Ship of Fools: Hantavirus Cruise’s Lax Infection Control Protocols Bare Need for Greater Vigilance

On April 1, 114 guests and 61 crew members, unaware of the presence of a killer virus among them, boarded the Motor Vessel Hondius. That ship has earned the moniker “Ship of Fools.” Because of the top brass’s reckless disregard of infection control principles, the ship’s passengers and thousands of people around the world have been exposed to the rare Andes strain of the hantavirus, a disease found in rat urine and feces, and which has a 40 percent mortality rate.Among the passengers who boarded that day was a 70-year-old birdwatcher who had spent his final days ashore traipsing through an Argentinian dump covered with rat feces and looking for rare birds. He was looking for species, not feces, but it’s the feces that did him in.On April 11, he dropped dead on board after five days of illness. No tests were done to figure out why he died, even though his wife was there to alert the ship’s staff to his whereabouts before boarding.Instead, several days later, the ship’s command allowed 34 passengers and crew to leave the ship freely at the port of St. Helena and catch planes to destinations across the globe. One of these passengers, the birdwatcher’s wife, became so ill while flying she had to be let off at Johannesburg, South Africa, where she was taken to a hospital and died almost immediately.A Spanish woman on the same flight now has symptoms and is being tested in her home province of Alicante.Health authorities across the globe are scrambling to trace the whereabouts of the passengers who left the ship and are still alive. Some have carried the virus onto airplanes and to big weddings, business meetings, hotels and hospitals in South Africa, the Netherlands, and Switzerland.Officials in Arizona, California, Georgia, New Jersey, Texas, and Virginia are waiting and watching to see if any passengers who disembarked from the ship early and entered America, as well as air travelers who were exposed to them, come down with the infection. The incubation period is up to seven weeks.This mad scramble was preventable. There’s a lot of handwringing over the fact that we don’t have a vaccine or medication to control Andes hantavirus. That’s not the real issue. It is not economically feasible to develop treatments for rarely seen viruses. Scientists report they have vaccines in progress that could be customized for a rare virus. Yet once you’re considering vaccination, infection control has already failed, and the disease has spread widely.The answer is to rigorously follow infection prevention principles. As we invade ecosystems that harbor thousands of untreatable viruses, the key is to isolate anyone showing symptoms of illness, identify the pathogen if possible, and curb the spread. The ship’s commanders blew it, not testing for the cause of the birdwatcher’s death or considering that more passengers might have become infected.The travel industry has to get with it. If customers are being taken to remote places, cruise ships and other travel purveyors need to be aware of the risks and have infection control routines locked into place. Any unexplained illness must be a red flag, particularly when it’s a birdwatcher or other traveler known to have been exposed to the wild.Not until May 2, almost a month later, did the ship’s authorities ask the World Health Organization for help, as more passengers and crew fell ill. Four were quickly evacuated to hospitals. On Sunday, WHO evacuated the remaining passengers, transporting them in sealed buses, wearing masks and infection control suits, to be flown to their home countries on military transport planes.Most of the Americans will be held in the National Quarantine Unit at Omaha, Nebraska. Two who tested positive are hospitalized at Atlanta. The saga, though, is not over yet. Hospitals on multiple continents are now dealing with patients who walked through their doors sick with an unidentified infection. There were no news reports yet about hantavirus. Where hospitals routinely practiced rigorous infection prevention, the virus was likely stopped in its tracks. Yet on Monday, a Dutch hospital disclosed that it is quarantining 12 staff members who handled the blood and urine of a hantavirus patient without taking precautions. Where hospitals were lax, the infection may have spread to other patients and health care personnel. Time will tell.That lesson was driven home in 2003 when two travelers from Asia unknowingly carrying severe acute respiratory syndrome showed up for help at two Canadian hospitals. The patient who went to an emergency room at Vancouver was asked immediately about recent travel, then whisked into an isolation facility and treated by personnel wearing gowns, gloves, goggles and masks. Yet the patient who went to a hospital at Toronto sat for hours in the emergency room, waiting and infecting patients around him, some of whom later died. Then he was treated by medical personnel who failed to take rigorous precautions, such as wearing goggles while inserting a breathing tube. Doctors became infected and took the disease home to their families and neighbors, sparking an epidemic.Global travel makes infection prevention more vital than ever. When it’s ignored, your life is at risk.Creators.com

Ship of Fools: Hantavirus Cruise’s Lax Infection Control Protocols Bare Need for Greater Vigilance

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