It Hantas Me: Part I

In this episode (Part I of II), Olivia breaks down Hantavirus: what it is, how it spreads, and why the outbreak aboard the MV Hondius has the world paying attention. She walks through the science of the Andes Virus (the only known Hantavirus strain capable of human-to-human transmission), the full outbreak timeline as of May 13th, 2026, and what key dates to watch in the coming weeks. Spoiler: this is probably not our next pandemic...but it is a warning sign we can't ignore.

Also, Ariel starts us off by sharing her public health good news: FDA Commissioner Marty McCary is out, and we break down why almost nobody is sad about it, but why we're still a little nervous about what comes next.

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In part two (coming soon!), Mattie & Olivia sit down with Dr. Elizabeth Soda, an infectious disease physician and former CDC employee, to discuss how mass federal layoffs and political appointees have dismantled U.S. public health infrastructure — and what that means for our ability to respond when the next serious outbreak hits.

Transcript

Speaker 1 0:07

Welcome to Public Health Group Chat, the podcast where we spend a portion of our free time deciding fun puns for infectious disease names.

Speaker 3 0:18

All views expressed in this episode are our own, and you can find us at Public Health Group Chat on Instagram. We would really love for you to subscribe and rate us because that helps other people find us. And also it gives us information on if you like us or not. And right now, y'all are quiet as hell.

Speaker 1 0:36

Yeah, we did hear one thing from threads about the undeclared stickers, and I am working on it. So everybody wait patiently. Maybe that will be a thing. Is this related to Cialis and Yes? Undeclared todolophil and sedenophil. We're gonna make undeclared todophil and sedenophil stickers. Oh my gosh. That was what the thread reply to you was.

Speaker 3 0:59

Yes. No, I know, I know. I just wanted to clarify for anyone that did not know what was going on. So, yes, there will be stickers about how you might get a boner accidentally. Anyways, today we're gonna be talking about Hantavirus. It's gonna be a special two-part episode. We're gonna tell you exactly what's going on in those episodes in a second, but we should probably also do some public health good news because that's really important these days. So, Ariel, what's up?

Speaker 1:23

What's going on? We do have good news. And if you are tuning in for the first time, my name is Ariel. I'm Mel. Yeah, yeah, yeah. I'm Olivia too. We forgot to do that. Okay, so I do have some good news, although it feels like good news and potentially bad news, depending on what happens next. Um, but it is hot off the press, so I wanted to share. So last night, May 12th, um, today is May 13th, Marty McCary resigned as the FDA commissioner, and he was in that position for 13 months. McCary had been disliked by people across the political spectrum, from hardcore Maha folks to more traditional and sensible public health professionals.

Speaker 3 2:07

Was this the guy that resigned by text message, or is that fake news? Ooh, I don't know. I didn't see anything about resigning by text message.

Speaker 1 2:13

So it's kind of a baller move.

Speaker 3 2:16

I don't know if it's fake news because Trump posted it and it was like, Dr. President Trump, I love you. I have to resign though. So I think it might be fake news.

Speaker 2:26

Um Yeah, the reporting that I saw said nothing about resigning by text, although now I'm like, do I need to go back and read those articles? No, I think it's just because I'm chronically online. Anyway, McCary has been disliked by a lot of people, from the hardcore Maha folks to more traditional public health professionals like ourselves. He upset RFK Jr. by not doing enough to advance the Maha movement. He upset Maha fanatics by approving an updated mRNA COVID vaccine. He disappointed pro-lifers by approving a second generic version of Mephapristone, which is a pill to indisaportion. And then he also made really interesting staffing decisions, including Viney Prasad, who Politico calls a quote, COVID contrarian, and then brought him back to the FDA just a couple of weeks after he was fired. Um and Prasad angered manufacturers of rare drug medications who stated that he moved goalposts for data required to approve them. But anyway, the last straw was McCarry's refusal to approve the sale of fruit-flavored vaping pods. A tobacco executive from RJ Reynolds met with Trump in Florida asking this favor. And I'm no tobacco expert, but I do have a colleague who does this work, and I've learned so much from this person. Anyway, flavored vapes are marketed to children and youth to create lifelong addicted users. They're really bad for you. And there's a whole industry-backed argument about how vapes are for people looking to stop smoking cigarettes and move to a quote unquote safer product. But actually, young people are the ones really being targeted here. So it's interesting to me that this was what he did to get himself pushed out. I mean, I agree with him on this issue completely of the vapes, but he made some questionable decisions along the way. So, like, why start following good science now? I just, I don't get it. And one thing he did, Olivia, I think you mentioned this in a previous episode, was to deny an application from Moderna for their mRNA flu shot last year. He questioned the methodology of a study and damaged trust with the pharmaceutical industry in the bedrock of the regulatory processes for FDA approval. Anyway, I wasn't super impressed with McCary. I think many were not. I'm assuming you two were not. However, he does have a medical degree, I believe, an active license, which are important credentials for this role. Interestingly, MD is not required, although the FDA commissioner role is traditionally held by a physician or scientist. And the new appointed acting commissioner is Kyle Diamantes and Maddie. I know you love Kyle's. You probably won't love this one.

