Americans on the cruise ship at the heart of adeadly hantavirus outbreakWe are set to go into quarantine on Monday, May 11, following their evacuation back to the United States.
Eighteen Americans stepped off theMV HondiusAfter arriving in Tenerife, Spain, on Sunday, May 10, the U.S. Department of Health and Human Services stated. They boarded a repatriation flight back to the United States, where they will go through an Air Force base before being admitted to the National Quarantine Unit at the University of Nebraska Medical Center.
Two of the Americans are thought to be affected - one who tested positive and another who is experiencing "mild" symptoms,USA TODAY previously reported.As global health officials work to manage an outbreak that has affected at least 9 individuals, with three fatalities reported, the virus's extended incubation period presents difficulties for quarantine efforts.
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Hantavirus is usually spread to humans by coming into contact with rodents' urine, droppings, or saliva. The strain involved in the outbreak has been identified as theAndes virus, which is thought to transmit from person to person, according to theWorld Health OrganizationIn certain instances, it may take several weeks or even months for an individual to develop illness following contact with the virus.
How long will it take to determine if individuals who are ill or might be ill are fully recovered? When will we have a clear understanding of the actual number of Americans who were infected by the virus? Here's what you need to be aware of.
What does the incubation period mean?
The "incubation period" is the time span between when an individual comes into contact with a pathogen, like a virus, and the onset of symptoms. Understanding the incubation period of a disease is crucial for medical professionals and researchers as it helps determine how long it takes for a person to show signs of illness after becoming infected.
Public health professionals also utilize incubation periods to decide how long to monitor an individual for symptoms of infection. For instance, if a person was exposed to a virus that has an incubation period ranging from 4 to 14 days, and they exhibit no signs of illness by the 14th day, this could indicate they were not infected with the virus.
Current hantavirus cases are somewhat more challenging to monitor compared to more prevalent diseases due to their rarity. Specialists have limited knowledge about hantaviruses and related conditions, particularly the Andes virus, and how it might transmit within the U.S., in contrast to something like the flu, which they encounter regularly.
What is the time period between infection and symptom onset for hantavirus?
In response to this outbreak, researchers are using previous data from smaller groups and prior research, according to Dr. Luis Marcos, an expert in infectious diseases at Stony Brook Medicine, who spoke with USA TODAY.
Hantaviruses are known to have extended periods between infection and the onset of symptoms, as per theCDCThe CDC states that symptoms may develop between 1 and 8 weeks. More precisely, the CDC estimates that signs of hantavirus pulmonary syndrome (HPS) typically show up between 1 and 8 weeks following exposure, while symptoms of hemorrhagic fever with renal syndrome (HFRS) usually occur within 1 to 2 weeks; however, in rare cases, symptoms may take as long as 8 weeks to appear.
Olivier Le Polan, head of the epidemiology and analytics unit for response at the World Health Organization,informed reporters on Monday, May 11,that it involves a 3 to 6-week period before symptoms appear, with the majority of individuals likely to experience them within three weeks after exposure.
"That period of incubation suggests that we may witness more cases emerging in the coming days, possibly even next week," he stated.
Why do these responses all appear different? Individuals who choose a longer timeframe may be exercising caution, as much of our understanding of the virus comes from studying smaller outbreaks, Dr. Scott Weaver, director of the Institute for Human Infections & Immunity at the University of Texas Medical Branch and Center Director for the Global Virus Network, said to USA TODAY.
How long following illness can individuals transmit the illness?
Typically, individuals must show symptoms to transmit the illness, according to specialists. Since the Andes virus has not yet been widely seen in the Americas, experts are relying on data collected from outbreaks in other nations.
Research on outbreaks in the Andes region of Argentina and Chile, with the latest study released in 2020, indicates that symptoms may not manifest for as long as 56 days following exposure, according to Marcos. Nevertheless, they still lack complete information.
Keep in mind, these are studies focused on individuals who exhibited symptoms," he stated. "A person without symptoms can still test positive, and no one has ever examined those patients to determine their potential contagiousness.
Nevertheless, he said, the general rule remains.
"Without showing any symptoms, it's highly improbable to transmit the virus to anyone unless there's an exchange of bodily fluids with a close partner," Marcos stated.
Weaver concurred, noting there is "fairly strong evidence" suggesting that few asymptomatic infections occur initially, and individuals with mild symptoms appear to have a low or negligible risk of spreading the virus.
If contagiousness begins with the onset of symptoms, when does it conclude?
People are only contagious for roughly two to three days prior to showing symptoms and then during the time they are symptomatic," Weaver explained. "Therefore, if an individual knows precisely when their symptoms began and who they might have interacted with two to three days before that, they can limit the group of people who need to be tracked.
Mild infections usually go away within a week, he mentioned, whereas individuals who contract illnesses such as hantavirus pulmonary syndrome may become "extremely ill" for up to three or four weeks.
Experts highlight that hantavirus is not as contagious as illnesses such as COVID-19.
It's crucial to keep in mind that hantaviruses are not transmitted in the same way as COVID-19 or the common cold, and typically need prolonged, close interaction, like being stuck on a cruise ship.
Hantavirus is primarily spreadWhen individuals encounter urine, feces, and saliva from rats, as stated by the CDC. The Andes virus can transmit between people, but only through very close contact and the exchange of bodily fluids, such as during sexual activity.
"Unlike measles and SARS-CoV-2, which are very contagious and classified as airborne, the Andes virus does not fall into the same level of transmissibility," said Scott Pegan, a professor of biomedical sciences at the UC Riverside School of Medicine.May 7 Interview with the university news outletAt the peak of the COVID-19 outbreak, an infected individual could, on average, spread the virus to 15–20 people. In comparison, individuals infected with the Andes virus usually transmitted it to less than one person on average.
Senior officials from the World Health Organization have consistently emphasized that the present outbreak does not signal an upcoming major health emergency.
"This isn't the beginning of an epidemic. This isn't the start of a pandemic," said Dr. Maria Van Kerkhove, acting director of epidemic and pandemic management at the WHO.mentioned during a May 7 news briefing.
How is the United States managing individuals who are ill or have been exposed?
Americans evacuated from the cruise shipare staying at a quarantine facility in Nebraska, where they will be observed for any signs of illness. They will remain at the National Quarantine Unit located at the University of Nebraska Medical Center in Omaha, the sole federally supported quarantine unit in the nation.
The time each passenger must remain in quarantine will differ and will depend on an evaluation conducted when they arrive in Nebraska,USA TODAY previously reported.
If passengers are asymptomatic and have not been in contact with anyone showing symptoms, they will be considered low risk. In such instances, passengers may opt to remain at the quarantine facility if they wish. Alternatively, they may be permitted to go home provided they can do so "without exposing others along the way," according to Dr. Jay Bhattacharya, director of the National Institutes of Health.
Travelers returning home will still need to go through a monitoring period, which states such as New York have set at 42 days, in accordance with WHO guidelines.
We have a good chance of containing this outbreak," Weaver stated. "I believe it's highly improbable that the situation will worsen, but it will take a significant amount of time before we can be certain that everyone is safe, as the incubation period is quite extended.
Contributor: Melina Kahn, Eduardo Cuevas, USA TODAY
This piece first was published on USA TODAY:Is hantavirus spreading? We might find out in the "next few days," experts state.
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