Another Webinar re: Hanta
Presented by Iris Gorfinkel, faculty at McGill School of Medicine:
Cruise ship situation and public health response
The video describes a cruise ship outbreak in which multiple passengers became ill and several died, with quarantine measures implemented onboard while arrangements for evacuation and reception were made.
Onboard mitigation includes staying in cabins, avoiding indoor gatherings, and masking in common areas.
[00:00]
What hantavirus is and how exposure happens (including on ships)
Hantaviruses are RNA viruses carried by wild rodents (rats/mice), which can be inadvertently brought onto ships with supplies at port stops.
Rodents shed virus in urine, droppings, and saliva; humans are infected mainly by inhaling aerosolized contaminated dust (e.g., sweeping/vacuuming in enclosed spaces) or by touching contaminated surfaces and then touching eyes/nose/mouth.
[00:49]
Incubation and clinical presentation
Incubation is typically 2–3 weeks after exposure but can be over a month.
Early symptoms mimic influenza: sudden fever, chills, headache, dizziness, severe fatigue, and myalgias (often back/hips/legs), with possible GI symptoms (nausea, vomiting, diarrhea, cramps).
In “New World” hantavirus pulmonary syndrome, some patients rapidly develop severe shortness of breath as lungs fill with fluid, with dry cough/chest tightness; hypotension and septic shock can occur.
“Old World” disease (Europe/Asia) is described as high fever with bleeding under the skin and kidney failure; a key diagnostic clue for either form is rodent (or rodent-excreta) exposure.
[00:49]
Person-to-person transmission: the Andes exception
Person-to-person spread is generally not expected for most hantaviruses, supported by long-term follow-up showing no transmission to healthcare workers or household contacts.
The major exception is Andes hantavirus (South America), which can transmit between people, though typically limited to close household or intimate contacts; this is the form suspected in the cruise ship event (per WHO, as stated in the video).
[00:49]
Frequency, severity, and treatment limitations
The video emphasizes that hantavirus infection is rare in the Americas (about 200 cases/year across North and South America combined) but can be severe.
No vaccine and no proven antivirals are noted; care is supportive.
Reported mortality: ~40% for New World hantavirus pulmonary syndrome and ~15% for Old World disease; early recognition and aggressive hospital supportive care are highlighted as important for improving survival.
[00:49]
Prevention and safe cleaning to reduce risk
Prevention focuses on rodent control (sealing holes/gaps to keep rodents out) and avoiding aerosolization of contaminated dust.
When cleaning areas with droppings/nests: do not sweep or vacuum; instead ventilate, wear gloves and an N95, wet the area with disinfectant/bleach solution, and double-bag waste.
[00:49]
Follow-up questions...
When should clinicians escalate to ICU for hantavirus?
Are there any FDA-approved antivirals for Andes hantavirus?
What control steps prevent hantavirus spread on ships?
Cruise ship situation and public health response
The video describes a cruise ship outbreak in which multiple passengers became ill and several died, with quarantine measures implemented onboard while arrangements for evacuation and reception were made.
Onboard mitigation includes staying in cabins, avoiding indoor gatherings, and masking in common areas.
[00:00]
What hantavirus is and how exposure happens (including on ships)
Hantaviruses are RNA viruses carried by wild rodents (rats/mice), which can be inadvertently brought onto ships with supplies at port stops.
Rodents shed virus in urine, droppings, and saliva; humans are infected mainly by inhaling aerosolized contaminated dust (e.g., sweeping/vacuuming in enclosed spaces) or by touching contaminated surfaces and then touching eyes/nose/mouth.
[00:49]
Incubation and clinical presentation
Incubation is typically 2–3 weeks after exposure but can be over a month.
Early symptoms mimic influenza: sudden fever, chills, headache, dizziness, severe fatigue, and myalgias (often back/hips/legs), with possible GI symptoms (nausea, vomiting, diarrhea, cramps).
In “New World” hantavirus pulmonary syndrome, some patients rapidly develop severe shortness of breath as lungs fill with fluid, with dry cough/chest tightness; hypotension and septic shock can occur.
“Old World” disease (Europe/Asia) is described as high fever with bleeding under the skin and kidney failure; a key diagnostic clue for either form is rodent (or rodent-excreta) exposure.
[00:49]
Person-to-person transmission: the Andes exception
Person-to-person spread is generally not expected for most hantaviruses, supported by long-term follow-up showing no transmission to healthcare workers or household contacts.
The major exception is Andes hantavirus (South America), which can transmit between people, though typically limited to close household or intimate contacts; this is the form suspected in the cruise ship event (per WHO, as stated in the video).
[00:49]
Frequency, severity, and treatment limitations
The video emphasizes that hantavirus infection is rare in the Americas (about 200 cases/year across North and South America combined) but can be severe.
No vaccine and no proven antivirals are noted; care is supportive.
Reported mortality: ~40% for New World hantavirus pulmonary syndrome and ~15% for Old World disease; early recognition and aggressive hospital supportive care are highlighted as important for improving survival.
[00:49]
Prevention and safe cleaning to reduce risk
Prevention focuses on rodent control (sealing holes/gaps to keep rodents out) and avoiding aerosolization of contaminated dust.
When cleaning areas with droppings/nests: do not sweep or vacuum; instead ventilate, wear gloves and an N95, wet the area with disinfectant/bleach solution, and double-bag waste.
[00:49]
Follow-up questions...
When should clinicians escalate to ICU for hantavirus?
Are there any FDA-approved antivirals for Andes hantavirus?
What control steps prevent hantavirus spread on ships?
80-89, M
