Five Cruise Passengers Cleared for Home Hantavirus Monitoring

Five of the 18 American cruise passengers quarantined in Omaha after exposure to Andes hantavirus aboard Oceanwide Expeditions’ MV Hondius were cleared Monday to go home and complete monitoring outside the University of Nebraska Medical Center. U.S. health officials said the five remained symptom-free and met the criteria for transfer from the National Quarantine Unit to home-based oversight.

The decision leaves 13 of the Hondius passengers in Nebraska about three weeks after the group arrived following a South Atlantic outbreak that the World Health Organization has linked to 13 confirmed or probable cases, including three deaths. The CDC said no Andes virus cases have been confirmed in the United States, and a Nebraska Medicine spokesperson said none of the passengers in Omaha has developed symptoms.

The UNMC quarantine unit has 20 rooms, putting the Hondius group close to the facility’s stated capacity before Monday’s releases.

Home monitoring shifts to state oversight

Federal officials arranged transportation for the departing passengers in coordination with state and local authorities. Health officials said the travel would not use commercial flights and would include appropriate biocontainment measures.

State health departments will conduct daily symptom checks, maintain round-the-clock oversight and provide guidance through the rest of the monitoring period. Two passengers returned to New York, two were bound for California and one arrived in Oregon, state health authorities said.

New York State Health Commissioner Dr. James McDonald said the two returning passengers are under quarantine orders requiring them to remain at their residences, avoid contact with others and participate in local monitoring. “It is important to emphasize that there is no immediate risk to the public,” McDonald said.

A sixth passenger expected to leave Monday remained at UNMC because the person’s home state had not agreed to federal monitoring requirements, the CDC said. The CDC has required receiving states to station law-enforcement or public-health personnel outside the homes of passengers who complete monitoring away from the facility.

Some passengers remain in Omaha by choice or order

Among those staying in Nebraska is Jake Rosmarin, who wrote Sunday that he planned to finish the quarantine period at the Omaha unit because he would have immediate access to care if he became ill. “For me personally, this experience has been incredibly traumatic,” Rosmarin said, adding that he did not want to leave until he was confident he posed no risk to others.

The Nebraska quarantine has also involved legal enforcement. About a week after the passengers arrived, U.S. health officials issued quarantine orders for two passengers who wanted to leave the facility.

Outbreak remains under extended monitoring

Health officials are monitoring the passengers because symptoms have appeared as late as 42 days after exposure in previous outbreaks. Some medical experts say most people who become ill develop symptoms within 21 days.

Hantaviruses typically spread when people inhale contaminated material from rodent droppings or urine. The Andes virus involved in the Hondius outbreak is different because it may spread between people in rare cases, generally after close contact with someone who is symptomatic.

The Hondius departed Ushuaia, Argentina, on April 1 for a South Atlantic itinerary and later disembarked passengers in Tenerife in Spain’s Canary Islands; Oceanwide said earlier that 87 guests and 35 crew members from 22 countries had left the vessel for repatriation, while the ship continued toward the Netherlands with 25 crew members and two medical professionals on board.

The CDC said some of the passengers still in Omaha may leave in the coming weeks to complete monitoring at home. UNMC physicians had said those decisions would be made individually, based on each passenger’s health status and whether the receiving jurisdiction has an acceptable monitoring plan in place.