Andes hantavirus: What would make this outbreak...

This is an update on the Andes hantavirus outbreak. Thanks for being here, supporting independent reporting, and for helping spread reliable information! Yesterday, I did an interview on Mo News. Sometimes these interviews do even more than help me reach a wider audience. They help me refine my thinking. In this case, the host, Mosh Oinounou, was circling around a couple of key questions: How worried should we be? What would dramatically elevate my concern? I found myself articulating some familiar concepts, but in more succinct ways than I had previously. Below are two clips, along with some additional context. For our whole conversation, check us out over on Spotify or iTunes/Apple Podcasts. Let me know what you think! In this first clip, I addressed the “How worried should we be?” question by homing in on what the question even means. We all know that this is a deadly disease. So, that isn’t the issue. But that’s also not really what anyone means when asking this question. What they seem to mean is, “How likely is this to become a problem that everyone has to deal with?” Like a Covid-19 scenario that changes the daily lives of most people for a significant period. My answer boiled down to this: Will there be uncontrolled spread or not? At the moment, it seems unlikely. That means that the average person does not currently need to change their behaviors. So that’s good! Take a listen and let me know what you think of my answer in the comments section. Here, I addressed the question, “What would dramatically elevate my concern?” (Or, what would it take for me to change my overall threat assessment regarding the Andes hantavirus outbreak?) Currently, I’m worried for anyone who was on the MV Hondius cruise ship, or those who otherwise had close contact with a known Andes hantavirus case. But, so far, I’m not worried for the rest of us. Here’s why: It all boils down to whether new cases occur among those with what we believe to have been low-risk exposures. Things like casual, brief contact. (Here’s the latest CDC guidance on what counts as high- versus low-risk exposures.) What would change my level of concern would be if we suddenly began seeing many new cases among people who we’d traditionally considered to have had “low-risk exposure” to Andes hantavirus patients. As I told Mosh, we can and should expect there to be more cases among those with high-risk exposures in the coming days and weeks—such as MV Hondius passengers and crew members who were on the ship at the same time as known cases. At this point, that alone is considered to be “high-risk contact.” Notably, the CDC is requiring that Americans who returned from the ship will have to quarantine for 42 days after disembarking. That’s a welcome change from the agency’s initial guidance. We might even see a few sporadic cases among “low-risk contacts.” But if we start seeing lots of cases from seemingly low-risk exposures, then we’d have to rapidly rethink things, and raise our level of concern. In sum, we can expect more cases from those who had “high-risk exposures” to confirmed Andes hantavirus patients. Those people know who they are and are being told they must quarantine appropriately. We might even tolerate a small number of cases from people who seemingly had “low-risk exposures.” But if we see more cases from low-risk exposures than high-risk exposures, then we’ve got a much bigger problem. Again, take a listen and let me know what you think of my answer in the comments section. Please join me in a MedPage Today Live Webinar today, Tuesday May 12, at 5 p.m. ET for the latest from infectious diseases expert and general voice of reason, Dr. B.K. Titanji. •If these don’t work, try the links on MedPage Today. Hemorrhagic fever with renal syndrome hantavirus. Thank you for reading! If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.

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Andes hantavirus: What would make this outbreak far more concerning?