Speaker 1 4:59

Love and Kyle, one singular Kyle.

Speaker 5:03

Well, you liked Kyle and there was a Kyle and Survivor.

Speaker 1 5:06

Kyle and Survivor.

Speaker 5:07

Okay, that's true.

Speaker 1 5:08

You're right. I like two Kyle's.

Speaker 5:10

Yeah. So you're a Kyle fan, but this Kyle maybe does not meet the standard of the other Kyle's So this Kyle was the Kyle was the deputy commissioner for food at the FDA. Diamantes is not a scientist or physician. Before coming to the FDA, he worked as a corporate lawyer for the law firm Jones Day. And anyway, he is viewed as industry-friendly and easier to work with than some other FDA officials by industry people. So I didn't do a super deep dive, but something tells me that he might not have the public's health best interest at heart. Time will tell. I also don't want to assume that just because someone came from industry, they're a bad person. Like I have plenty of friends who are industry scientists. And if they were to come to government or academia, which I know they won't, like I wouldn't question their motives, but because this is the Trump administration, I'm really not too sure about this guy.

Speaker 3 6:04

Yeah, it sounds like he like woke up and I don't know, was visited by the ghost of Christmas past or something and realized that he was potentially in a powerful position that could impact people's health.

Speaker 1 6:14

I still stand by. I think it would be kind of a flex in this day and age to just quit via text message like that is one of my dreams. TTFN disappear.

Speaker 3 6:25

Oh man. Well, I mean, good riddance. Bye. To the gallows.

Speaker 1 6:29

To the gallows. It feels like that, but then it's also like spooky because then it's like, what is this gonna be replaced by?

Speaker 6:37

Exactly. So I'm not really sure what's coming. I didn't do a super deep dive on Diamantas, so I don't know much about his background other than that he was a corporate lawyer before coming to the FDA.

Speaker 1 6:48

It's like the devil you know versus the devil you don't. I'm gonna assume it's not gonna go well at this point. I want to root for a Kyle, but sometimes Kyle's make it really hard to root for them, you know?

Speaker 3 6:59

So the good news is he's gone. The bad news is that there's fruit-flavored vaping pods now FDA approved, which has never been done before. Is that correct?

Speaker 7:09

That is my understanding. I don't know a ton about tobacco. I know that there are flavored products available though, so I'm not sure what is new about these vaping pods versus other flavored products because that's how they get youth is with flavors. So definitely I didn't do my homework too deeply to dive into that.

Speaker 3 7:26

No, I think we should do some sort of follow-up episode for sure about the FDA process for approval and these things.

Speaker 1 7:33

Yeah, that'd be cool. Ariel, you're not like super informed on the process of vapes. I'm shocked. I know, I know. I have another piece of public health good news, and it's my hat. So today's hat. I picked it specifically for the hantavirus episode, and it says, epidemiologists, their charm is infectious.

Speaker 3 7:53

I love it. I love it.

Speaker 1 7:55

Is this a new one or is this one you've had? I've had this one for forever, but I forget that I have it until I was like doing an inventory of my hats and seeing what I had left. And then we were talking about how we were gonna do the hantavirus episode, and I was like, I have to wear it for that. That's perfect. Because I was gonna wear it for measles and I forgot.

