Hantavirus Exposure: Quarantine Update for Cruise Passengers
Some of the 18 American cruise ship passengers who may have been exposed to hantavirus will be released from a quarantine facility on Monday, after almost three weeks in isolation.
However, federal officials have indicated that these passengers must remain at home and be monitored by local health or law enforcement for an additional three weeks. This extended supervision is quite beyond what is usually required in public health situations.
“It seems the C.D.C. wants someone local to ensure the individual stays at home,” said Steven Hyman, a lawyer for two New York passengers, based on information from his clients.
Earlier this week, it looked like Mr. Hyman’s clients wouldn’t be able to leave the National Quarantine Unit in Nebraska. Yet on Friday, Dr. James McDonald, New York’s health commissioner, announced they could fly home on a private flight and isolate there until June 22.
He did not mention if they would face continuous oversight from state authorities.
Federal health officials didn’t respond to queries regarding release conditions, but the Department of Health and Human Services stated that “the C.D.C.’s top priority has been the health and safety of the returned U.S. passengers and American communities.”
It’s still unclear how many passengers will leave Nebraska on Monday. Some, including a third New York passenger, have shown a preference to stay in quarantine until the complete 42-day incubation period has passed, in case any symptoms arise. None have shown symptoms so far.
The 18 passengers are part of a group who were on a cruise ship linked to a global hantavirus outbreak this month. After being repatriated from the Canary Islands on May 11, they have been under observation in federally funded facilities, and so far, they do not appear to have contracted the virus.
On Wednesday evening, officials from the C.D.C. first requested states to place a law enforcement officer outside the homes of these passengers if they left the facility. This plan was later changed to require 24/7 monitoring by a health worker after states raised concerns about costs and authorizations surrounding that level of oversight.
The restrictions imposed by the Trump administration significantly surpass the protocols used during a 2018 hantavirus outbreak.
At least two passengers received federal orders from Jay Bhattacharya, the interim C.D.C. director, to remain in the quarantine center until at least Sunday, coinciding with the end of the 21-day period when symptoms are most likely to develop.
This was unexpected for many public health experts, as the orders conflicted with earlier suggestions allowing them to self-isolate at home after initial testing. The protocols also seemingly contradict the philosophies promoted by Dr. Bhattacharya and health secretary Robert F. Kennedy Jr., who have argued for more individual freedoms and fewer restrictions.
Others who left the cruise before the outbreak was recognized, or who were in close contact with someone who died later, have been permitted to quarantine at home.
During the previous hantavirus outbreak in 2018, many individuals who might have been exposed were allowed to monitor their own symptoms at home for 42 days, and none fell ill.
Caitlin Rivers, an epidemiologist with the Johns Hopkins Bloomberg School of Public Health, noted that constant monitoring for those possibly exposed to hantavirus isn’t typical. She mentioned that allowing quarantining at home with periodic check-ins would be an appropriate measure, but the insistence on 24/7 monitoring is unprecedented. “I’ve never encountered that approach, and it seems excessive,” she remarked.
Hantavirus is a rare type of virus commonly associated with rodents. The World Health Organization recognized the Andes subtype, which can be spread among those in close contact, as the variant involved with the cruise passengers.
The outbreak began on the MV Hondius, a Dutch-registered ship that started its voyage in Argentina in early April. Three passengers subsequently died from the virus, with others becoming ill or testing positive. Thus far, the C.D.C. hasn’t confirmed any cases of the Andes virus in the U.S. stemming from this outbreak.
A total of 16 people began their quarantine in the Omaha unit on May 11, with two more starting their quarantine in Atlanta before joining the others in Nebraska, raising the total to 18.
Meanwhile, at least seven other Americans who left the cruise early and traveled home commercially have mainly been monitored at home, receiving daily check-ins from local health workers, either virtually or in person. Dr. Rivers expressed confusion about the differing protocols for these individuals compared to those who remained in the quarantine unit.
“It seems like there are different rules or different approaches regarding how the passengers have been handled,” she observed.
