Hantavirus?

[Anonymous]

Anonymous wrote:The flight attendant tested negative. I'm an infectious disease epidemiologist - there is very little risk to the general public.

This was a very positive development!

[Anonymous]

Anonymous wrote:

Anonymous wrote:The flight attendant doesn’t surprise me. The news said that the woman was asked to leave the flight because she was too ill to fly. I think the woman died the next day. So she was probably very sick. The flight attendant probably assisted her in getting off the flight with the woman breathing and coughing on her. If I were in the seat next to the woman or in front of her, I’d also be pretty worried.

The good news is that all the Americans who came back don’t have any symptoms which means they probably weren’t contagious on their flights home and hopefully if they get as much as a scratchy throat they will quarantine.

The patient zero couple had spent four months bird watching in remote areas so again not super surprised they picked something up. Argentina had over 100 cases this year, including at least a couple human to human transmission so it’s low level endemic in rural Argentina.

1-6 week incubation period. The concern is you can be shedding the virus before you exhibit symptoms.

From what we know about this strain of hantavirus is that it is really only possible to transmit during a very limited time frame- like, once you get a fever, and for the next 24 hours or so. Thankfully it does not seem to spread asymptomatically or pre-symptomatically the way that covid was doing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I didn't hear about the France case being infected on a plane. Link?

Also, I was under the impression that this strain of hantavirus is endemic in Argentina- it's not a novel thing- and it requires very close contact to spread, like sharing a bed, or sharing food. So I suppose being right next to someone on the airplane and sharing a drink with them or something could spread it, but I did not think it was very easily transmissible, not airborne or small droplet spread like flu or covid etc.

The study that supported human to human transmission reported very close contract - “deep kissing” and sexual contact. And a later systematic review, which is a higher level study, said the first study was flawed in several ways and did not look at other environmental exposure besides close contact. So I think there are a lot of questions marks here and the WHO is dealing with a unicorn case where they need to be cautious, but hantavirus is well known to result in small clusters of infections with no history of large outbreaks.

Hantavirus is not prone to mutation despite being an RNA virus, so that is reassuring as well. I wouldn’t be worried about hantavirus this summer, but a month ago, I would have said the chances of a cluster on a cruise ship was close to zero, so what do I know? Retired ID doc here.

Thanks for your expertise!

[Anonymous]

I have plans to go to Europe in June and am not remotely concerned about hantavirus, for the reasons everyone above has outlined. Low transmission rates + high mortality rates = tough for this thing to spread.

[Anonymous]

Wear a mask when traveling, and especially flying, just to protect yourself and minimize exposure from whatever viruses are out there. It's not rocket science.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Did everyone forget that Gene Hackman’s wife died of hantavirus?

Google says there are between 10k and 200k cases of hantavirus each year around the world.

Argentina has its own strain and Patient Zero contracted it before he got on the ship? How? Because he spent weeks birdwatching across Argentina—including around landfills…where he likely acquired the virus.

Hantavirus typically pops up in western US states (again: remember Hackman’s wife?).

With the disgusting rat problem in DC, y’all should worry about what could happen in your own backyard rather than some fancy hotel in a nice European city.

PS - Always resist the urge to visit landfills when traveling. #themoreyouknow

The strain that she died from is not person to person transmissible. The concern is when multiple people started getting infected and had not been in contact with rodents, etc. that this was a different strain.

Right.

But it is a strain that has existed in Argentina…where the man contracted it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:The flight attendant doesn’t surprise me. The news said that the woman was asked to leave the flight because she was too ill to fly. I think the woman died the next day. So she was probably very sick. The flight attendant probably assisted her in getting off the flight with the woman breathing and coughing on her. If I were in the seat next to the woman or in front of her, I’d also be pretty worried.

The good news is that all the Americans who came back don’t have any symptoms which means they probably weren’t contagious on their flights home and hopefully if they get as much as a scratchy throat they will quarantine.

The patient zero couple had spent four months bird watching in remote areas so again not super surprised they picked something up. Argentina had over 100 cases this year, including at least a couple human to human transmission so it’s low level endemic in rural Argentina.

1-6 week incubation period. The concern is you can be shedding the virus before you exhibit symptoms.

That may be your concern, but I don't think the people who know about this virus have that concern.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I didn't hear about the France case being infected on a plane. Link?

Also, I was under the impression that this strain of hantavirus is endemic in Argentina- it's not a novel thing- and it requires very close contact to spread, like sharing a bed, or sharing food. So I suppose being right next to someone on the airplane and sharing a drink with them or something could spread it, but I did not think it was very easily transmissible, not airborne or small droplet spread like flu or covid etc.

