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The deaths of three passengers aboard the expedition cruise ship MV Hondius have triggered an international scramble to trace passengers and crew exposed to the rare Andes strain of hantavirus. The outbreak has reignited public fear about a virus most Americans associate with rural rodent exposure, and raised an uncomfortable question about whether human-to-human spread could become more common.<\/p>\n
Two scientists working on opposite ends of the hantavirus problem\u2014Dr. Scott Pegan, a virologist at the UC Riverside School of Medicine, and Dr. Marieke Rosenbaum, a veterinary public health expert at Tufts University\u2019s Cummings School of Veterinary Medicine\u2014both say the same thing: don\u2019t panic, but take this seriously.<\/p>\n
For most of its known history, hantavirus has been a disease of close rodent contact: a dusty barn, a mouse-infested cabin, a grain shed. The Andes strain circulating through MV Hondius is unusual because it can spread, it seems, between people. But Pegan said the conditions on the ship were extraordinary.<\/p>\n
\u201cIt\u2019s a hypothesis that the virus builds up a higher titer in the saliva,\u201d said Pegan of the blood test that measures the concentration of specific antibodies. He compared it to aspects of the early COVID-19 strain\u2014which also was christened with a famous cruise ship of its own, the Diamond Princess. Cruise ships, as society learned six years ago, are a perfect breeding ground for viruses. \u201cAnd that\u2019s, of course, going to be a respiratory venue, and so that\u2019s going to be likely to infect more people.\u201d<\/p>\n
But that doesn\u2019t mean the Andes virus behaves anything like COVID. The transmission Pegan described is what virologists call nosocomial, meaning hospital-acquired or close-contact spread. <\/p>\n
\u201cIf a patient shows up at a hospital and they don\u2019t really know what they have, and then no one does any protection, and then all of a sudden, the healthcare workers come down with it, because they\u2019ve been intimately involved with the individual,\u201d he explained.<\/p>\n
A cruise ship cabin, he said, is functionally the same problem. \u201cIf they weren\u2019t on a cruise ship in a small container, then it wouldn\u2019t have supported itself in spreading.\u201d<\/p>\n
Rosenbaum, who has been studying urban rats in Boston for over a decade as part of the Boston Urban Rat Study, agreed. <\/p>\n
\u201cThe risk of human-to-human transmission of hantavirus is really low, and this cruise was just like the perfect condition for it to spread to more people than I think it might have otherwise,\u201d she said. \u201cIf these people were home and started feeling ill, they probably would stay home and there wouldn\u2019t be as much exposure to other people.\u201d<\/p>\n
Both researchers were emphatic that the average person\u2019s risk from hantavirus has not changed because of the cruise ship outbreak. The virus still spreads almost entirely the way it always has, through aerosolized particles from rodent urine, droppings, or saliva.<\/p>\n
\u201cYou\u2019re not exactly going to, you know, be face to face with a rat breathing heavily on you,\u201d Pegan said.<\/p>\n
Instead, the issue is with how most of us typically interact with rodents, in cleanup. \u201cMost cases, like in the United States, it\u2019s usually because somebody is cleaning out a rat-infested area, and maybe not using sufficient PPE, mask, whatever, to do it,\u201d Pegan said. \u201cThey\u2019re basically dusting up old rat urine and things of that nature, and that gets it in the air, and they breathe it in.\u201d<\/p>\n
\u201cIf you\u2019re cleaning up an area that has rodent urine or droppings, you should be careful,\u201d Rosenbaum said. \u201cYou should wear gloves, you should wear a mask, and you should spray the area with water, because if you just sweep it, it\u2019s going to aerosolize all the dry particles and feces and urine particles, and potentially increase your inhalation.\u201d And absolutely no vaccuuming.<\/p>\n
The most dangerous exposures, she added, tend to happen indoors: in attics, sheds, basements, or any enclosed space \u201cwhere you have limited ventilation, so you\u2019re aerosolizing that material, and it doesn\u2019t have anywhere to go.\u201d<\/p>\n
Both scientists offered the same short, unglamorous list of advice: don\u2019t sweep or vacuum rodent droppings; wet contaminated areas before cleaning; wear gloves and a mask; ventilate the space; and if you\u2019ve recently traveled to South America and start running a fever with muscle aches, tell your doctor.<\/p>\n
\u201cIf somebody comes in and they say, hey, I\u2019ve got some muscle aches, and I recently went down to South America, they\u2019re probably getting a blood test for hantavirus,\u201d Pegan said. The diagnostic isn\u2019t perfect: it\u2019s most reliable more than 72 hours after symptoms begin.<\/p>\n
And seeing a rat on the street, Pegan said, is not a reason to panic.<\/p>\n
\u201cThis is really the principal way hanta is still very much spread: It\u2019s mostly stirring up of the feces and the urine, saliva. The rat can bite you and things like that,\u201d he said, but added, unless you\u2019re in the same air space as a rat, you\u2019re probably fine.<\/p>\n
While Pegan focuses on the molecular machinery of the virus and on developing vaccines and antibody therapeutics, Rosenbaum works on a question that\u2019s harder to fund and harder to solve: what\u2019s actually circulating in the rodents living among us?<\/p>\n
For more than a decade, she has run the Boston Urban Rat Study, partnering with the city\u2019s inspectional services to test wild Norway rats for pathogens including leptospirosis, Staphylococcus aureus, influenza A, and hantavirus. Her team is finishing a paper on hantavirus in Boston rats now.<\/p>\n
\u201cIt\u2019s quite a wicked problem,\u201d she said of urban rodent control and disease surveillance, \u201cbecause it would require so much cooperation across sectors to deal with.\u201d<\/p>\n
