Andes Virus Makes Its Way to US: What We Know—and How Public Health Laboratories Are Responding

This is a rapidly evolving situation. Check back for updates. 

[May 19 update]

Federal, state and local authorities continue to monitor American passengers of the cruise ship MV Hondius for symptoms of Andes virus. There are currently no cases of the virus in the US. 

[May 14 update]

Federal, state and local authorities continue to monitor American passengers of the cruise ship MV Hondius for symptoms of Andes virus.  

• To date, there have been no confirmed cases of Andes virus in this country resulting from the cruise ship outbreak. 
• In response to the outbreak, the Nebraska Public Health Laboratory developed a CLIA-validated PCR test specific for Andes, which is available to other public health laboratories. California and the Wadsworth Center in New York State are also on the brink of validating a PCR test. Serology tests can still be used to detect Andes, and all testing should be conducted in consultation with CDC. 
• The Illinois Department of Health is investigating a possible hantavirus case that is not associated with the cruise ship outbreak or international travel. Officials suspect the patient may be infected with the Sin Nombre type of hantavirus, which is found in North America and is not passed from human to human. The individual did have contact with rodents and that is the primary way that Sin Nombre virus is transmitted. Additional testing is being conducted. 

[Published May 12]

The US Centers for Disease Control and Prevention (CDC), along with other international agencies, is responding to a multi-nation cluster of the Andes virus linked to travel on the cruise ship MV Hondius. Andes virus is a type of hantavirus that is spread through contact with the feces, urine, saliva or bite of rodents that carry the virus. However, the risk of Andes virus to Americans is extremely low, says CDC. 

While the Andes virus is the only type of hantavirus that can spread from human to human, it is not easily transmissible, says CDC. The virus is spread via prolonged, direct contact with an infected person. To cut down on risk, experts advise frequent handwashing, avoiding kissing or sharing utensils, drinks, food etc., with anyone who could possibly be infected and to maintain a safe distance (generally 6 feet or more) from infected individuals. The outbreak has been linked to travel on the Dutch cruise ship MV Hondius. Some passengers on the ship had traveled to parts of South America where rodents that carry the Andes virus are typically found.  

CDC is partnering with other federal, state and local partners to coordinate and manage a public health response. 

Andes virus in the US 

On May 11, 17 American passengers (and one passenger with dual American/British citizenship) who disembarked the Hondius arrived in the US after being airlifted from the Canary Islands where the ship ultimately docked. 

Sixteen of those travelers are at the Regional Emerging Special Pathogen Treatment Center (RESPTC) at the University of Nebraska Medical Center; 15 of them are in the quarantine unit where they are being monitored and one, who has tested positive but is not showing symptoms, is in the biocontainment unit. Another American passenger who is symptomatic and their traveling partner are at another RESPTC at Emory University Hospital. Additional Americans who had left the ship prior to its final disembarkation are being monitored in their home states. 

There are 13 RESPTCs located around the country. RESPTCs are federally funded hospitals that can accept and treat patients infected with special pathogens.  

APHL activates response team 

On May 8, APHL stood up an Incident Command System (ICS) to ensure a unified organizational response to Andes virus. The ICS team includes APHL subject matter experts and operations staff to allow for effective coordination and communication between public health laboratories, CDC and other key partners. Through this standardized system, APHL can quickly begin sharing critical information, convening national calls and facilitating resource sharing to support member laboratories in their response efforts. 

Testing for Andes virus 

Andes virus is rare in the US. A more prevalent type of hantavirus seen in this country is the Sin Nombre virus, which is carried by deer mice and is most often seen in the western and southwestern states. 

CDC and some state public health and clinical laboratories can currently conduct IgG and IgM testing for New World hantavirus, which encompasses the Andes virus. The presence of IgM antibodies in a blood sample indicates a recent infection; IgG antibodies indicate a past infection. CDC can perform a PCR test specific for Andes virus but results are for surveillance use only. 

The Nebraska Public Health Laboratory staff worked over the weekend to develop and validate its own PCR test specific to the Andes virus to ensure high-quality testing is available. Other public health laboratories are currently evaluating how best to support testing in their jurisdiction.  

“We are trying to balance being prepared with the recognition that this outbreak is small,” said APHL’s Kelly Wroblewski, senior director, infectious disease, and ICS team science officer. “There are more than enough testing capabilities in the country for the number of people who have been exposed at the moment. But we want to be prepared in the unlikely event this gets bigger.”