Canada confirms one Andes hantavirus case

The Public Health Agency of Canada said on May 17 that it had confirmed one laboratory-tested case of Andes hantavirus in Canada linked to the MV Hondius cruise ship. The agency said the patient had been reported a day earlier by British Columbia’s provincial health officer as a presumptive positive case among passengers tied to the outbreak. Canadian officials said they were working with domestic and international partners, including the World Health Organization, as countries continue to trace and monitor exposed travelers. WHO said on May 13 that the overall public-health risk remained low, while U.S. officials said last week they had not confirmed any American cases. ### Which Canadian case was confirmed? British Columbia’s provincial health officer said on May 16 that one of four high-risk individuals who had been self-isolating and under symptom monitoring had tested presumptive positive for Andes hantavirus. PHAC said on May 17 that laboratory testing had confirmed that case. Canada’s statement did not identify the patient by age or sex. The agency said only that the person had been among passengers on the MV Hondius and that public-health authorities were continuing follow-up. ### How does this fit into the wider cruise-ship outbreak? The World Health Organization said on May 13 that the cluster was linked to the MV Hondius, a cruise ship on which severe respiratory illness cases were reported after travel in the South Atlantic. WHO said that, as of May 13, 11 cases including three deaths had been reported worldwide, with eight laboratory-confirmed Andes virus infections, two probable cases and one inconclusive case still under further testing. The European Centre for Disease Prevention and Control said on May 17 that the count had risen to 12 reported cases, including nine confirmed, two probable and one inconclusive, with no new deaths since the previous update. ECDC said the ship carried passengers and crew from 23 countries. ### Why are health officials treating Andes virus differently from many other hantaviruses? The U.S. Centers for Disease Control and Prevention said in a May health alert that Andes virus is the only hantavirus known to spread from person to person. CDC said transmission risk is highest with close contact, particularly exposure to body fluids from a symptomatic patient. WHO said human-to-human spread of Andes virus has been documented before, including in household and healthcare settings. The agency nonetheless kept its global risk assessment at low and said the likelihood of broader spread remained limited. ### What have Canada and the United States said about people being monitored? PHAC said on May 12 that it was coordinating with provinces, territories and international partners as passengers returned to Canada. In remarks published last week, Canada’s chief public health officer said the federal government had set up a Strategic Response Team and was discussing containment measures with provincial and territorial counterparts. Reuters reported on May 14 that U.S. officials were monitoring 41 people for possible exposure and had confirmed no U.S. cases. CDC’s health alert said exposed travelers should be monitored for symptoms for 42 days after their last exposure. ### What symptoms are officials watching for? CDC said early symptoms can include fever, headache, muscle aches and gastrointestinal complaints, and that severe disease can progress to cough, shortness of breath and respiratory failure. WHO said Andes virus infection can range from mild illness to hantavirus cardiopulmonary syndrome, a severe condition that can be fatal. Canada’s public statements have not provided a broader case breakdown beyond the one confirmed infection. PHAC has directed readers to its online media updates and risk-assessment pages as the situation evolves. ### Where will the next official updates come from? PHAC said its latest Canada update was posted on May 17, one day after British Columbia first disclosed the presumptive positive case. WHO’s most recent disease-outbreak notice was issued on May 13, and CDC’s health alert remains in effect as U.S. authorities continue follow-up with exposed passengers.