ALBUQUERQUE, N.M. — A rodent-borne disease is suspected to have caused an outbreak on a cruise ship, killing three people and sickening others.
Research shows that hantaviruses have been around for centuries, with outbreaks recorded in Asia and Europe. In the Eastern Hemisphere, it has been linked to hemorrhagic fever and renal failure. In the early 1990s, a previously unknown group of hantaviruses emerged in the southwestern United States as a cause of an acute respiratory illness now known as hantavirus pulmonary syndrome.
The disease gained attention last year after late actor Gene Hackman’s wife Betsy Arakawa died from hantavirus infection in New Mexico.
The World Health Organization said in a statement on Sunday that a detailed investigation into the cruise ship outbreak is underway, including further clinical testing and epidemiological investigations. The sequence of the virus has also been determined.
This virus is spread by rodents and, rarely, by humans.
Hantaviruses are spread primarily through contact with rodents and their urine, saliva, and feces, especially when the material is disturbed and becomes airborne, creating an inhalation hazard. People are commonly exposed to hantavirus around their homes, cabins, and huts, especially when cleaning enclosed spaces with little ventilation or exploring areas with rat droppings.
The WHO says hantaviruses can also spread directly from person to person, although it rarely happens.
The Centers for Disease Control and Prevention began tracking the virus after a 1993 outbreak in the Four Corners region, an area where Arizona, Colorado, New Mexico and Utah meet.
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Astute doctors at the Indian Health Service first noticed the pattern of deaths among young patients, said Michelle Harkins, a pulmonologist at the University of New Mexico Health Sciences Center who has studied the disease and helped patients for years.
Most of the U.S. cases are in western states. New Mexico and Arizona are hotspots, Harkins said, likely because rural areas are more likely to encounter rats and humans.
The disease begins with flu-like symptoms
The infection progresses rapidly and can be life-threatening. Experts say it can start with symptoms such as fever, chills, muscle aches and sometimes headaches.
“Early in the disease, you may not be able to tell the difference between hantavirus and influenza,” says Dr. Sonja Bartolome of UT Southwestern Medical Center in Dallas.
Symptoms of hantavirus pulmonary syndrome usually appear 1 to 8 weeks after contact with an infected rodent. As the infection progresses, the lungs fill with fluid and the patient may feel tightness in the chest.
Another syndrome caused by hantaviruses, hemorrhagic fever with renal syndrome, usually develops within 1 to 2 weeks after infection.
Mortality rates vary depending on which hantavirus causes the disease. According to the CDC, hantavirus pulmonary syndrome kills about 35% of those infected, while mortality rates for hemorrhagic fevers with renal syndrome range from 1% to 15% of patients.
There are many unknowns about the disease and its treatment.
There is no specific treatment or cure, but early treatment increases your chances of survival.
Harkins said that despite years of research, many questions remain unanswered, including why the disease is mild for some people and very severe for others, and how antibodies are produced. She and other researchers have been following patients over long periods of time in hopes of finding a cure.
There are “a lot of mysteries,” she said, noting that what researchers do know is that exposure to rodents is the key.
The best way to avoid germs is to minimize contact with rodents and their droppings. Use protective gloves and bleach when cleaning rodent droppings. Public health experts warn against vacuuming or vacuuming, which can introduce virus particles into the air.
— Susan Montoya Bryan
