What an infectious disease specialist wants you to know about hantavirus

As the number of suspected or confirmed hantavirus cases linked to the MV Hondius cruise ship rises to about a dozen, people across the country are watching with concern. The strain of hantavirus is called the Andes virus. It can lead to what the Centers for Disease Control and Prevention calls “a severe and deadly disease that affects the lungs.”

But the agency’s director said on CBS News that the risk to the public is “much, much lower” than with COVID-19.

Others are more cautious, raising questions about how the Andes strain of hantavirus is transmitted and the length of its incubation period.

Here’s what Stephen Thacker, M.D., an infectious diseases specialist at MUSC Children’s Health, wants the public to keep in mind.

Q: First, what is hantavirus?

A: Hantavirus is a group of viruses that can cause severe illness and, unfortunately, have a high rate of risk. They're usually transmitted to humans through infected mice and rats through their urine and droppings or saliva. The rare hantavirus infections that we see globally and in the U.S. are related to exposure to rodents and aren’t related to exposure to other people who have this Andes virus.

Q: But this one appears to have spread from person to person. Can you talk about that?

A: The Andes virus, which is within the hantavirus family, is the only strain that we know can spread person to person. But that ability is actually pretty poor. It requires prolonged exposure, close contact with someone who is symptomatically infected. So, it's usually direct physical contact, meaning that they're in the same enclosed space for quite some time and may be spread through saliva or respiratory secretions from coughing or from kissing.

Q: Hantavirus is considered a rare disease. Can you put the current outbreak into perspective?

A: It is rare. And I think it's helpful for folks to know this isn't a new discovery. The Andes virus has been recognized as a known pathogen. Thankfully, it's extremely rare to see it reach humans. And when it does, it's extremely rare to see it spread from human to human.

I think the reason that this has unfortunately impacted several individuals is the fact that they were in close quarters while traveling.

Q: Some people are looking back to COVID and its variants, wondering if Andes is the equivalent of a hantavirus variant that spreads more easily.

A: It's a natural concern. But, thankfully, compared to how infectious COVID-19 is, it is not in the same vein of concern. This is something that I fully expect will be controlled here in the U.S.

Q: The head of the World Health Organization said the incubation period is six to eight weeks. Does that mean we’re likely to see more cases tied to the cruise ship outbreak?

A: It certainly is possible. The U.S. citizens that came back off the ship are being monitored very closely. And those that are symptomatic are being cared for in very specific environments to minimize spread.

But it’s still possible there will be more cases. Folks who were around individuals actively infected may show signs or symptoms in the future. That's why we have our public health services to help monitor those folks, providing them support and direct care.

Q: Hantavirus is not something we normally talk about in South Carolina.

A: That’s in part because there are no known cases in South Carolina. This virus comes from being around, essentially, the droppings and urine of mice and rats. And it's really the arid Southwestern part of the U.S. where we see the risk in this country. In a lot of cases, it's folks cleaning out their garages, cleaning out a barn, and they breathe in aerosolized droplets.

Q: But you’re still keeping close watch?

A: Those of us in infectious diseases are trained to have a healthy worry when this concern arises for the well-being of patients. We just had a CDC statement sent out through the South Carolina Department of Public Health, which is really a reminder to clinicians about how hantavirus can present, what the risks are and how to respond if concerned.

Q: Bottom line: Should the public, apart from people who came into contact with people affected by the current outbreak, be worried?

A: I would say certainly for those of us here in South Carolina and, honestly, throughout the United States, you should keep in mind that this outbreak is really linked to this very specific ship. It was in the Atlantic Ocean. Now, if we do end up having this concern here, the question becomes: Are we prepared with the resources we would need, with the education of our team members, to respond quickly if something changes? MUSC is actively preparing.