Speaker 3 8:10

I really look forward to having a PhDC hat, stickers, mugs in the future made by Maddie, who's fantastic at making mugs. That would be so cool. And yeah, and also guys, future subscriber episodes. We've been talking about that lately. So I think it's a good time to mention that we are going that route in the future and really recommend subscribing if you want to learn more about us and some special topics, some AMAs, and then also topic requests. And you can subscribe right now on Buzz Sprout, where we're which is hosting our podcast. Um, feel free to give whatever you feel is comfortable. We're not asking for a specific amount, but it pays for Maddie's hat fund. So someone's gotta buy these hats. Someone's gonna buy the hats. You know? All right. Are we feeling good about moving on to the hontivirus aspect of this episode?

Speaker 4 9:00

Yes.

Speaker 3 9:00

Hit me with it. Amazing. Let's do it. This is gonna be, like I mentioned, a two-part episode. We are today is gonna be our part one. So we're covering the science and the outbreak itself that's happening from the MV Hondius. And it's gonna be an accurate, up-to-date summary of publicly accessible knowledge about this Hantavirus outbreak. It began on the MV Hondius this past April, a ship that was in Argentina. We're gonna walk through some infectious disease epidemiology concepts that can be hard to follow, whether you've seen them in the news coverage or online or in misinformation recently, and make them understandable as well. And in part two, which is coming shortly, we're gonna be looking directly at how the United States politically appointed leadership has systematically stripped down our public health system and infrastructure to a level that should concern every single person, which is probably why you're listening to us in the first place. We're talking about mass firings of federal workers and a communication breakdown at the institutional level, which we're seeing during this Hantavirus outbreak, and also a leadership structure that has not set this country up for success when that next serious outbreak occurs. So, to put some numbers on that, approximately one quarter of CDC's staff have resigned, retired, or been laid off, with political appointees now filling positions that were previously held by career federal employees. And to help us understand what that actually means on the ground, we'll be joined by Dr. Soda, part two of this episode, a physician specializing in infectious disease who formerly worked at the CDC. Um we were connected with her through an organization called Fired but Fighting. You might know them on threads or on Instagram, or maybe you just knew about them anyways. We want to take a moment to shout them out though, because what they're doing is important. Fired by Fighting is part of the National Public Health Coalition and advocates specifically for workers at the CDC. And their broad mission is to rebuild public health infrastructure at the federal level. Because if you've seen this past year or so, especially during COVID, we need a refresh and a new start. And they want to make it work for everyone, not just the wealthy. They have an advocacy team doing congressional outreach, a data team that runs CDCDataproject.org. And you can find this all in our show notes. And they have a partnership team that is actively working to connect us with people like Dr. Soda. They have fantastic accessible online presence. And if you're someone who's just starting to pay attention to this and want to understand what's happening to federal workers, but you would like to without getting a policy degree, then you should follow their accounts and amplify their work. So we'll put information on how you can connect with them and support them in the show notes. But the short version is call your congressperson, volunteered with Fired But Fighting, and share their work on social media. Five Calls is an app that you can use to call your representatives. It makes it very easy. It gives you scripts on what you can call your representatives about. So, anyways, the next part of this episode, we're going to walk through what's actually been lost with the CDC, what it means for our preparedness, and why, while Hantavirus is very likely not to be our next pandemic, which I will talk about. This outbreak is a warning sign that we cannot ignore. And here's what you will not get from either of these episodes. You're not going to get speculation, misinformation, or outcome promises. We don't know if this is going to be our next pandemic. I'm saying it's very unlikely based on what we know about hantavirus, but we can't tell you that won't happen for sure. What we can tell you right now is that the outcome is very unlikely, like I said, but we will also not be criticizing our frontline public health officials who are responding to this outbreak. Those individuals have lots of expertise and we trust them. And they are experienced professionals just doing their job. They're also under enormous pressure with fewer resources than they should have had at this point. One last thing before we dive in, this episode was researched and recorded as of today, May 13th, 2026. Things are currently in an active outbreak and they can change very quickly. So if tomorrow the numbers don't match what I'm saying today, just know that this is up till May 13th. What you're hearing right now represents the most current publicly accessible information. All right, Maddie and Ariel, any quick thoughts before we get into it?