Norway rats, the brown rats that thrive in nearly every major American city, are the reservoir for Seoul virus, a hantavirus that causes hemorrhagic fever with renal syndrome. \u201cMost of the investigation in America and Europe has been related to colonies of rats that are being bred for research purposes, or for pets or pet food purposes,\u201d Rosenbaum said. \u201cThere\u2019ve been very few studies that have actually looked at wild rats. So we really don\u2019t know a lot about if it\u2019s out there.\u201d<\/p>\n
Severe hantavirus cases are rare in humans, she said, but that\u2019s partly because no one is looking. \u201cYou could get infected and develop mild symptoms and overcome the infection and never go to the doctor and get diagnosed.\u201d<\/p>\n
The issue is there hasn\u2019t been plenty of funding to increase surveillance and research into the hantavirus, in part because it never had its big, attention-grabbing American outbreak.<\/p>\n
\u201cThe funding landscape has just generally shifted a lot,\u201d Rosenbaum said. \u201cWhen it comes down to surveillance in rats, it can be challenging, because people might think, well, we should do surveillance in humans first.\u201d She compared it to West Nile virus surveillance, which is now a routine public health function in cities, but only because of past outbreaks. \u201cIf there is an outbreak of hantavirus in New York City that stems from rats, there probably may be more interest in longer-term surveillance, but until that happens, it\u2019s probably not going to capture the interest of dollars.\u201d<\/p>\n
Surveillance in wildlife is also just hard. \u201cFor rat trapping, we\u2019re trapping in the middle of the night,\u201d she said. \u201cIt takes a lot of effort, a lot of money, a lot of time.\u201d<\/p>\n
Pegan, who recently received a $3.4 million NIH grant for his work on Crimean-Congo hemorrhagic fever (CCHF) virus, a close cousin of hantavirus in the bunyavirus family, made a similar point about therapeutic development. \u201cIf you talk about, like, what\u2019s the vaccine, or what\u2019s the countermeasure? Well, there really isn\u2019t any. And that\u2019s just because, again, we haven\u2019t valued that virus enough to invest the billions of dollars it would take to get one. It\u2019s not that we couldn\u2019t get one. It\u2019s just that it\u2019s a prioritization of what we\u2019re spending funds and money on.\u201d<\/p>\n
His lab has developed a vaccine platform currently aimed at CCHF that he said could be adapted for hantaviruses. \u201cWe developed a vaccine platform for bunyaviruses. We were using it for CCHF right now, but that\u2019s a platform, and like other platforms, it could be adapted for hantaviruses.\u201d The platform protects in as little as three days, he said: \u201cYou can take it on Friday, bingewatch Netflix, and go back to the public on Monday.\u201d<\/p>\n
The only existing hantavirus vaccine, Hantavax, \u201cis only really effective against the Seoul and Hantaan virus, and those are older viruses,\u201d Pegan said. \u201cThere\u2019s zero evidence that that would do any good against the Andes or anything else.\u201d (Rosenbaum has a research paper coming out about finding the Seoul variant of the hantavirus in Boston rats, but again, calmed fears and said it\u2019s incredibly rare to contract).<\/p>\n
It may not be the hantavirus, but given how social humans are and how viruses evolve, it\u2019s just a matter of time before the world may experience another pandemic. <\/p>\n
\u201cI can safely say there\u2019ll be another pandemic in our future,\u201d Pegan said. \u201cDo we know when or where? We are one population that\u2019s increasing. We are moving more into these areas where some of these viruses hang out, and where these animals are, and that does have consequences.\u201d<\/p>\n
It\u2019s the breakdown of the boundary between people and wildlife, Pegan said, pointing to the same dynamic that drove COVID-19, Ebola, and now this hantavirus outbreak. \u201cYou\u2019re breaking down that human-wilderness interface, and that\u2019s where you\u2019re going to get these cross events, much like COVID.\u201d<\/p>\n
Decades ago, an Ebola case in a remote village might burn itself out. Today, that\u2019s no longer how the world works. \u201cYou\u2019re going to have more of those situations of people getting exposed in those climates, and hopping on a cruise ship and hopping on a plane,\u201d Pegan said. \u201cThat\u2019s just kind of the way we live our lives today.\u201d<\/p>\n
He noted that a virology researcher happened to be aboard the cruise ship as a passenger: Dr. Stephen Kornfeld, who was there bird-watching, again toying at the lines between humans and wildlife. \u201cIt\u2019s just going to bring more of these,\u201d Pegan said. The combination of population growth, encroachment on wildlife habitat, and global travel means more spillover events, more often. \u201cEvolution is just not tied down, you know, it\u2019s not like the virus is saying, \u2018I\u2019m not leaving rats ever.\u2019 But it doesn\u2019t mean that it\u2019s not going to start sampling other things if you keep getting exposed to it over and over again.\u201d<\/p>\n
Rosenbaum said the cruise ship outbreak does not change the immediate risk profile for Americans, but she\u2019d like cities to think harder about who\u2019s most exposed. One of the Boston Urban Rat Study\u2019s trapping sites was at the heart of Boston\u2019s opioid crisis, where street encampments overlapped directly with rodent activity. \u201cThere\u2019s direct physical contact that\u2019s occurring for that population,\u201d she said. \u201cThere are certain pockets of individuals that we should consider focusing on when we think about risk of contracting rodent-borne diseases.\u201d<\/p>\n<\/div>\n
#Youre #safe #Hantavirus #outbreak #heres #absolutely<\/p>\n","protected":false},"excerpt":{"rendered":"
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