people who remain in Nebraska, one tested positive for the virus. That person was an oncologist who helped manage sick passengers on board after the ship’s doctor became sick. He is now in the facility’s biocontainment unit, where he remains asymptomatic.

The other 15 passengers are in Nebraska’s quarantine unit, where they will be assessed, and eventually they will have the choice about where to quarantine — either at the facility or at home, if it’s determined that can be done safely.

Unfortunately, the quarantine period is 42 days, which is thought to be the upper limit of the incubation period for the Andes virus, the strain of hantavirus involved in the outbreak. That can seem like a long time to spend in a quarantine facility, but it does guarantee access to the nation’s top experts in outbreak response and treatment.

“If I was exposed to this and I had the option to stay in a quarantine unit proximate to that care, I would definitely take that, because you’re putting yourself in a position, if you were to turn positive, to take advantage of all those things that will give you the best chance of survival,” said Michael Wadman, MD, an emergency physician and medical director of Nebraska’s quarantine unit.

Here’s where patients are being monitored:

Arizona: one passenger

California: one passenger; one air travel

Georgia: four passengers

Kansas: three air travel

Maryland: two air travel

Minnesota: one air travel

New Jersey: two air travel

Nebraska: 16 passengers; one tested positive

Texas: two passengers

Virginia: one passenger