As a Nebraska health system monitors 18 passengers for Andes hantavirus and several states track potential exposure, the CDC outlined three hantaviruses U.S. clinicians should consider when evaluating patients.
The Andes hantavirus is a New World hantavirus that the CDC typically records about 30 cases in the U.S. per year. The rare virus has gained global attention following a cruise ship’s outbreak that, so far, has nine confirmed infections, two suspected infections and three deaths. More than 120 passengers have returned to their home countries, including 18 Americans.
In a May 18 health alert, the CDC told clinicians to consider these hantaviruses:
1. Andes virus infection if patients have symptoms compatible with hantavirus infection and were either aboard the M/V Hondius cruise ship or had direct contact with someone associated with the cruise ship’s outbreak.
Clinicians are instructed to immediately report suspected Andes virus cases to local health departments, which can assist with diagnostic testing.
The agency said May 15 it does not recommend testing people for Andes virus who are not experiencing symptoms, which can take up to 42 days to present. In the May 18 alert, the CDC recommended testing “for non-Andes hantavirus in patients who have symptoms compatible with hantavirus infection and have a history of rodent exposure, but who are not associated with the M/V Hondius Andes virus outbreak.”
2. Other New World hantaviruses if patients have symptoms compatible with hantavirus pulmonary syndrome or non-HPS hantavirus infection, and if they have a known or suspected exposure to rodents.
3. Old World hantaviruses in patients who have symptoms compatible with hemorrhagic fever with renal syndrome and have a known or suspected exposure to rodents.
The CDC said there are no confirmed Andes hantavirus cases in the U.S. related to the cruise ship’s outbreak. “Therefore, the overall risk to the American public is still considered extremely low at this time,” the agency said.
The outbreak’s timeline
- April 1 — The M/V Hondius departed Argentina and traveled across the South Atlantic Ocean, stopping at several remote locations, including Antarctica, South Georgia Island, Tristan da Cunha, St. Helena and Ascension Island. It carried 147 people — 86 passengers and 61 crew — from 23 countries. Seventeen Americans were on board.
- April 6 — A passenger on the cruise ship got sick with Andes hantavirus, which is often contracted through rodents yet may also be transmitted from human to human in rare cases.
- April 11 — The passenger died, and the ship was unable to determine cause of death. His body was disembarked April 24 at St. Helena.
- April 26 — The man’s wife became sick and died on her travel home, according to USA Today and Oceanwide Expeditions, the cruise ship’s operator. Both passengers were Dutch nationals, and testing showed they had a variant of hantavirus.
- May 2 — A third passenger, who was of German nationality, died and was later determined to have been infected with hantavirus, according to the World Health Organization and reported by CBS News.
- May 10 — Passengers and crew members disembarked from the ship to the island of Tenerife, the largest of Spain’s Canary Islands.
- May 11 — The University of Nebraska Medical Center in Omaha received 17 American passengers. Two were at Emory University’s Serious Communicable Diseases Unit in Atlanta for a few days before joining the other passengers in Nebraska May 15.
- May 18 — The cruise ship docked in the Netherlands, where Oceanwide Expeditions is coordinating an in-depth cleaning and disinfection process. The company has canceled two planned voyages on the M/V Hondius and said it plans to proceed with trips as scheduled June 13.
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