The study that supported human to human transmission reported very close contract - “deep kissing” and sexual contact. And a later systematic review, which is a higher level study, said the first study was flawed in several ways and did not look at other environmental exposure besides close contact. So I think there are a lot of questions marks here and the WHO is dealing with a unicorn case where they need to be cautious, but hantavirus is well known to result in small clusters of infections with no history of large outbreaks.

Hantavirus is not prone to mutation despite being an RNA virus, so that is reassuring as well. I wouldn’t be worried about hantavirus this summer, but a month ago, I would have said the chances of a cluster on a cruise ship was close to zero, so what do I know? Retired ID doc here.

Thanks for your expertise!

The study I saw from Argentina said close contact but not to the level of deep kissing. One of the examples was someone that went to a wedding while ill and gave it to several people there. Here's a different article, where several medical professionals that assisted ill people were infected -- so I think close contact, but not necessarily deep kissing. I wouldn't want to be on a dance floor with people coughing and breathing heavily if they had this strain, for instance.
https://pmc.ncbi.nlm.nih.gov/articles/instance/2627608/pdf/9204298.pdf

[Anonymous]

I don't stress about this at all.

I'm sure we'll have another COVID level pandemic soon enough..this is not it.

Scientifically, it just isn't the same. They know this.

The one thing I will NEVER do is cruise. It's never something I was ever interested in - you are trapped in a microcosm on the sea - I mean there is no way out! You are screwed should anything happen on that boat whether it's damaged, contagious virus or an ax murderer on board. No thanks, I much rather vacation on land and fly x number of hours to move from one place to another.

[Anonymous]

Anonymous wrote:I have plans to go to Europe in June and am not remotely concerned about hantavirus, for the reasons everyone above has outlined. Low transmission rates + high mortality rates = tough for this thing to spread.

I feel better (if that's an ok way to put it) about something like Ebola, where yes it spreads from person to person, yes it's harder to get than the flu or covid because you need large droplets I think (so not just being across from someone at the dinner table while they talk), and I think you get more and more contagious the sicker you get, and then you're most contagious as you're dying and right after you've died. That's why despite insane precautions, those nurses got Ebola from the man hospitalized with Ebola in the US 8ish years ago. But it's also why those nurses didn't spread it to anyone else- even the nurse who traveled by plane, went shopping, etc even with a low grade fever when she was first coming down with it. Because she was barely contagious during that early phase. I read that this strain of hantavirus is only all that contagious during a very specific window, mainly during those first 24 hours of fever at the start of the illness. So if people aren't jerks and just stay home for a couple days when they have a fever, I mean, theoretically we should be good. It's not like covid where people were forced to stay home for 10-14 days even with no symptoms.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I didn't hear about the France case being infected on a plane. Link?

Also, I was under the impression that this strain of hantavirus is endemic in Argentina- it's not a novel thing- and it requires very close contact to spread, like sharing a bed, or sharing food. So I suppose being right next to someone on the airplane and sharing a drink with them or something could spread it, but I did not think it was very easily transmissible, not airborne or small droplet spread like flu or covid etc.

The study that supported human to human transmission reported very close contract - “deep kissing” and sexual contact. And a later systematic review, which is a higher level study, said the first study was flawed in several ways and did not look at other environmental exposure besides close contact. So I think there are a lot of questions marks here and the WHO is dealing with a unicorn case where they need to be cautious, but hantavirus is well known to result in small clusters of infections with no history of large outbreaks.

Hantavirus is not prone to mutation despite being an RNA virus, so that is reassuring as well. I wouldn’t be worried about hantavirus this summer, but a month ago, I would have said the chances of a cluster on a cruise ship was close to zero, so what do I know? Retired ID doc here.

Thanks for your expertise!

The study I saw from Argentina said close contact but not to the level of deep kissing. One of the examples was someone that went to a wedding while ill and gave it to several people there. Here's a different article, where several medical professionals that assisted ill people were infected -- so I think close contact, but not necessarily deep kissing. I wouldn't want to be on a dance floor with people coughing and breathing heavily if they had this strain, for instance.
https://pmc.ncbi.nlm.nih.gov/articles/instance/2627608/pdf/9204298.pdf

the article is 30 years old!!!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I didn't hear about the France case being infected on a plane. Link?

Also, I was under the impression that this strain of hantavirus is endemic in Argentina- it's not a novel thing- and it requires very close contact to spread, like sharing a bed, or sharing food. So I suppose being right next to someone on the airplane and sharing a drink with them or something could spread it, but I did not think it was very easily transmissible, not airborne or small droplet spread like flu or covid etc.

The study that supported human to human transmission reported very close contract - “deep kissing” and sexual contact. And a later systematic review, which is a higher level study, said the first study was flawed in several ways and did not look at other environmental exposure besides close contact. So I think there are a lot of questions marks here and the WHO is dealing with a unicorn case where they need to be cautious, but hantavirus is well known to result in small clusters of infections with no history of large outbreaks.

