Hantavirus protocol breach at Dutch hospital as medics race to curb spread

Highlights:

• WHO has confirmed total of nine cases in outbreak
• More cases expected, incubation time is long
• Dutch hospital staff quarantined after protocol breach
• WHO sees no sign of a larger outbreak

A Dutch hospital has quarantined 12 staff members as a preventive measure after blood and urine from a hantavirus patient were handled without observing strict protocols, as medics around the world work to stop the spread of the outbreak.

The 12 will be quarantined for six weeks, the Radboudumc hospital in the city of Nijmegen said, adding that the infection risk was very low and patient care continued uninterrupted.

The quarantining of the medics illustrates the challenge of quickly introducing and implementing stricter protocols needed in hospitals and elsewhere for dealing with the hantavirus strain behind the outbreak that hit the Hondius luxury cruise ship.

The World Health Organization increased its tally of confirmed cases in the outbreak to nine, up by two from the previous day.

The head of the UN agency said more cases could come because of the long incubation period, but that this was not a pandemic, and was nothing like COVID-19.

The virus can be deadly, although it does not spread easily from person to person.

Strict protocols

The Radboudumc hospital admitted its hantavirus patient, a passenger from the cruise ship, on 7 May.

"What happened ... is that strict procedures were followed, but not the very strictest procedures that apply in cases involving this hantavirus," Dutch Health Minister Sophie Hermans told parliament. "The likelihood that staff have been infected as a result is small, but because we know we are dealing with a serious virus, (the hospital) has said: we will play it safe."

"It really is a different situation than with COVID. With the knowledge we have and the measures we are taking, we are confident we can keep this virus under control," Hermans said.

After the last passengers disembarked the ship in Spain's Canary Islands, the Hondius set sail for the Netherlands late on Monday evening with 25 crew, a doctor and a nurse. It is expected to arrive in the Netherlands by 17 May, ship owner Oceanwide Expeditions said.

Three people - a Dutch couple and a German national - have died since the start of the outbreak of the virus, which is usually spread by wild rodents but can be transmitted person-to-person in rare cases of close contact.

Possible we might see more cases

In addition to the nine confirmed cases, the WHO recognises two suspected cases - one person who died before being tested, and one on Tristan da Cunha, a remote South Atlantic island where there were no tests available. So far, all are considered to have been contaminated on the cruise trip, or before boarding the ship.

All suspected cases have been isolated and placed under strict medical supervision, minimising any risk of further transmission, WHO chief Tedros Adhanom Ghebreyesus said.

Tedros warned that more cases were to be expected as there had been "a lot of interaction" between passengers before hantavirus was detected.

"At the moment, there is no sign that we are seeing the start of a larger outbreak, but of course the situation could change and given the long incubation period of the virus, it's possible we might see more cases in the coming weeks."

All passengers who had disembarked the ship at earlier stages in the cruise had been located, Tedros said, adding it was up to their respective countries to implement protocols to prevent the virus from spreading.

Test of international coordination

In the latest report of a potential case, Italy's top infectious diseases hospital said it would examine biological samples from a man who had been in contact with the Dutch woman who died of hantavirus.

Arnaud Fontanet, head of Epidemiology of Emerging Diseases at France's Pasteur Institute, said the hunt for new cases could drag on for months, since the incubation time was up to six weeks. Still, because it does not transmit easily, his guess was that there would be no more than a few dozen more cases in total.

The crisis, though, "is a good way for us to try to test all that has been done since COVID-19," to check how international coordination works, he told Reuters.

Spain announced late on Monday that a Spaniard had tested positive, one of 14 quarantining at a military hospital in Madrid. It said on Tuesday that definitive tests had confirmed negative results for the 13 others in quarantine.

The confirmed cases also include a French passenger who tested positive after the ship docked in the Canary Islands on Sunday and was in intensive care but in a stable condition.

US Department of Health and Human Services officials said on Monday that 18 passengers from the Hondius were flown back to the US and quarantined, with the one passenger who tested weakly positive now in a Nebraska biocontainment unit.