Speaker 12:59

Yes, and I just want to say this information we're sharing is so important. I had someone tell me this week that they think the hantavirus situation is a government conspiracy. And I was like, hantavirus is actually very real and a very scary disease. And then this person clarified they didn't think that hantavirus wasn't real. They just thought the government was trying to cover it up. And I was like, with what workers? Like they fire their whole workforce. Like you're hearing misinformation. So anyway, just want to reiterate that we will be sharing the truth, what is publicly available, no misinformation, not trying to scare you, just science and facts.

Speaker 3 13:37

This is a very real outbreak. And Hantavirus has been around for a while. So I wanted to mention it's not a novel virus.

Speaker 1 13:43

Yeah, Hantavirus is like not a new thing. And I think especially living in Colorado, like I think we probably have heard about hontivirus relatively frequently because it's known to like have outbreaks like within the Four Corners area. So this is not a new thing to us. It's interesting to see the um response on the internet because we are all just like, we know this is a thing. Everyone's known this is a thing. So people who are like, this is a conspiracy, this is brand new. I'm like, this is not. This is not.

Speaker 3 14:14

Hantavirus is not COVID, and we'll definitely go over that. And the response to Hantavirus, while limited from the United States, is not limited everywhere else, right? So there's other countries that are responding, even if the WHO doesn't have as much money as they did, we can still trust that they're doing what they're supposed to. It it is worth talking about that. We'll talk about that more in part two of the episode, though, and pulling out of the WHO. So let's get into it because I got a lot for you guys. Um, let's start with science here. And I think it's the best place to start. So you have some background as a listener on Hantavirus moving forward, what it is, how it spreads, why this particular outbreak has drawn so much attention globally. I think you'll figure that out by the end. Move out to move on then to the full outbreak timeline and where things stand today. So a few terms, and I'll mention this again, but there are some terms you're going to hear throughout the episode and what they actually mean include a suspected case of hontivirus is anyone who has had contact with what is called a confirmed or probable case while that person was symptomatic. A probable case is someone that has been exposed to somebody that is confirmed and is showing symptoms but has not received a test result yet. A confirmed case has been confirmed by laboratory testing. And an inconclusive result means that the test may have come back from somebody and it was unclear. There might be two conflicting tests, positive and negative, or the test needed to be redone for various issues. And then finally, a case fatality ratio or CFR, it basically measures the proportion of confirmed cases that result in death. So it tells us how lethal a disease is in a given outbreak. So you have a bunch of people that are cases and you divide that by the number of people that actually die who are cases from this disease.

Speaker 1 15:56

And during outbreaks, a case definition can like kind of, as an outbreak is going on, can be changed. So it's not going to be the same as like if we had like an outbreak of COVID versus like an outbreak of hantavirus. So a case is going to be defined by like the situation. So it's going to be very situational. Some little epidemiology info for y'all there.

Speaker 3 16:13

No, that's a really good point because one thing about Hantavirus is they they do testing once the person shows symptoms. And it has to do with the viral load and level to be able to actually tell on PCR that the person is positive. For other, you know, for COVID or something, that's not always the case. Get it, case sorry.

Speaker 16:30

Good pun. I I have a quick question. But what is the case rate fatality for Hantavirus?

Speaker 3 16:36

It depends on the outbreak, but it's not great. It's kind of scary, actually. And that's really what's causing a lot of concern online right now. So currently for this outbreak, and again, the case fatality rate changes, right? If you have more deaths and less cases, you have a higher case fatality rate. If you have more cases, less deaths, then it changes. So in the beginning of any outbreak, you're probably gonna see you're gonna see more deaths, a higher case fatality rate. In this case, for the beginning of the outbreak, it's around 38%. It's dropped to 27 as more people have been confirmed and less deaths. It does take some time to die in some cases from this situation. Um, in any given situation, it's usually after the outbreak ceases. And from a history of knowing about Hantavirus, it's usually around 35 to 50%, which is what makes this disease dangerous because it has a very high case fatality rate. And just for reference, and I will get into this a little bit, COVID at the peak of our situation with like the original strain was like 10% case fatality rate. And we had refrigerator trucks trying to deal with the over mass of bodies in New York City. So while I'm not trying to fear monger, it is definitely concerning. But the good news is it doesn't transmit as easily as COVID, right? And so we need to be sure to mention that is while the case fatality rate is high and the likelihood of death is high if you do get infected, the likelihood that you get infected is a lot less than if you were to be exposed to COVID or something like that.

