The U.S. Centers for Disease Control and Prevention is sending staff to the Canary Islands to meet the cruise ship at the center of a hantavirus outbreak that global health authorities are racing to contain.
There, they are expected to help facilitate the next leg of the journey for 17 American passengers on board the vessel.
That destination: high-tech quarantine facilities in Omaha, Neb., that include a unit used in 2014 to monitor U.S. citizens with Ebola and again in 2020 for Americans returning from Wuhan, China, and from the Diamond Princess cruise ship stricken with Covid-19 at the start of the pandemic.
Public-health officials in states including Virginia, Texas and Georgia are now monitoring other Americans who got off the ship before authorities confirmed the outbreak. States like New Jersey are watching people who shared flights with cruise passengers who later were diagnosed with the virus.
As of Friday, none of the passengers currently aboard the MV Hondius were showing signs of hantavirus, the rare infection carried by rodents that has so far killed three people and infected five others aboard the Hondius. But the contagion risk is still a mystery. There are confirmed cases among those who already left the boat and questions swirling over possible exposures on flights, pressuring U.S. health officials to escalate their strategy to halt its spread.
The Hondius is expected to dock early Sunday local time at Tenerife, the largest of the Canary Islands in Spain, according to the ship's operator, Oceanwide Expeditions. The State Department is organizing a repatriation flight to bring the Americans still on board the ship back to the U.S., a spokesperson said. Another CDC team will go to a Nebraska Air Force base to meet the flight on its return, the agency said Friday.
The American cruise ship passengers will be quarantined at the University of Nebraska Medical Center's National Quarantine Unit, the center said. The 20-room facility is the only quarantine facility funded by the federal government in the U.S., and its rooms are equipped with personal bathrooms, exercise equipment, Wi-Fi and special ventilation systems, according to the center. It was funded by a nearly $20 million federal grant.
The facility looks more like a hotel than a hospital, said Dr. Gaby Frank, director for the Center for Special Pathogens at Johns Hopkins Hospital.
Nurses and physicians trained in infection control staff the quarantine center. If any cruise ship passengers develop symptoms while in quarantine, they will be moved to the nearby Nebraska Biocontainment Unit -- a facility isolated from the rest of Nebraska's medical center designed to treat patients infected with highly hazardous communicable diseases, according to Nebraska Medicine.
Scientists confirmed that the rare Andes variant of hantavirus is the source of the outbreak on the ship. It is the only form of the disease carried by rodents that can be transmitted between humans. Normally, humans can only transmit it to one another through very close contact, like sharing food or living quarters, according to infectious disease specialists.
The World Health Organization said two passengers who later died from hantavirus boarded the vessel after traveling through Argentina, Chile and Uruguay on a bird-watching trip that included visits to areas where rats known to carry the Andes variant live.
The quarantines for returning travelers could end up being lengthy. Argentina, which deals with this strain of hantavirus more than most countries, sets guidelines based on a person's exposure. The incubation period is around six weeks, or 42 days. U.S. public health officials might take guidelines from Argentina into account when determining how to handle the ship's passengers or any others who might have been exposed, Frank said.
"The monitoring can be a little more intense or less intense," she said. If a person was at high risk of exposure, she said, that person would likely be asked to have no contact with any other person until the roughly six-week incubation period has passed.
That said, a person with a lower-risk exposure might only need to check in with public-health officials by phone once a day. In Texas, for example, the state's health department said two residents who were aboard the ship are now checking their temperatures daily and agreed to contact public-health officials if they start to show any symptoms.