Two people in Maryland are now being monitored after taking an overseas flight with a passenger, who has tested positive for hantavirus, from the affected cruise ship. Meanwhile, American passengers linked to the outbreak have returned to the United States for quarantine, with one testing positive and another showing symptoms.
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The Centers for Disease Control and Prevention says it is confident in its response, as 11 likely cases are linked to the outbreak.
"We know this virus. It's not novel, and we know what we need to do," said Dr. David Fitter of the CDC, Monday.
Eighteen U.S. residents who were on the ship have returned. Two were transported to the specialized communicable diseases unit at Emory University Hospital in Atlanta, where doctors are evaluating their condition.
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"One is undergoing treatment and the other one is undergoing further evaluation and monitoring," said Dr. Anish Mehta, chief of infectious diseases at Emory University Hospital.
The remaining 16 passengers are in Omaha, Nebraska. One confirmed case is being treated in biocontainment, while 15 others are being monitored in the national quarantine unit.
In New Jersey, health officials are also monitoring two people who were not on the cruise ship but may have been exposed during air travel. Health experts stress that the situation is not comparable to the COVID-19 pandemic and say the risk to the general public remains low.
"There were about seven cases of hantavirus in the U.S. last year, two deaths. Let's compare that to 40 to 50,000 COVID-19 deaths, 45,000 flu deaths, so by comparison, hantavirus, minor," said Dr. Perry Halkitis, dean of the Rutgers School of Public Health.
"What I am seeing is an anxiety, a fear, a panic that we saw during COVID-19 amongst some people. No, it's not rampant yet, but surely people are expressing concern about cruise ships. They're expressing concerns about this disease spreading, and here's why, because this version of the virus, this Andes version of the virus, has person-to-person transmission abilities," Halkitis added.
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Hantavirus is contracted by inhaling particles contaminated with rodent droppings, and officials say that while person-to-person transmission is possible, it is very difficult.
"I do not believe this will be another pandemic like the coronavirus," Dr. Halkitis said.
Still, the public health expert and epidemiologist said individuals should make personal decisions about travel and gathering.
"If it's a risk you're not willing to take, there's probably places you should not go, and maybe a cruise ship is one of those places," he said. "At this point, I don't think there is that need for panic, but at the same time, I don't want to diminish people's feelings because people are right to feel that, and they should be processing it, and talking about it, and getting the correct information that they can to make the decisions that are safe for them."
Officials say three people have died in the outbreak so far, including two Dutch nationals and one German national. Monday, federal officials also sought to reassure the public.
"We have this under control and are not worried about it," said Health and Human Services Secretary Robert F. Kennedy Jr. from the White House.