Speaker 1 18:06

And I but like why there's kind of a range in that case, that percentage you were talking about was like 35 to 50 percent, is it also depends on the strain as well. So there's a multiple strains of Hantavirus. So we're gonna specifically talk about the Andes Virus because that's what's going on. But some have like a higher case fatality rate than others. So that's why if you're like, that's a big range, why is it such a big range? That's why.

Speaker 3 18:28

Yeah, exactly. Um, okay, so what is Hantavirus? So Hantavirus is actually naturally found in rodents. You can probably bet that if you've seen a rodent, it has a hontivirus strain within its body. That's because it's naturally occurring. And people have been getting infected by Hantavirus for decades at this point, that we have been able to identify Hantavirus since like the 1970s. And so people get infected through contact with infected rice. Rice, rats. I put rats and mice together and it was rice. Rice, infected rice. That would be awful. Imagine being like exposed to rice, and that's what Hantavirus is. Too bad.

Speaker 1 19:06

My husband would be fucked up. That actually would fuck the entire world because rice is such a foundational food in so many cultures. Daniel would be dead. He eats so much rice. Daniel's patient zero, actually.

Speaker 3 19:21

Okay, so people get infected through contact with infected rats or mice, not rice. And most commonly, this is through exposure to their urine droppings or saliva. Bites and scratches can also transmit the virus, though that's really less common because normally you're not having that kind of one-on-one exposure with a rat or a mouse. However, it also can happen through if you're actually cleaning up their feces, like I found the other day in my unfortunate garage in my new house, cleaning it up without a respirator, you know, like brushing it up, vacuuming it, and then it goes aerolizes, aerosolizes, and you breathe it in. So urine droplets or aerosolized feces into the air and you're breathing it in. So this has been something that's been around for a long time. There are over 40 official recognized hantavirus species with many more distinct strains, over 30 identified in the Americas alone. So North America, South America. These viruses can cause two main disease syndromes, and which one you get depends largely on where you are in the world. So Hantaviruses found in the Western hemisphere, what we call the New World Hantaviruses, cause the hontivirus pulmonary syndrome or HPS. This is a severe respiratory disease. And in the United States, the most common strain is carried by what we know as deer mice. Hantaviruses in Europe and Asia are also referred to as old world hontiviruses, and they cause a very different syndrome called hemorrhagic fever with renal syndrome. And I hate hemorrhagic fevers. The idea of that is just no thanks. That sounds fucking terrible.

Speaker 1 20:48

Listeners, we have been talking about, you might have heard us talk about hemorrhagic fevers before. So that's like marabug, Ebola. We've talked about Ebola before because that shit's spooky.

Speaker 3 20:58

Yeah, no thanks. Um, and that's also referred to as HFRS, but we're not going to really be talking about that much because we're going to talk about more of the new world hontiviruses today. But HFRS primarily affects the kidneys rather than the lungs. Um, to give you a sense of scale, in 2025 alone, eight countries in the Americas reported a combined of 229 cases of HPS, that Hantavirus pulmonary syndrome that I mentioned from the Americas. And that resulted in about 59 deaths. So that's a case fatality rate of about 26%. Um in Europe, nearly 1,900 hemorrhagic fever with renal syndrome cases were reported in 2023. And that's actually the lowest count recorded between 2019 and 2023. So while that's kind of sounds awful, it's lower than the other years before. In East Asia, particularly China and South Korea, that hemorrhagic fever syndrome continues to produce thousands of cases annually. And the incidence has actually been declining over recent decades. So again, while that sounds high, we're seeing it decline. Which is nice to see, but it's not something that's brand new or novel. This has been happening. For today's episode, we're focusing specifically on that pulmonary syndrome from the new world hontivirus strains, because that's what's relevant to the MV Hondius outbreak. So anything before I jump in, y'all? Lots of big words. Lots of big words. MV Hondius sounds pretty close to Hantavirus. MV Hondius is a Dutch ship. This is where the outbreak begins. And it was not included in the naming when they thought there was a Hantavirus outbreak was going to occur.

Speaker 1 22:37

I was gonna say, I was like, I'm shocked. I mean, I'm sure there's still time because the internet moves quickly that there's not some sort of conspiracy theory about how Hondius sounds like hontivirus.

