'This is not COVID': A Louisville doctor's message on the Hantavirus outbreak

What is Hantavirus and should Kentuckians be worried? According to a Louisville doctor- no.

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You've probably seen the headlines this week- hantavirus on a cruise ship. And if you're like most people, your first reaction was probably something like: wait, what exactly is hantavirus again, and should I be worried?

According to Dr. Daniel Blatt- a pediatric infectious disease physician at Norton Children's Hospital- this is not another pandemic.

"Hantavirus is a virus that is normally found in rats or rodents," Dr. Blatt said. "It's been around for a very long time."

The outbreak was reported on May 2nd. The World Health Organization has confirmed the strain involved is Andes virus, which can lead to hantavirus pulmonary syndrome, or HPS- a severe and potentially deadly disease that affects the lungs.

But before the alarm bells go off, Dr. Blatt has a message for Kentuckians.

This is not COVID.

"As an infectious disease doctor, I'm always scared about another pandemic," Dr. Blatt said. "But this is not COVID. This is different."

He explained why. COVID was a novel virus that spread easily with minimal contact. Andes virus doesn't work that way. "It requires very close, intimate contact for one human to get it from another human," he said. "And to get it from an animal, you have to be around an animal that's infected- and that's only in South America currently for this particular strain."

His bottom line: "I don't want people to think this is going to turn into another pandemic. It's a public health risk, and that's why we need to monitor people who do have this infection. But it is very different than COVID."

How does it spread?

People usually get hantavirus from contact with rodents- specifically through exposure to their urine, droppings, and saliva. Dr. Blatt explained it further: if that feces or urine gets stirred up, it can become airborne. "You could breathe it in. Or if you touch it and then touch your face, you can get infected that way. But it's not extremely easy to get infected by hantavirus."

What makes the Andes strain notable- and what makes the cruise ship situation particularly unusual- is that it's the one hantavirus strain that can spread person-to-person. The Andes virus is the only type of hantavirus known to spread this way, and that spread is typically limited to people in very close contact- through direct physical contact, prolonged time in enclosed spaces, or exposure to an infected person's saliva or respiratory secretions.

"That's not the main mode of transmission," Dr. Blatt said, "and it's not extremely easy to transmit human to human. You need a lot of very close contact between humans for it to transmit."

He also offered his read on how the cruise ship outbreak likely started. "I would imagine it came from a singular source, not transmitting from person to person to person on the cruise ship," he said. "Knowing how this virus spreads, it probably was a small source of infection that spread to a number of people, rather than one person spreading it to another person spreading it to another."

What does it do to your body?

This is where things can get serious- but context matters.

Early symptoms include fatigue, fever, and muscle aches, especially in the large muscle groups. About half of all patients also experience headaches, dizziness, chills, and gastrointestinal symptoms like nausea, vomiting, and diarrhea. And here's the part that complicates things: symptoms can appear anywhere between 4 and 42 days after exposure- a long window that makes tracking cases more difficult.

Dr. Blatt was clear that the majority of cases are going to look more like a bad flu. "Most of those cases are going to be mild," he said. "A smaller amount of those cases will progress to severe disease, but the vast majority are going to be more mild illnesses."

That context is critical when you see the mortality number that's been circulating. The CDC says 38% of people who develop respiratory symptoms may die from the disease. That number is alarming- but Dr. Blatt says it needs to be read carefully.

"That is not 30-something percent of people that get hantavirus who will die," he explained. "It's of the people that have progressed to severe disease that is the mortality rate they're quoting. A lot of people will have more mild symptoms."

What about treatment?

There's no silver bullet here. There is no specific treatment for hantavirus infection. Patients receive supportive care- rest, hydration, and treatment of symptoms. For severe cases, that means respiratory support. HPS can cause serious breathing difficulties, and some patients may need intubation to help get oxygen to the lungs, according to the CDC.

"The people that get ill, if they need treatment, they need that supportive care early to improve their chances of doing well," Dr. Blatt said.

Should Kentuckians be worried?

The short answer: no- unless you were on that ship.

No cases of Andes virus have been reported in the United States as a result of this outbreak, and at this time the overall risk to the American public remains extremely low.

World Health Organization Director-General Tedros Adhanom Ghebreyesus said the organization could not make countries follow its hantavirus guidelines. "We cannot force countries to take on our protocols; we can only advise and recommend," he said at a press conference.

He added that more cases would likely emerge but that there "is no sign that we are seeing the start of a larger outbreak." However, he added that the situation could change.

What to remember...

One final point from Dr. Blatt that I think is worth sitting with: unlike COVID, this isn't a mystery. "We know what hantavirus is. We've known about this for a while," he said. "It's a known illness, and we're tracking it like every other known illness."

That said- he was also careful to leave room for the unknown.

"Like any infection, things can change," he said. "We do need to keep an eye out for what the public health authorities say in terms of the progression of this, because like any other public health outbreak, the data changes. And that's how medicine and science work, especially in infectious diseases."

The CDC says routine travel can continue as normal. But if you have concerns about potential exposure or feel like something's off, don't wait- call your doctor.

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