Hantavirus is not prone to mutation despite being an RNA virus, so that is reassuring as well. I wouldn’t be worried about hantavirus this summer, but a month ago, I would have said the chances of a cluster on a cruise ship was close to zero, so what do I know? Retired ID doc here.

Thanks for your expertise!

The study I saw from Argentina said close contact but not to the level of deep kissing. One of the examples was someone that went to a wedding while ill and gave it to several people there. Here's a different article, where several medical professionals that assisted ill people were infected -- so I think close contact, but not necessarily deep kissing. I wouldn't want to be on a dance floor with people coughing and breathing heavily if they had this strain, for instance.
https://pmc.ncbi.nlm.nih.gov/articles/instance/2627608/pdf/9204298.pdf

the article is 30 years old!!!

And?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I didn't hear about the France case being infected on a plane. Link?

Also, I was under the impression that this strain of hantavirus is endemic in Argentina- it's not a novel thing- and it requires very close contact to spread, like sharing a bed, or sharing food. So I suppose being right next to someone on the airplane and sharing a drink with them or something could spread it, but I did not think it was very easily transmissible, not airborne or small droplet spread like flu or covid etc.

The study that supported human to human transmission reported very close contract - “deep kissing” and sexual contact. And a later systematic review, which is a higher level study, said the first study was flawed in several ways and did not look at other environmental exposure besides close contact. So I think there are a lot of questions marks here and the WHO is dealing with a unicorn case where they need to be cautious, but hantavirus is well known to result in small clusters of infections with no history of large outbreaks.

Hantavirus is not prone to mutation despite being an RNA virus, so that is reassuring as well. I wouldn’t be worried about hantavirus this summer, but a month ago, I would have said the chances of a cluster on a cruise ship was close to zero, so what do I know? Retired ID doc here.

Thanks for your expertise!

The study I saw from Argentina said close contact but not to the level of deep kissing. One of the examples was someone that went to a wedding while ill and gave it to several people there. Here's a different article, where several medical professionals that assisted ill people were infected -- so I think close contact, but not necessarily deep kissing. I wouldn't want to be on a dance floor with people coughing and breathing heavily if they had this strain, for instance.
https://pmc.ncbi.nlm.nih.gov/articles/instance/2627608/pdf/9204298.pdf

the article is 30 years old!!!

Yes. It’s not a novel virus. It’s endemic to certain areas of Argentina and Chile and periodically there are small outbreaks that have been studied. I think it’s typically a little hard to figure out if it’s a human to human transmission because if a guy gets it and his wife and kids do,,, is it because they are in close contact or because they all had a picnic someplace with infected rodents? The long incubation period makes it challenging to track things like that.

[Anonymous]

Okay if anyone cares I found the article talking about the outbreak in Argentina about a decade ago, where one person went to a birthday party with 100 people and gave it to 10 of them. I think the person was actively sick though, with a fever and coughing.
https://www.nejm.org/doi/full/10.1056/NEJMoa2009040

I’m very curious about the jobs of the people on the ship that got sick. It’s been reported one was tj doctor but I wonder if the other two were people that were actively helping the man who got so sick. If he was sick enough to die on the boat he probably needed assistance getting to the sick bay or getting to his room or whatever.

[Anonymous]

Anonymous wrote:Okay if anyone cares I found the article talking about the outbreak in Argentina about a decade ago, where one person went to a birthday party with 100 people and gave it to 10 of them. I think the person was actively sick though, with a fever and coughing.
https://www.nejm.org/doi/full/10.1056/NEJMoa2009040

I’m very curious about the jobs of the people on the ship that got sick. It’s been reported one was tj doctor but I wonder if the other two were people that were actively helping the man who got so sick. If he was sick enough to die on the boat he probably needed assistance getting to the sick bay or getting to his room or whatever.

One of the main criticism of that New England journal article was that the authors sequenced the virus, found that the patients had the same strain, but did not investigate whether they had a common exposure other than the party, especially since most of them lived in the same town. Some of the patients had minimal contact with the index case. Perhaps they had gotten infected by an environmental exposure in town - we don’t know because they didn’t look for any other cause.

The other thing we know is that in several studies, after a clusters of Andes virus infections, they did bloodwork on the health care workers and the town residents and no one had antibodies to hantavirus, meaning that they had not been exposed to the virus despite having human to human contact with the patients.

I am the retired ID doc and I would love to have the epidemiologist chime in here - I think the number of infected patients points to either rare human to human transmission from a unique situation that entailed l sustained and close contact, or a shared exposure. The shared exposure seems less likely because both crew and passengers were infected. If it were just passengers, it would point to an exposure from an excursion.

On the bright side, I suppose that the 100+ people on the norovirus plagued cruise ship can at least be relieved they have norovirus and not hantavirus.