Cruise Virus Outbreak Hits Santa Clara Resident

The County of Santa Clara said on May 11 that a resident exposed to Andes hantavirus aboard the MV Hondius cruise ship had returned home and was under close monitoring. The individual was at home, had no symptoms and was following restricted-activity guidance based on recommendations from the Centers for Disease Control and Prevention, the county said. California health officials said the risk to the public remained extremely low. The case has drawn attention because Andes virus, unlike the hantavirus strain usually seen in North America, has documented person-to-person transmission after prolonged close contact. ### How did a Santa Clara resident become part of an international outbreak? The MV Hondius outbreak was first reported to the World Health Organization on May 2 after a cluster of severe respiratory illness was identified aboard the Dutch-flagged ship. WHO said the vessel had 147 people aboard — 88 passengers and 59 crew — and had departed Ushuaia, Argentina, on April 1 before sailing across the South Atlantic with stops including Antarctica, South Georgia, Tristan da Cunha, Saint Helena and Ascension Island. (publichealth.santaclaracounty.gov) Santa Clara County told healthcare providers on May 12 that the returned traveler was one of four California residents linked to the outbreak. Two other California cruise contacts were being repatriated and held at a medical facility in Nebraska, and a fourth California contact was not on the ship but was a close contact of a case, the county said. (who.int) ### What do officials say about the Santa Clara resident’s condition? Santa Clara County Health Officer Dr. Sarah Rudman said on May 11 that the resident was “feeling well” and reporting no symptoms. The county said it would continue monitoring the person for the CDC-recommended 42-day period and had a care plan in place if symptoms developed. (publichealthproviders.santaclaracounty.gov) The California Department of Public Health said public health protocol included daily temperature checks, symptom assessment and direction to modify activities. State officials did not identify the resident and said no additional personal information would be released. ### Why are health officials treating Andes virus differently from other hantaviruses? (publichealth.santaclaracounty.gov) The CDC said on May 11 that Andes virus is a type of hantavirus normally found in parts of South America and is the only hantavirus known to spread person to person. The agency said spread does not happen easily and is usually limited to people who have close contact with a symptomatic person. (cdph.ca.gov) Santa Clara County’s provider advisory said person-to-person transmission requires prolonged close contact and that exposed people are not considered infectious unless they develop symptoms. County officials told clinicians there were no cases of Andes hantavirus in Santa Clara County and that an exposure does not mean a person is sick or will become sick. (cdc.gov) ### How severe has the cruise ship outbreak been? WHO said on May 4 that seven cases had been identified at that point, including two laboratory-confirmed cases and five suspected cases, with three deaths. Illness onset ranged from April 6 to April 28, and reported symptoms included fever, gastrointestinal illness, rapid progression to pneumonia, acute respiratory distress syndrome and shock. (publichealthproviders.santaclaracounty.gov) Santa Clara County’s May 12 advisory cited a later WHO update and said that, as of May 8, there were eight cases — six confirmed and two probable — including three deaths. All six confirmed cases were infected with Andes virus, the county said. ### What are California and local officials telling the public now? (who.int) Dr. Erica Pan, California’s state public health officer, said on May 8 that local, state, federal and global health partners were working together to assess exposed people, prevent spread and provide testing support. Pan said years of experience in South America showed Andes hantavirus rarely spreads between people, unlike influenza or COVID-19. (publichealthproviders.santaclaracounty.gov) The CDC said the overall risk to the American public and travelers remained extremely low, and WHO said the global risk from the event was low. Santa Clara County said it would keep monitoring the resident and would notify healthcare facilities before sending any known symptomatic contact exposed to Andes virus for care. Santa Clara County’s next public step is continued daily monitoring through the 42-day incubation window, while the county, the California Department of Public Health and the CDC coordinate any testing or care if symptoms appear. (cdph.ca.gov) (publichealth.santaclaracounty.gov) (cdc.gov)