Americans from hantavirus cruise ship monitored in Nebraska : NPR

Sixteen of 18 passengers transferred to the U.S. from a cruise ship where there was an outbreak of hantavirus arrived in Omaha, Neb., on Monday for evaluation after disembarking from the ship in Spain’s Canary Islands over the weekend.

Of the 15 US citizens and one dual US-British citizen who arrived in Nebraska, all but one are currently being held in a national quarantine unit. That patient has tested positive for the virus and is being housed in a Nebraska biocontainment unit, officials said at a news conference Monday. The 15 people in the quarantine unit will continue to be monitored for symptoms of the disease.

Nebraska may seem an unlikely place to process these individuals, but it is home to the National Quarantine Unit – the only federally funded quarantine unit in the US – and the separate Nebraska Biocontainment Unit. They are highly specialized facilities located at the University of Nebraska Medical Center (UNMC) and are widely considered one of the best in the world.

A $1 million, five-room biocontainment unit was dedicated in 2005. This was a joint project with Nebraska Health and Human Services and UNMC. It has been set up to safely provide medical care to patients with highly dangerous and infectious diseases and was used to treat two doctors infected with Ebola in 2014. According to the Associated Press, the national quarantine unit was completed in late 2019. It cost approximately $20 million. Both facilities were used during the COVID-19 pandemic.

“We are prepared for situations exactly like this,” Dr. Michael Ashe, CEO of Nebraska Medicine, said in a statement. “Our teams have trained for decades with federal and state partners to ensure we can safely provide care while protecting our staff and the broader community. We are proud to support this national effort.”

Two additional American passengers on the cruise ship – a couple, one of whom showed symptoms of hantavirus – were transferred for observation to Emory University Hospital, where another advanced biocontainment facility is located.

When the biocontainment unit was first dedicated more than 20 years ago, the biggest concerns were anthrax attacks and severe acute respiratory syndrome, commonly known as SARS, Dr. Phil Smith, who led efforts at the University of Nebraska Medical Center to build the biocontainment unit, told the AP in 2020. Smith died last year.

The quarantine unit has 20 negative pressure rooms designed to prevent potentially harmful particles from escaping by maintaining air pressure inside the rooms lower than outside. According to the medical center, single-occupancy rooms provide patients with en-suite bathrooms, exercise equipment and Wi-Fi.

“We have protocols in place in the quarantine unit that provide safe care for these individuals, including all activities of daily living so that they can … remain comfortable, but also keep it in an area that is protected and limits the spread of the pathogen,” Dr. Michael Wadman, medical director of the national quarantine unit, said at a Friday news conference.

The biocontainment unit, by contrast, is a patient-care space where people are able to receive medical treatment, Dr. Angela Hewlett, medical director of the biocontainment unit, told reporters on Monday.

He stressed that the facility – which has a capacity of 10 beds – operates independently from the quarantine unit and has its own dedicated air-handling system. “We don’t share it with any of the rest of the facility,” he said, noting that the unit uses HEPA filtration on the ceiling and is designed in a “very different” way than what most people typically imagine in a hospital setting.

Nebraska Gov. Jim Pilen, speaking at a Monday press conference, welcomed the recently arrived patients, who were among about 150 people from 23 different countries who were aboard the MV Hondius when the disease most commonly transmitted to humans spread through contact with infected rodents. As of Monday, the World Health Organization has reported at least nine cases of hantavirus, including three deaths.

“We’re glad you’re here,” Pilen said. “We’re going to make sure you get the best world-class care possible.”

Pilen also tried to reassure Nebraskans that the facilities are safe: “We are working diligently to ensure that no one leaves security in an unsafe manner at an inappropriate time.” “Nobody poses a public health threat walking out the front door onto the streets of Omaha.”

The hantavirus outbreak on the cruise ship has been identified as the Andes strain of the disease, which can spread from person to person, although rarely, according to the Centers for Disease Control and Prevention. It can cause severe respiratory disease with initial flu-like symptoms.

According to Adam Brian Christine, assistant secretary of health at the U.S. Department of Health and Human Services, “The Andes variant of this virus does not spread easily, and it requires prolonged close contact with someone who already has symptoms.” “Nonetheless, we have taken this situation very seriously from the beginning.”

“The risk from hantavirus to the general public is very low,” he said.

The full quarantine period for hantavirus is 42 days, Christine said, but she said patients will be allowed to go home if they show no symptoms.

“At the moment, the passengers who are in the assessment phase – they will stay here for at least a few days while we evaluate and coordinate on what happens next,” he said. He said they had the option to remain in the quarantine facility for the entire period as “the safest and most effective option for them”.