Hantavirus: Calm urged as SA health teams race to trace contacts

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JEREMY MAGGS: South Africa’s health authorities are urging calm after the cruise ship hantavirus scare. But I think the bigger issue now is not the ship itself necessarily. It’s whether South Africa has a clear, credible and coordinated strategy for imported disease threats.

With global travel, ports and airports and medical evacuations creating potential entry points, I think this becomes a test of surveillance, border health controls, hospital readiness and public communication.

Read: Hantavirus outbreak on cruise ship leaves 3 dead, WHO says

I want to discuss this in a little more detail, particularly in terms of preparedness and a response strategy. I’m joined by the Minister of Health, Dr Aaron Motsoaledi. Minister, welcome to you.

What is South Africa’s national strategy when a potentially serious imported infection is detected before it reaches our borders? How does this play out?

AARON MOTSOALEDI: Jeremy, you’ll be aware that diseases don’t know any borders, so when you develop strategies of making sure that there are no imported diseases, you don’t do it alone.

As a country, we do it severally, and the body that coordinates that is the World Health Organisation (WHO), which takes its cue and its decisions from the World Health Assembly. The World Health Assembly is a gathering of all ministers of health, which has an annual caucus, and the next one happens in ten days’ time in Geneva.

In the World Health Assembly, they adopted what they call [the] International Health Regulations 2005 that guides all the countries on what to do.

Especially the core of the International Health Regulations 2005 is to contain diseases where they occur in order not to spread them all over the world. So those international health regulations guide us.

Now, in our case, we do have port health authorities, which is a special unit, a chief directorate in the department that deals with matters arriving from other countries, that port health authorities have been transferred to the Border Management Authority (BMA).

I’m sure you are aware that we established the BMA to deal with borders, inside it there is port health, which has got rules on what to do.

Once there is an outbreak somewhere, if it is serious, it needs people around the borders to be watchful.

The World Health Organisation will then declare what they call a Public Health Emergency of International Concern (PHEIC). Even with that, it has got rules that once the WHO does that, what then is the next step.

You may remember that during Covid, after Covid struck, when people were still thinking about it, what to do and so on, we reached a situation where the WHO declared a PHEIC.

That’s when borders were closed around the country, travel stopped, certain activities were stopped and so on.

JEREMY MAGGS: Minister, are you confident that the situation regarding the hantavirus scare has now been contained? You are asking South Africans to exercise a degree of calm. Where is the concern here?

AARON MOTSOALEDI: Yeah, let’s outline the way the issue happened, Jeremy. Firstly, let me start here, the hantavirus is not like Covid. Why am I saying it’s not like Covid? Because Covid was never known. It was a new virus that just jumped on us, and we had to start from the beginning to understand what it is.

Hantavirus has been there for ages. It has been there. We know it has caused 88 strains, and we know certain strains occur in the Americas, especially in South America. Other strains occur in Asia.

Of course, I don’t have any evidence of any strain in Africa and or whether there’s been any outbreak in Africa, but we know there are quite a number of outbreaks that happened in Argentina.

We know that it’s a zoonotic disease. That means it’s a disease that is (passed) from animals to human beings, in this case rodents. Rats and mice carry the disease.

If anybody comes into contact with their excreta, especially urine, their droppings or even saliva, that’s how a person gets infected. Once it infects the person, in rare cases, that person can infect others.

But there has to be very close contact. It’s not like Covid where just being in the same vicinity, you have to have very, very close contact with that person.

That is why the man, the first person who died in Saint Helena on the ship, the wife who flew here to OR Tambo en route back home to Netherlands got infected because obviously she was in close contact with her husband.

Those are the facts we know. So what we are doing now is who else was in close contact with these people?

We have got the gentleman who was airlifted from Ascension Island after he left Saint Helena, he got sick when he arrived at Ascension, and because they’ve already lost one person, he was airlifted to South Africa. That is the man who is in intensive care now in a hospital in Sandton.

They tested him and he’s the one who was found to have hantavirus. Then the lady who collapsed at OR Tambo, who was en route back home, her blood was taken, but not to test for the virus, because nobody at that time knew that it was hantavirus.

So they went to collect her blood in the laboratory, which was still there, and tested it and found that it’s actually hantavirus.

So what we are doing is, who came in contact with these people, with this lady who collapsed at OR Tambo and died in a hospital in Kempton Park, and with this gentleman who is now in ICU in a hospital in Sandton, who was in contact with them. Those are the people we are looking for.

Firstly, we know they are health workers and we have put together three teams.

The National Institute of Communicable Diseases (NICD) have got a method of tracing people who were in contact. We are busy doing contact tracing. Before we can tell anybody the extent of whether they must worry or not, we need to get all those facts.

JEREMY MAGGS: And how long is that contact tracing process going to take, Minister?

AARON MOTSOALEDI: It will depend, because we are not the only ones who are doing contact tracing.

The World Health Organisation is going to do it because this was a multinational trip. These are people from many countries.

The people who died are from Netherlands. The gentleman in the hospital here is from the UK. There are people from other areas. So it all depends how far the people spread, where do we find them and all that.

So it’s not easy for me to mention that within this time we will have finished that contact tracing.

JEREMY MAGGS: A final question, what then should South Africans be judging you and your department on here, is it speed, transparency, containment or proof that the country is genuinely prepared?

AARON MOTSOALEDI: Well, as far as speed is concerned, it’s a relative term. But in terms of competency and transparency, we have always done that.

Remember, Jeremy, this is not the first outbreak we’ve had. I must say that we have got a tendency in South Africa of undermining ourselves or undermining each other.

South Africa has got a world class institution when it comes to communicable disease called the NICD. It is recognised by the World Health Organisation; it is recognised globally.

Actually, it is one of the collaboration centres or reference centres of the World Health Organisation when diseases occur. It has always been guiding us, and it has got a good history.

You may remember during the outbreak of listeriosis, it was the NICD that established exactly where that listeriosis came from when they found it in the Tiger Brands factory in Polokwane.

Tiger Brands did not even believe it. They took the samples, sent them to Paris, in France, to say we need a laboratory from a so-called first world country, and the Paris laboratory confirmed exactly what the NICD found out. So in that we also do have that expertise, even on the African continent.

JEREMY MAGGS: I’m going to leave it there. The Minister of Health, Dr Aaron Motsoaledi, thank you very much.