Why Hantavirus Patients from the MV Hondius Were Transferred to Emory University Hospital

Two passengers linked to a hantavirus outbreak aboard the MV Hondius cruise ship were transferred to Emory University Hospital because of its nationally recognized Serious Communicable Diseases Unit (SCDU), one of only a few specialized biocontainment facilities in the United States equipped to safely evaluate and treat infectious diseases like hantavirus.

The gripping account of passengers stranded on the hantavirus-plagued MV Hondius cruise ship took a hopeful turn this week, when passengers were allowed to disembark the ship by country for isolation, evaluation, and medical care. 

On Monday, 17 U.S. citizens departed the ship, docked in Canary Islands, and were flown to specialized isolation and treatment units at the University of Nebraska and Emory University Hospital. One symptomatic individual is receiving care in Emory’s biocontainment unit, and one asymptomatic individual—identified as a close contact—is undergoing evaluation and monitoring.

What is a Serious Communicable Diseases Unit?

Emory University Hospital is one of a handful of units in the country with the specialized infrastructure, training, and clinical expertise required to safely manage high-consequence infectious diseases such as hantavirus. Along with the University of Nebraska Medical Center/Nebraska Medicine and NYC Health + Hospitals/Bellevue, Emory is a consortium lead of the National Emerging Special Pathogens Training and Education Center (NETEC).

It is also a Regional Emerging Special Pathogen Treatment Center. These designations reflect the hospital’s advanced capabilities, including: 

• air lock entry systems that allow clinical teams to safely put on PPEs before entering patient rooms without mixing with contaminated air, 
• negative air pressure environments designed to prevent contaminated air from spreading 
  infected air from moving from one room to another
• specialized waste decontamination and sanitation systems, as well as
• highly trained multidisciplinary teams that regularly prepare for and respond to emerging infectious disease threats.

“The Emory Serious Communicable Diseases Unit has been around since 2002 when it was established as part of a collaboration with the Centers for Disease Control and Prevention (CDC) to provide a place where CDC employees that had been exposed to high consequence pathogens,” says Carlos del Rio, MD, H. Cliff Sauls Distinguished Professor of Medicine at Emory School of Medicine.

“The unit is staffed by a specialized treatment team that prepares for potential outbreaks or concerns throughout the year. 

What is Hantavirus and How Does it Spread?

Hantavirus is a relatively rare zoonotic disease transmitted through exposure to infected rodents – particularly through contact with rodent urine, droppings, or contaminated dust particles. Hantavirus made headlines late last year after Betsy Arakawa, wife of actor Gene Hackman, died from the disease. Most strains of the disease are not transmissible by humans. 

Hantavirus symptoms are like those associated with the flu, and include sneezing, aches, fever, dizziness, nausea or vomiting, coughing, and difficulty breathing. Symptoms can accelerate quickly and lead to respiratory failure and death. 

The Andes strain of the virus can be spread through close contact with infected people. As of the date of this article, 11 people from the MV Hondius have tested positive—or are suspected as positive— for the Andes strain of hantavirus. 

There is currently no known treatment or vaccine for hantavirus.

Is the Current Hantavirus Outbreak a Public Threat? 

According to Laurel Bristow, infectious disease researcher and host of the Health Wanted podcast, the risk of spread is very low. “The species of hantavirus that exists in the U.S. has never been shown to spread between people. With the Andes version that has spread on the ship, spread is limited to close or prolonged contact,” she says. “I expect we’ll see more cases develop in people who were on the ship, but the risk to the general public is very low.”  

How Can I Reduce My Risk of Hantavirus?

• Avoid areas where mice are present—especially deer mice—and, when cleaning spaces like barns, sheds, or attics 
• Wear N95 masks, gloves, and make sure rooms are well-ventilated 
• Avoid activities that stir up dust that can contain mouse feces (like dusting or sweeping) 
• Opt for wet cleaning instead, like mopping. 

What Do I Do if I Think I Have Hantavirus?

If you are experiencing hantavirus symptoms after being around pest waste, you should seek medical attention immediately and inform health care providers about the potential exposure concern.