A suspected outbreak of hantavirus on a cruise ship sailing the Atlantic Ocean has all the hallmarks of a nightmare scenario: A handful of people have fallen gravely ill, three have died and nearly 150 people are stuck off the coast of Cape Verde while global health experts are scrambling to understand — and stop — the infections.
However, while tragic, there is no reason for panic. This likely is not the opening scene for a bigger, scarier movie.
That is mainly because this type of virus is not known for easily spreading to and between humans. Still, infectious disease detectives need to quickly and carefully study what happened to rein in the situation and better understand how these deadly viruses function. They have a lot of work ahead of them.
Illustration: Mountain People
Although eight people aboard the cruise ship have been sickened, three of whom have died and one remains in intensive care, only three hantavirus infections have so far been confirmed in a lab. The most urgent questions are what strain of hantavirus is responsible for the cases, where the outbreak began and whether any transmission occurred between passengers.
Hantaviruses are spread by mice, rats and other rodents. Human infections, which occur when people come in contact with droppings or urine, are relatively uncommon: From 1993 to 2023, the US recorded just under 900 cases.
Yet those infections are deadly. The type of hantavirus prevalent in North and South America damages the lungs and heart, killing nearly 40 percent of the people it infects. The type found in Europe and Asia goes after the kidneys, with a mortality rate of anywhere from 1 percent to 15 percent. A big problem is that early symptoms are often mistaken for other, more common viruses — and there are no specific treatments for hantavirus infections.
The first step in understanding what unfolded on the cruise ship is to identify the specific strain of virus causing infections — a task the WHO likely would have completed in the next day or so.
Infectious disease experts strongly suspect the outbreak was caused by the Andes virus. Not only is that strain of hantavirus endemic to parts of Argentina, where the cruise ship first embarked, but it also is the sole pulmonary-syndrome-causing strain known to be capable of spreading between humans.
Infectious disease sleuths have two main theories for what happened. One scenario is that mice carrying the virus somehow made it onboard the vessel and exposed passengers, say, through the ship’s ventilation system.
An alternate, much knottier scenario — one that is looking increasingly likely — is that one or more passengers contracted the virus before the ship left Argentina or during one of its many stops. On Tuesday, WHO officials told reporters that the first passengers to get sick — a husband and wife who both tragically died — had boarded the vessel in Argentina and that passengers had been on excursions to multiple islands with rodents.
“There could be some source of infection on the islands as well for some of the other suspect cases,” said Maria Van Kerkhove, WHO’s chief of epidemic and pandemic preparedness and prevention. “However, we do believe that there could be some human-to-human transmission that’s happening among the really close contacts,” such as the husband and wife and others who have shared cabins.
It can take up to six weeks for people to show signs of an infection, complicating efforts to track it back to its origins. That might involve tracing passengers’ footsteps and potentially even catching and testing rodents, a process that could take several months, said Maria (Gaby) Frank, director of the Johns Hopkins Special Pathogens Center.
The good news is that none of the potential scenarios or viral culprits, not even the Andes virus, is likely to cause a much broader outbreak.
“It’s not a virus that spreads like wildfire,” said Steven Bradfute, associate director of the Center for Global Health at the University of New Mexico Health Sciences Center.
Previous person-to-person transmission has required very close contact — people living and dining in close quarters, or the exact environment of a cruise ship.
Bradfute’s own research underscores the notion that this virus is not very efficient at attacking humans. New Mexico has had the highest number of hantavirus infections in the US — a situation that captured the public’s attention last year with the shocking death of Betsy Arakawa, the wife of actor Gene Hackman. By sampling mice in his own backyard, Bradfute found that more than a quarter of rodents in the state were carriers of Sin Nombre virus, the hantavirus strain found in North America.
In other words, hantavirus is ubiquitous in certain parts of the country, but infections are still rare. While it is always good to be alert when such unusual outbreaks occur, it is unlikely to turn into anything bigger.
Meanwhile, anyone worried about being exposed to the virus can take simple measures to protect themselves.
People living or traveling in an area where the virus is endemic, whether that is Patagonia or the Four Corners, can wear a mask and wash hands after any activity in a space — say, a garage or a hiking trail — where infected dust could be kicked up.
After COVID-19, even a handful of cases of a deadly virus is enough to raise all our hackles. While the situation is evolving and merits caution, this particular outbreak is likely to be an isolated tragedy rather than a reason for mass anxiety.
Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, healthcare and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News. This column reflects the personal views of the author and does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
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