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Chapter 1: What is the main topic discussed in this episode?
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Chapter 2: What is the background of the cruise ship hantavirus outbreak?
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It's been a long ordeal for those who embarked on a cruise across the South Atlantic in early April, and it's not over yet. Ships' passengers are being repatriated across the world after potential exposure to hantavirus, which caused the death of three passengers. Among those heading home are four Australians, who will soon be placed in a quarantine facility in Western Australia.
Chapter 3: How did the hantavirus spread among cruise ship passengers?
Today, epidemiologist Rainer McIntyre from UNSW on everything you need to know about Hantavirus. I'm Sam Hawley on Gadigal land in Sydney. This is ABC News Daily. Raina, I want to start where this virus outbreak began because it will give us a real sense of how dangerous it is and how widely it can spread. A cruise of a lifetime tainted by a deadly outbreak.
Almost 150 passengers were on board the MV Hondias, including four Australians. Three people have been confirmed dead so far.
Passengers are being evacuated from a cruise ship hit by a hantavirus outbreak after it was finally able to dock at the Spanish island of Tenerife.
On Monday local time the final passengers were evacuated with officials from the World Health Organisation overseeing the operation.
Because of the interaction while they were still in the ship we would expect more cases.
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Chapter 4: What are the symptoms and dangers of hantavirus?
Now it's thought the initial victims, a couple from the Netherlands, may have contracted the virus at a rubbish dump in Argentina. What do we know about that?
We can't say definitively where they acquired it. On probabilities, it's likely they picked it up in Argentina because they'd actually... been travelling around Argentina but also Uruguay and Chile since November.
Chapter 5: How is hantavirus transmitted from animals to humans?
But when you look at the incubation period of the virus and the husband got ill on the 6th of April, that's when he started feeling unwell, the likelihood is that he picked it up somewhere in Argentina and there's been speculation about a rubbish tip on the island where the cruise set off but the local health authorities have denied it.
And by the way, that rubbish tip, just to explain that, is a bird watching area. So that's why people would actually go there. A hantavirus, it has been detected, hasn't it, in Argentina before? There has been an outbreak there.
Yes. In fact, Argentina is one of a small handful of countries that has the Andes variant of the hantavirus, which is the only one that's documented to spread from human to human. Right. And the incidence of hantavirus seems to have been going up last year. So there was an uptick in cases and outbreaks last year, which was a bit of a warning sign that this could be a risk for travellers.
And it's a virus spread by rats. Just explain that.
Yeah, so hantaviruses typically are first spread from rats to humans through their excreta, both urine and faeces, and those can get aerosolised in dust particles and so on and breathed in, or occasionally from touching contaminated stuff, but usually it's thought that it's breathed in. It occurs around the world, but the European and Asian cases of hantavirus are a different category.
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Chapter 6: What measures are being taken for the repatriation of affected passengers?
hantavirus and they're not as severe. It's the Andes virus that causes the most severe illness.
Right. And as you said, that can spread between person and person. Is that close contact is needed or how is that transmitted?
It's spread through the air, through respiratory aerosols. So it's inhaled. We don't have data to say, you know, close contact. Certainly the last big outbreak of Andes hantavirus in 2018, which was also in Argentina, was but a different type of the Andes virus.
Chapter 7: How does Australia plan to manage the quarantine of returning passengers?
The Andes virus also has what's called clades. That was a clade two outbreak. And this has just been characterised as clade three. That outbreak in Argentina in 2018, there were 34 cases and there was very clear evidence it was spread through the air.
Wow. Okay. And in that case of the 34, there were 11 deaths. Now, this Dutch couple, they then continued their travels, of course. They were among the 146 people, including crew, who embarked on a luxury cruise ship, which left Argentina on April the 1st. Ten days into this cruise, the 70-year-old Dutchman who became very ill on board, he died.
But alarms about an infectious disease weren't really raised, were they, until a bit later when his wife died.
also became ill that's correct from what i've read the captain assumed it was all you know he was advised it was a non-infectious death and he made an announcement to the passengers that someone had died and that it you know it was from non-infectious causes good morning everybody i'm told by the
He did not raise the possibility of an infectious disease and so a whole lot of passengers condoled with the widow who was potentially, you know, incubating the illness or had infection already.
Right, and sadly his wife also died and then several other people became ill and then on the 2nd of May a German woman also died. What a terrible plight for the passengers. One of them actually posted a video on social media and you could just tell how anguished he was.
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Chapter 8: Why is the hantavirus outbreak not expected to lead to a pandemic?
Just tell me, Raina, how does this virus actually cause death?
So the Andes virus causes pneumonia and cardiac complications as well. So it's a cardiorespiratory syndrome. It's called Hantavirus pulmonary syndrome. It's quite severe and, you know, people have difficulty breathing, but you can also get fluid on the lungs and it's severe enough to cause death in anywhere from 30% to 50% of people with it.
Wow. Oh gosh, okay, so much higher death rate than something like COVID. Orders of magnitude higher. There are, of course, a number of people who are continually testing positive now for this virus. But there were, as we said, 146 people on board. So is that a large number or is that looking pretty good?
I think we can expect to see more cases popping up in the next couple of weeks, possibly, you know, even in the next month or two. Because remember, there's been
Other people who've been exposed more recently during medical evacuations and so on, such as in South Africa, there's been healthcare workers, paramedics, passengers on aeroplanes, because some of the people who got infected were on commercial airlines, including the Swiss patient went back to Switzerland and then heard about it on the news. And presented with symptoms.
With any travel-related outbreak, there's always the possibility of dispersal around the world. And the other interesting point is that the cases that tested positive in the US and Spain were asymptomatic at the time they tested positive. You know, it's not a super common disease like influenza or COVID, so we don't have
as much research about it, but from what's known, we can't rule out asymptomatic transmission, which makes the whole outbreak control a bit more difficult if that's a factor.
So, Raina, let's talk about the response now. The cruise ship arrived in the Canary Islands in Spain on the weekend to allow those on board to be repatriated. There was about 90 people still on board and, of course, four of them are from Australia. Another is a permanent resident here and another is from New Zealand.
Now, they will be coming back here, but the Health Minister, Mark Butler, has announced they will have to quarantine for three weeks.
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