Speaker 3 22:48

Oh, there's a hundred percent one out there.

Speaker 1 22:50

Yes. Yeah, I mean there has to be. There has to be. The second you like mix that up, I was like, the internet's gonna take that shit and run with it.

Speaker 3 22:58

Yeah, put me in a reel right now. Um okay, so hontivirus pulmonary syndrome, HPS. It's severe. Symptoms typically appear anywhere from one to eight weeks after exposure. And it's about one to eight weeks after exposure to an infected rodent or its secretions. In the early stage, you're looking at fatigue, fever, muscle aches, particularly in the large muscle groups like your thighs, hip, back, sometimes shoulders. So if you're like an avid person that like goes to the gym or like runs like Ariel, sorry, you may not know. You have it. Um, that's what happens when you're a runner. Sucks to suck. Ariel, do you want to say something on behalf of runners? I can't speak for all runners, so no. Ariel stretches and makes sure that her muscles don't hurt the next day. So you should too.

Speaker 1 23:40

See, this is why I don't run. Because you don't want to stretch? Because I have to know if I have Hantavirus or not, you know. That's that's the truth. I'm really just thinking ahead. Yeah. Two-thirds of this podcast does not move fast. No one says I run fast. You're you're running faster than I do. I can promise you that. Only one of us is surviving the zombie apocalypse if it involves running and it's gonna be aerial. You can all just like leave us behind. I'm stopping to help a dog and then I'm dead.

Speaker 3 24:10

So that's just been decided as a group. Um okay, so half of patients also experience headaches, dizziness, chills, gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain. So, like a lot of those things could be easily confused with the flu or like early stages of COVID, right? So four to 10 days after those symptoms appear, the disease can shift into a much more dangerous phase, which is that HPS group syndrome. So this is when patients develop coughing and shortness of breath, and in severe cases, a feeling of tightness in the chest. This sounds pretty similar to COVID. And at that late stage, it can be fatal. And so roughly 38% of people who progress to respiratory symptoms may die from the disease. That's wild. There's no treatment and no cure. It's all about just keeping them comfortable.

Speaker 24:57

Yeah, it's so scary because I feel like so many viruses have similar symptoms to like, oh, do I just have a common cold? Do I need to, you know, lay low, take the day off work, whatever? Like, do I have hantavirus? I mean, most people don't have hantavirus, but just thinking about all these viruses that can cause anything from vile symptoms to death that and the symptoms are similar is just terrifying.

Speaker 3 25:19

And also during that period, thinking about viral transmission, it's the first time of which you show symptoms in the first few days where you might be able to say, Oh, I have a cold, or I just got something from my kid, or XYZ, like I might have COVID or the flu. That's when you're the most infectious. So you might not be staying home right away, right? And so it kind of works in favor of the virus in transmission that way because you're not healing over and unable to breathe, and you're most infectious during that very early period of symptoms. So there's no cure, as I mentioned. Patients receive rest, hydration, and supportive care, meaning treatment of symptoms as they arise. If breathing becomes severely compromised, patients may need incubation, intubation, not incubation. You're not a chicken. Intubation and mechanical ventilation. You might not be a chicken, but you might wear a chicken shirt like Ariel. She has a really cool chicken shirt. You guys should check it out.

Speaker 26:10

Yeah, I'm not wearing it today. I wore it when we had dinner on Saturday, and I wore it to work today, but I have changed out of my work clothes.

Speaker 3 26:18

I will post the photos of us so we can see the chicken shirt.

Speaker 1 26:21

It's a great shirt.

Speaker 3 26:22

Such a great shirt.

Speaker 2 26:23

Truly it is.

Speaker 3 26:25

Um, so the WHO World Health Organization estimates that in any given outbreak, the case fatality rate can reach as high as 50%. Historically, it's ranged between 35 to 50. Um, that doesn't mean that it's going to be 35 to 50 with this outbreak that I'm going to overview in a second, but that's historically what we've seen. One thing that makes this outbreak different is that almost every Hantavirus on the planet spreads the same way, from rodent to human. So human to human transmission, especially does like essentially doesn't happen in most cases, with one exception, the Andes Virus. The Andes Virus is only the only hHantavirus that we have identified, doesn't mean it's the only one, but the only one that we've identified that is capable of spreading from one person to the other. So we're seeing that human to human transmission.

