Three King County residents connected to international cruise ship in Public Health monitoring for hantavirus

Actions requested

• Identify

  Screen patients with flu-like symptoms for travel within 42 days before symptom onset and be alert for possibility of returning travelers with exposures. Public Health is working with DOH and CDC to identify anyone potentially exposed to the hantavirus cluster linked to the cruise ship in order to monitor them and coordinate healthcare as needed.

  • Include hantavirus pulmonary syndrome (HPS) in the differential diagnosis for an ill person who has compatible symptoms AND who has reported epidemiological risk factors, including at least one of the following, within the 42 days before symptoms onset:
    • Had direct physical contact, or spent time in close or enclosed spaces, with a symptomatic person with confirmed or suspected Andes virus infection or with any objects contaminated by their body fluids.
    • Had exposure to an infected person's saliva, respiratory secretions, or other body fluids (e.g., kissing, sharing utensils, handling contaminated bedding).
    • Experienced a breach in infection prevention and control precautions that resulted in potential contact with body fluids of a patient with suspected or confirmed Andes virus infection.
  • Consider and perform diagnostic testing for more common illnesses as well, such as COVID-19, influenza, and other common causes of gastrointestinal and febrile illnesses in an acutely ill patient with epidemiological risk factors and compatible symptoms.
• Manage

  Be prepared to follow CDC's guidance for Andes virus under Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions.

  • In healthcare settings, for patients with suspected or confirmed Andes virus infection, CDC recommends patient placement in an airborne infection isolation room and the use of a gown, gloves, eye protection, and an N95 or higher-level respirator when entering the patient's room.
  • Early supportive care is critical even before the diagnosis is confirmed. Patients with suspected hantavirus pulmonary syndrome can deteriorate rapidly, and delayed care reduces the chance of survival. In severe cases, extra-corporeal membrane oxygenation (ECMO) can significantly improve survival (up to ~80%) if started early.
• Test

  Call Public Health at 206-296-4774 if hantavirus is suspected to approve and coordinate testing at CDC.

• Notify

  Immediately report suspected cases of hantavirus to Public Health at 206-296-4774.