Hanta Virus Infection
To those who refuse to believe science, stop reading this! Do not argue with what i wrote.
I have been trying to glean as much information as possible about the hanta virus, beyond what I knew from my medical education. I never personally had a patient with it.
The WedMD group offered a Webinar yesterday 5/12 which I attended. Here are some of my notes:
From Webinar 5/12/26
The loss of confidence in public health because of the politicalization of COVID is proving to be somewhat of a problem. Usually physicians in the US, at least, would seek information from the CDC website at the report of an outbreak. This time, there was no information at all on the CDC website until day 4 after the WHO reported this outbreak. Counter intuitively, the feeling is that it is far safer to spread the patient population out rather than to concentrate it. Thus the fact that the 150 passengers are now in their home countries is thought to be positive. There was no real discussion of the crew.
The ship is to dock in Rotterdam to be sanitized. It will not return to service until totally free of virus.
Volunteer physicians from 23 countries boarded the ship to help care for the passengers. There was no mention of if anyone from the CDC Intelligence service were included.
The virus involved is a single stand RNA one. There are approximately 60 hantaviruses. They break out into old world and new world strains. Five of the patients have had their viruses sequence, that is they have the genetic picture of them. They are all nearly identical, considered a proof that there was a single infection that caused the outbreak. This particular strain is common to Chile and other S American nations, and is a zoonotic, this can spread from animal to human and then capable of spread human to human. All 150 passengers are considered high risk to develop the disease. That is why they will be quarantined for the full expected incubation period, which is very long, up to 42 days from time of exposure. The “new worls” varieties seem to produce a hematological and renal illness. They cause destruction of blood cells and bleeding and kidney failure. The old world variety is responsible for the cardiac illness, that which this current virus is responsible.
The initial infection is likely to have jumped from a rodent to a human, it isn’t yet known if the human index case was infected on the ship or on land, although it seems as if it is considered more likely that the human came onto the ship already infected. There was no discussion about any attempt at case finding of all contacts of all passengers before boarding the ship.
At the present time, we have to be very humble about how little we know about the epidemiology of the virus. We do not know how long a viral particle may persist on surfaces, it does appear to be spread via respiration, but we do not know if an asymptomatic, infected person can spread the virus. We need to learn from this event, hopefully the WHO will coordinate the efforts, since US CDC seems to not be taking any sort of lead role. Scientists have not characterized the immune response in the human host. We do know that the anti-viral agent ribavirin has been studied and is ineffective as is high dose steroids.
The WHO suggests repeated viral testing for those at risk. Currently, if someone has symptoms but is viral negative they are considered to not have disease but the testing should be repeated. Again it is unknown if an asymptomatic patient may have viremia, virus duplicating in their body, and if it can be spread.
We do not understand why the virus seems so much more common in some geographic locations than other, why not seen in NY City? We do know that patterns of geographical distribution of other diseases is changing due to climate change, so we cannot depend upon current geographical limitations.
It will be difficult to follow the information as it develops since the US seems to have abrogated its former role as leader in infectious disease to other countries and the WHO which we are no longer a member of.
I have been trying to glean as much information as possible about the hanta virus, beyond what I knew from my medical education. I never personally had a patient with it.
The WedMD group offered a Webinar yesterday 5/12 which I attended. Here are some of my notes:
From Webinar 5/12/26
The loss of confidence in public health because of the politicalization of COVID is proving to be somewhat of a problem. Usually physicians in the US, at least, would seek information from the CDC website at the report of an outbreak. This time, there was no information at all on the CDC website until day 4 after the WHO reported this outbreak. Counter intuitively, the feeling is that it is far safer to spread the patient population out rather than to concentrate it. Thus the fact that the 150 passengers are now in their home countries is thought to be positive. There was no real discussion of the crew.
The ship is to dock in Rotterdam to be sanitized. It will not return to service until totally free of virus.
Volunteer physicians from 23 countries boarded the ship to help care for the passengers. There was no mention of if anyone from the CDC Intelligence service were included.
The virus involved is a single stand RNA one. There are approximately 60 hantaviruses. They break out into old world and new world strains. Five of the patients have had their viruses sequence, that is they have the genetic picture of them. They are all nearly identical, considered a proof that there was a single infection that caused the outbreak. This particular strain is common to Chile and other S American nations, and is a zoonotic, this can spread from animal to human and then capable of spread human to human. All 150 passengers are considered high risk to develop the disease. That is why they will be quarantined for the full expected incubation period, which is very long, up to 42 days from time of exposure. The “new worls” varieties seem to produce a hematological and renal illness. They cause destruction of blood cells and bleeding and kidney failure. The old world variety is responsible for the cardiac illness, that which this current virus is responsible.
The initial infection is likely to have jumped from a rodent to a human, it isn’t yet known if the human index case was infected on the ship or on land, although it seems as if it is considered more likely that the human came onto the ship already infected. There was no discussion about any attempt at case finding of all contacts of all passengers before boarding the ship.
At the present time, we have to be very humble about how little we know about the epidemiology of the virus. We do not know how long a viral particle may persist on surfaces, it does appear to be spread via respiration, but we do not know if an asymptomatic, infected person can spread the virus. We need to learn from this event, hopefully the WHO will coordinate the efforts, since US CDC seems to not be taking any sort of lead role. Scientists have not characterized the immune response in the human host. We do know that the anti-viral agent ribavirin has been studied and is ineffective as is high dose steroids.
The WHO suggests repeated viral testing for those at risk. Currently, if someone has symptoms but is viral negative they are considered to not have disease but the testing should be repeated. Again it is unknown if an asymptomatic patient may have viremia, virus duplicating in their body, and if it can be spread.
We do not understand why the virus seems so much more common in some geographic locations than other, why not seen in NY City? We do know that patterns of geographical distribution of other diseases is changing due to climate change, so we cannot depend upon current geographical limitations.
It will be difficult to follow the information as it develops since the US seems to have abrogated its former role as leader in infectious disease to other countries and the WHO which we are no longer a member of.
80-89, M
