Concerns Over Hantavirus Exposure from Cruise Ship

A resident of Manhattan who was aboard the cruise ship linked to a hantavirus outbreak moved around freely after disembarking, raising alarms since the U.S. Centers for Disease Control and Prevention (CDC) did not inform health authorities in New York of her exposure, as noted by officials in both New York City and the state.

This woman, who holds dual citizenship in New Zealand and the U.S., was one of 30 passengers to leave the MV Hondius while it docked at Saint Helena island in late April, shortly after one passenger died from a severe strain of hantavirus. Tragically, two more passengers passed away shortly thereafter—one on the ship and another in a South African hospital. By the time the ship garnered international attention, the woman was already continuing her travels around the globe.

While the CDC did alert some states about individuals who may have been exposed, they notably failed to notify New York officials regarding this traveler.

There’s no evidence suggesting that she planned to return to the U.S. anytime soon. Instead, she continued a multi-continent journey, prompting concerns about the virus’s potential spread. Dr. Abraar Karan, an infectious disease expert from Stanford, expressed the need for awareness about her potential return to New York. “If she’s out there, we should know where she might show up,” he said.

Reports indicate that the 75-year-old former pharmaceutical executive resembles a passenger who is currently in quarantine in Taiwan. Her travels were highlighted in a piece by Intercept contributor Jacqueline Sweet.

The situation was complicated by her dual residency, which muddled lines of communication about her exposure. A representative from the New York State Department of Health mentioned that after contacting the CDC about this issue, they discovered that the agency had informed a different state about her exposure, although that state wasn’t identified. Interestingly, records indicate she is registered to vote in Fort Lauderdale, Florida, yet she refers to her Manhattan apartment as her home on social media.

The CDC and the Florida Department of Health did not respond to inquiries about the situation. Nonetheless, Florida has not announced any monitoring for local residents who may have been exposed.

Multiple states, including New York, California, Arizona, Washington, Georgia, Virginia, and North Carolina, reportedly identified residents with possible exposures. Some states claimed they were alerted by the CDC, while others noted that individuals self-reported. At present, all 18 U.S. citizens who flew back directly from the cruise are quarantined across facilities in Omaha, Nebraska, and Atlanta, Georgia. Additionally, another 16 individuals who traveled on the same plane as a woman evacuated to Johannesburg are currently under observation.

From Cruise Ship to Global Travel

The outbreak initially took place aboard the MV Hondius, a cruise ship known for its specialized polar tours, appealing to wildlife enthusiasts and deep travelers who are willing to spend considerable amounts for unique experiences.

A Dutch traveler fell ill on April 6 and later died on April 11. Following her husband’s death, his 69-year-old wife disembarked on April 24 and subsequently died in South Africa. A third passenger died shortly after the World Health Organization declared the outbreak on May 2, coinciding with the revelation that hantavirus was the cause.

The CDC has faced criticism for its delayed reaction, holding its first briefing about the situation a week after the WHO’s announcement of the hantavirus deaths. The Andes strain, which is transmitted in South America, presents initial symptoms that can easily be misidentified as typical viral infections, complicating early detection efforts.

Dr. Karan emphasized the importance of proper quarantining to prevent the outbreak from expanding further. He remarked that having occurred on a cruise ship helped to identify the problem quickly, but monitoring individuals after they leave proves to be a challenge.

A significant concern arises from the nature of the cruise passengers, many of whom belong to a group known for adventurous travel. Despite the heightened awareness surrounding the outbreak, some have still embarked on extensive journeys globally.

After departing the ship, the Manhattan woman’s travels included flights to Johannesburg, Hong Kong, and Bangkok. In Turkey, she reported shuttle travel across the city before ferrying to various locations, with her last post prior to the Taiwan quarantine being from Hanoi, Vietnam.

She was among those who disembarked at Saint Helena before the outbreak declaration, prompting urgent efforts from global public health officials to reach all potentially exposed individuals.

Alina Chan, a molecular biologist, noted that the selection of passengers for the cruise could have led to a higher risk for virus spread, especially if someone with symptoms presented at an international hospital unaware of the ship exposure.

While most health officials do not expect this hantavirus outbreak to escalate into a pandemic, the incubation period poses a risk. It can range from four to 42 days, meaning travelers could spread the virus before exhibiting severe symptoms. Consequently, global health authorities are scrambling to identify and inform affected passengers.

As the case with the Manhattan traveler illustrates, the communications between the CDC and local health departments have proven inconsistent. While the CDC did alert many states about potential exposures, it appears that the traveler fell through the cracks, with substantial delays in communication highlighted by the inquiries made by Sweet.

Subsequently, New Zealand authorities mistakenly reported that this passenger was solely a New Zealand citizen. However, after further inquiries, it was clarified that she resides in the U.S. and communications with her were initiated as health officials worked to reach out to her.

The latest reports indicate that a resident, initially identified as from California, has surfaced on Pitcairn Island after traveling from Saint Helena. Her health status was unknown prior to embarking on her travels, and she is now in quarantine on the island.

Officials from the California Department of Public Health pointed to existing notices on monitoring the hantavirus without providing detailed updates. Chan suggested that the WHO should compile a comprehensive list of all passengers to inform countries about exposures. The communication challenges during this outbreak demonstrate the need for better preparedness in the future.