- Hantavirus Andes strain confirmed in two cruise passengers evacuated to South Africa
- Andes virus is the only hantavirus known for limited human-to-human transmission
- Symptoms include fever, muscle pain, respiratory failure, and rapid lung fluid buildup
The hantavirus outbreak aboard the Atlantic cruise MV Hondius has raised global health concerns. While the risk to the general public remains low, the virus has the potential to cause severe disease. According to a recent update from South African authorities, the rare Andes strain of hantavirus, the only one capable of human-to-human transmission, has been confirmed in two passengers evacuated from the Atlantic cruise to South Africa. The World Health Organisation has confirmed a total of 8 cases of hantavirus till now.
What is the Andes virus?
Hantavirus is primarily transmitted to humans through contact with infected rodents, particularly through their droppings, urine, or saliva. While there are over 40 strains of hantavirus, Andes virus, found in South America, is the only currently known hantavirus for which limited human-to-human transmission among contacts has been documented.
Andes strain, which has been confirmed in two passengers from the cruise, is the most common cause of hantavirus pulmonary syndrome (HPS) in South America. Andes virus is transmitted mainly by the long-tailed pygmy rice rat (Oligoryzomys longicaudatus). The virus is transmitted mainly through inhalation of aerosols containing rodent excretions, saliva, or urine.
Also read: Hantavirus Outbreak: Authorities Evacuate Suspected Cases From Cruise Ship
How does it spread?
"To date, human-to-human transmission has been documented only for the Andes virus in the Americas and remains uncommon. When it occurs, transmission between people has been associated with close and prolonged contact, particularly among household members or intimate partners, and appears most likely during the early phase of illness, when the virus is more transmissible," mentions WHO.
Symptoms
- Early (Prodromal) phase: Fever, muscle aches, headache, fatigue, and gastrointestinal issues (nausea, vomiting, abdominal pain).
- Cardiopulmonary phase: Rapidly worsening shortness of breath, coughing, and fluid buildup in the lungs. This can lead to respiratory failure and shock within hours.
In a study published in the journal Emerging Infectious Diseases, the researchers looked at three people in Argentina who got sick in 2014.
Patient 1: A man who lived in a forest area and likely caught the virus from a rodent.
Patient 2: His twin brother. He didn't live in the forest but spent a lot of time with his sick brother.
Patient 3: A nurse who took care of the second brother in the hospital.
They found that most hantaviruses in the US and elsewhere do not spread this way. The fact that a nurse caught it while working shows that hospitals need very strict safety rules when dealing with the Andes virus to prevent super-spreader events.
Additionally, the study noted that people are most contagious during the prodromal phase, the early period when they just feel like they have a common flu, before the severe lung problems start.
It concluded that the Andes virus doesn't just stay in the woods, it can travel from one person to another through close contact.
Also read: Rare Human-To-Human Spread Confirmed In Hantavirus Outbreak On Cruise Ship
2018: Andes outbreak in Argentina
Another study published in the New England Journal of Medicine provides a detailed analysis of an Andes outbreak that occurred between November 2018 and February 2019 in Chubut Province, Argentina. The outbreak involved 34 confirmed cases, resulting in 11 deaths.
The study revealed the following details about the Andes variant:
Andes virus causes Hantavirus Pulmonary Syndrome (HPS), a rare but acute and often fatal respiratory disease.
- Zoonotic origin: The primary reservoir is the long-tailed colilargo (Oligoryzomys longicaudatus), a rodent. Humans typically contract it by inhaling aerosolised saliva, urine, or feces from these rodents.
- Person-to-person transmission: Unlike most other hantaviruses, the Andes virus can spread directly between humans via respiratory droplets, aerosols, or close physical contact.
- Risk factors: The study found that high viral loads and liver injury in a patient significantly increased their likelihood of becoming a super-spreader.
- Incubation period: Typically ranges from 16 to 28 days.
Complications reported by the infected individuals:
Common clinical markers in infected patients included:
- Thrombocytopenia (97%): Low platelet count
- Lymphopenia (93%): Low white blood cell count (lymphocytes)
- Elevated Liver Enzymes: High AST (94%) and ALT (81%) levels
- Elevated LDH: 100% of patients showed high lactate dehydrogenase levels (Elevated LDH (high LDH) suggests tissue damage or disease in the body. It is a general marker for acute or chronic damage, including infections, liver disease, lung issues, heart attacks, and certain cancers)
- Coagulation Issues: Delayed aPTT (88%) was frequent (delay in blood clotting)
The study concluded that self-isolation and quarantine of contacts are the most effective ways to control spread, as there is currently no specific vaccine or highly effective antiviral treatment widely available for the pulmonary stage of the disease.
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