Hantavirus patient in Paris ICU

A French woman infected with Andes hantavirus remained in intensive care in Paris this week after being repatriated from a cruise-linked outbreak that prompted France to tighten isolation rules for contacts. French authorities said 26 identified contacts were placed under reinforced quarantine in hospital settings or were being transferred there, while the patient was being treated at Bichat hospital in Paris. The World Health Organization said the broader outbreak was linked to a cruise ship and had caused multiple severe respiratory illnesses and deaths. French officials said investigations were continuing and described the risk to the general public as low. ### Which patient is in intensive care in Paris? Paris officials said the patient is a French passenger repatriated after travel linked to the cruise ship cluster, and she tested positive for the Andes strain of hantavirus. Reuters reported on May 12 that she was hospitalized in Paris in serious condition, while Prime Minister Sébastien Lecornu said earlier that she was stable in intensive care. (ici.fr) Bichat hospital in Paris was identified by French media and officials as the site of her treatment. The government moved to centralize care and monitoring after the positive test result, according to statements carried by AFP and French outlets. ### Why did France isolate 26 contacts? French authorities said 26 contacts were identified among people exposed to the patient or linked to the travel chain, and all were ordered into reinforced quarantine despite having no symptoms at that stage. (boursorama.com) The Health Ministry’s urgent notice said recommendations for handling French nationals from the ship and their contacts were drawn up with national and international experts. (ici.fr) The government said the stricter protocol was adopted after France confirmed its first imported case linked to the outbreak. France 24, citing AFP, reported that all contacts were to be kept in hospital quarantine rather than home isolation under the revised rules. ### What outbreak are French authorities responding to? (boursorama.com) The World Health Organization said on May 4 that a cluster of severe respiratory illness aboard a cruise ship had produced seven cases, including two laboratory-confirmed hantavirus infections, three deaths and one critically ill patient. Illnesses began between April 6 and April 28 and included fever, gastrointestinal symptoms, pneumonia, acute respiratory distress syndrome and shock. (france24.com) WHO said in a May 8 update that the total had risen to eight cases, including three deaths, and that six laboratory-confirmed infections were identified as Andes virus. WHO said experts suggested an initial exposure in an endemic area in Argentina or Chile, followed by secondary person-to-person transmission aboard the ship through close contact in a closed setting. ### How unusual is person-to-person spread in this case? (who.int) Santé publique France says hantaviruses are viral zoonoses usually transmitted by infected wild rodents. In mainland France, the agency says about 100 cases of hemorrhagic fever with renal syndrome are detected on average each year, involving strains such as Puumala, Seoul and Tula. The Andes virus involved in the cruise outbreak is different from the strains more commonly monitored in mainland France. (who.int) WHO and the French Health Ministry said the risk associated with the current situation was considered low, even as they maintained strict monitoring for identified contacts. ### What are French authorities doing next? France’s Health Ministry said epidemiological investigations were still under way and that management protocols had been coordinated with international experts. (santepubliquefrance.fr) French media reported on May 14 that the Paris patient remained in intensive care and that the 26 contacts were still in isolation. WHO said further investigations into the cruise-linked outbreak were ongoing, including tracing exposures and monitoring linked passengers and crew. (sante.gouv.fr) Any change in the status of the Paris patient or the quarantined contacts is likely to come from the French government, public health agencies or WHO outbreak notices. (who.int)