The hantavirus outbreak linked to the MV Hondius cruise ship has prompted a two-facility response across the U.S., with American passengers now being monitored and treated at both the University of Nebraska Medical Center in Omaha and Emory University Hospital in Atlanta. The CDC classified the outbreak as a level 3 emergency response and 17 Americans arrived at UNMC on May 11 for monitoring.
The CDC also confirmed May 13 that no federal or state quarantine orders have been issued; monitoring is voluntary, with passengers and contacts encouraged to stay home and check in daily with state and local health departments.
Here are six updates:
1. The response has been split between UNMC and Emory due to capacity.
Sixteen of the 18 people being monitored in U.S. medical facilities are at UNMC — one person who tested positive in the Nebraska Biocontainment Unit and 15 in the National Quarantine Unit. The Georgia Department of Public Health confirmed May 11 that two individuals who disembarked the MV Hondius are being transported to Emory University’s Serious Communicable Diseases Unit, with federal healthcare workers taking every precaution. The transfer was part of contingency planning, as UNMC’s biocontainment unit does not have enough capacity for all passengers currently under monitoring.
2. Emory’s symptomatic patient has tested negative.
The symptomatic patient transferred to Emory’s biocontainment unit has tested negative for hantavirus. HHS confirmed the two Emory patients are a couple, according to a May 11 CBS News report. The Georgia Department of Public Health said there is no risk to the public.
3. The U.S. monitoring footprint grows to include Kansas and Minnesota.
The Kansas Department of Health and Environment is monitoring three individuals with high-risk exposure to a confirmed Andes hantavirus case — exposure that occurred internationally after contact with a MV Hondius passenger who later tested positive, according to a May 12 news release from the department. The three were not aboard the cruise ship and are not currently symptomatic. The health department noted that based on current knowledge of the Andes virus, individuals are not considered infectious unless they become symptomatic and assessed the risk to the public as extremely low.
The Minnesota Department of Health is also monitoring one person who may have briefly been exposed overseas to a Hondius passenger who tested positive, and that the individual is cooperative, currently asymptomatic and being checked daily for symptoms, according to a May 12 news release from the department. An additional 12 U.S. residents are being monitored by state health departments. Seven were cruise passengers who disembarked early across Texas, Georgia, Virginia, Arizona and California, and five others were exposed to an infected individual during air travel across New Jersey, Maryland and California. None are symptomatic.
4. Global case count rises to 11; no new deaths since May 2.
As of May 12, the European Centre for Disease Prevention and Control has reported 11 total cases — nine confirmed and two probable — following completion of disembarkation and repatriation of all passengers on May 11. World Health Organization Director-General Tedros Adhanom Ghebreyesus, PhD, said May 12 there have been no new deaths since May 2, when the WHO was first notified of the cluster, and that all cases have been isolated and managed under strict medical supervision.
5. UNMC biocontainment patient identified as physician who treated fellow passengers. The passenger in UNMC’s biocontainment unit is Stephen Kornfeld, MD, an oncologist who stepped in to care for ill passengers after the ship’s own physician contracted the virus, according to a May 13 CNN report. Kornfeld told CNN he experienced night sweats, chills, mild respiratory symptoms and more than two weeks of severe fatigue aboard the ship. He is now asymptomatic.
6. Illinois is investigating an unrelated domestic hantavirus case.
Illinois is investigating a potential hantavirus case in a Winnebago County resident near Rockford who had not traveled internationally and had no contact with the cruise ship outbreak, according to a May 12 Illinois Department of Health news release. The suspected case involves a North American strain, believed to have been acquired while cleaning a home where rodent droppings were present. The patient experienced mild symptoms and did not require hospitalization. CDC confirmatory testing could take up to 10 days. Unlike the Andes strain driving the cruise ship outbreak, North American strains are not known to spread person to person.
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