South Africa IDs cruise hantavirus

South African infectious-disease specialists traced a rare Andes hantavirus outbreak to the Dutch cruise ship MV Hondius after a passenger evacuated from Ascension Island arrived at a Johannesburg hospital on May 1, according to the National Institute for Communicable Diseases and Associated Press reporting. Lucille Blumberg, an infectious-disease expert who worked on the case, said a U.K.-based colleague flagged the patient while South Africa was observing the Labor Day holiday. Within about 24 hours, South African scientists had identified the virus as the Andes strain, a rare hantavirus variant that public-health agencies say is the only one known to spread from person to person. The identification helped the World Health Organization and national health authorities begin tracing passengers and contacts across several countries. ### How did South Africa get pulled into an outbreak on a ship far from its shores? May 1 is the date Blumberg told AP she opened an urgent email about a cruise passenger who had been taken off the ship on Ascension Island and admitted in Johannesburg with suspected pneumonia. The ship was in the Atlantic Ocean, and other people aboard were reportedly ill, prompting South African specialists to begin testing for a range of respiratory pathogens before narrowing the cause. (apnews.com) Johannesburg became central because the evacuated passenger was hospitalized there, giving South African laboratories access to the first critical sample. AP reported that scientists ruled out other possibilities, including more familiar respiratory infections, before confirming hantavirus and then the Andes strain. ### Why was the Andes strain such an urgent finding? (apnews.com) The World Health Organization said hantaviruses are generally carried by rodents and usually infect people through contact with contaminated urine, droppings or saliva. WHO and the U.S. Centers for Disease Control and Prevention say Andes virus is unusual because it is the only hantavirus known to spread between people, typically through close contact. (apnews.com) That distinction mattered on a cruise ship because passengers and crew share enclosed spaces for days at a time. WHO said the outbreak involved severe respiratory illness, and the agency classified multiple infections as confirmed Andes virus cases linked to the voyage. ### What do we know about the shipboard outbreak itself? MV Hondius is a Dutch expedition cruise ship that became the focus of a multi-country health response after passengers fell ill during the voyage. (who.int) AP and WHO said the outbreak was linked to several countries because travelers disembarked and returned home while authorities were still determining what pathogen was involved. (who.int) The World Health Organization said in a May 13 disease-outbreak update that 11 cases, including three deaths, had been reported. WHO said eight cases were laboratory-confirmed for Andes virus infection, two were probable and one U.S. case remained inconclusive and was undergoing further testing at that time. ### What did the South African team actually do once the alert came in? (apnews.com) Blumberg told AP that the team moved immediately despite the public holiday, and the case was routed through the National Institute for Communicable Diseases in Johannesburg. The scientists used lab testing to identify hantavirus and then determine it was the Andes strain, a result AP and other reports said came within roughly 24 hours. (who.int) That rapid result gave the WHO and health agencies in affected countries a basis for containment steps, including contact tracing and monitoring exposed passengers. WHO’s outbreak notice shows how the response quickly became international, spanning confirmed or probable cases in several countries after the ship’s voyage ended. ### What happens next for passengers and health authorities? (apnews.com) May 13 is the latest WHO outbreak bulletin cited in public reporting, and the agency said further testing was still underway for at least one U.S. case linked to the voyage. Public-health authorities in countries with exposed passengers have continued case finding, testing and contact follow-up tied to the MV Hondius itinerary and disembarkation. (who.int)