U.S. closes hantavirus cruise response amid quarantine questions
HHS says no U.S. cases were found after the MV Hondius outbreak, but officials have not explained strict quarantine orders for some passengers.
By James Whitfield · Staff Writer
3 min read
The U.S. hantavirus response tied to the MV Hondius cruise ship ended without any reported American cases, the Department of Health and Human Services said. The close of the response leaves unresolved questions about why federal officials imposed stricter quarantine rules than international guidance and some state health officials recommended.
HHS announced the end of the response on June 24 in a release dated June 23. According to Ars Technica, the final 42-day monitoring window for U.S. passengers ended June 21.
Health Secretary Robert F. Kennedy Jr. said in the HHS announcement that the agency moved quickly and that federal action prevented sustained transmission in the United States. Jay Bhattacharya, acting director of the Centers for Disease Control and Prevention, said the response prevented new U.S. cases.
CDC officials also held a short briefing after the announcement. Ars Technica reported that officials praised the result but did not directly answer reporters’ questions about the quarantine rules.
Quarantine rules drew scrutiny
The outbreak involved Andes virus, a type of hantavirus that is endemic in Chile and Argentina, Ars Technica reported. Hantavirus transmission has been documented when infected people have symptoms, and the World Health Organization has recommended remote monitoring with daily checks for symptoms and fever based on experience in those countries.
Federal officials required potentially exposed U.S. passengers who were repatriated from the ship to remain either in a federal quarantine unit in Nebraska or, in some cases, at home under local health department supervision. Ars Technica reported that the home option required round-the-clock surveillance and twice-daily in-person fever and symptom checks.
The rules did not apply in the same way to MV Hondius passengers who had already returned to the United States before the outbreak was identified, according to Ars Technica. Of 18 repatriated passengers, five were allowed to go home before the 42-day period ended, and at least four home states accepted the CDC’s conditions.
Florida case became a flashpoint
One passenger held at the Nebraska unit, Angela Perryman, asked to complete quarantine at home in Florida, Ars Technica reported. Florida health officials declined the CDC’s terms and instead proposed remote monitoring with once-daily fever and symptom checks, which they found sufficient.
Federal officials rejected that proposal and ordered Perryman to remain in Nebraska, according to Ars Technica. Perryman appealed, and CDC medical reviewer Michael Bell assessed the case.
In a review obtained by Jeremy Faust of Inside Medicine, Bell recommended rescinding the amended federal quarantine order so Perryman could return home if Florida accepted responsibility for continued monitoring. Bell wrote that once-daily remote monitoring matched the transmission risk linked to Andes virus infection and was consistent with how several other exposed MV Hondius passengers were being handled.
Kennedy later signed an order keeping Perryman in Nebraska, Inside Medicine reported. Ars Technica reported that the order did not explain why Bell’s recommendation was rejected.
At the CDC briefing, reporters repeatedly asked about Perryman’s case and the basis for the federal monitoring requirements. Brendan Jackson, acting director of the CDC’s Division of High-Consequence Pathogens and Pathology, said it was a complex response and that the monitoring requirements were decided across the federal government, Ars Technica reported.
The WHO said in a June 24 briefing that the global outbreak count remained 13 cases and three deaths. More than 650 contacts had been traced across 33 countries and territories, with 54 contacts still in quarantine. WHO said the last quarantine period is scheduled to end July 2, and the outbreak will be considered over if no further cases are found before then.
This story draws on original reporting from Ars Technica.