Speaker 1 27:09

I was just thinking about my own story in my head that when this first started happening, I was like, uh, there's so many strains of hontivirus. I'm sure it's just rodent to human. It can't be the Andes one. It can't be. It can't be. How could it? That's what I was thinking in my head was I was having that this exact same. I have a friend who's a nurse and she was like texting me. She's like, how worried should we be? I was like, uh, the odds are so low. They're not.

Speaker 27:33

This can't be what the Andes candies is named after, is it? The Andes God, I love that. The hontivirus.

Speaker 1 27:39

Yeah. No, I don't think it's not. This is our new conspiracy theory is that Andes candies caused hontivirus.

Speaker 3 27:48

So it is one of the only ones that has been identified at this point of the human-to-human transmission that we're talking about. Normally it's rodent to human. And you know, you could have a few people in an outbreak, they could all work in the same warehouse and get exposed to the same rodent secretions. But then if those people are sick, they're not giving it to another person because it's rodent to human and that's where it stops. So for Andes Virus, it's human to human. So rodent to human and then human to human. It's a new world hontivirus, as I've mentioned. So they're found primarily in Argentina and Chile, and it's the strain at the center of this outbreak. So in past Andes Virus outbreaks, investigations have found that human-to-human transmission involves close, prolonged contact. Specifically, it spreads through what is called droplet transmission, either inhaling large respiratory droplets from another person who's talking, yelling, speaking very loudly, like myself, maybe coughing, those kind of things. And it then settles in your upper respiratory tract. Or you're touching a surface where those droplets have settled and then you touch your mouth or your nose. And so this is distinct from airborne transmission, though we will talk about why there's potential that this is also something we should consider. And it's always good to be more conservative in our outbreak response, like wearing masks. The Andes Virus does not linger in the air from what we know, as COVID does. However, there is a journal article out there, and I will talk about this later, and some arguments from scientists that are saying that this is something we should be looking into. And I'm always going to say I'm always a proponent of being more conservative and protecting yourselves as if it's airborne. So it requires sustained close interaction. That's what we know at this point. And it does its best work in an environment exactly like a cruise ship because you are experiencing prolonged exposure to strangers on multiple times a day or week. You may not talk to each other, but you're going to be in the same dining hall. You're going to be walking past each other in the hall. You might use the same bathrooms. So those are the kind of things that that prolonged contact, that droplet transmission really thrives in. Incubation period, you need to know this. It's this time between exposure to a pathogen, bacteria, virus, parasite, we're talking about a virus in this case, and the first appearance of symptoms. For Hantavirus, the average incubation period is approximately three weeks with a range of four to 42 days. This is another challenge, right? Because you might be exposed, not have those symptoms. And again, you're most infectious at the beginning of your symptoms that could be just confused with something else. And you may not equate it to anything other than just maybe your child brought home something from preschool. You know, it's an outer boundary of when symptoms could reasonably still appear after exposure. After the incubation period ends and symptoms begin, that's called the onset of clinical disease. And that's when the person becomes ill. And in the case of the Hantavirus, when they're the most infectious, as I've mentioned. So that's the foundation of the background. Any thoughts? What are you feeling right now?

Speaker 30:43

My takeaway from this, and I hope that other people are taking this away, is just so much respect for epidemiologists and other people who do disease investigations, like having to know things like the incubation period and knowing how to do these investigations to figure out what illness people could potentially have. So just like really want to elevate people who do this work day in and day out because it's a lot of stuff to remember. And then you think about multiple diseases they have to investigate and like all the things they have to know about each one. So yeah, that's what I'm thinking about right now.

Speaker 1 31:16

Thanks, Ariel. I feel appreciated.

Speaker 3 31:19

You're welcome. Also, the one thing I haven't said so far that's probably important for us to reference is the RO, right? The reproductive number. So the average number of people that an infected individual, once they start having those symptoms with Hantavirus or Andes Virus specifically, can infect during the period of infectiousness from the time their symptoms begin to when they're not infectious anymore. We need to be clear about this. This is an average, but from what we know from each outbreak that has occurred in the past, it's around 2.1 people, right? So that's still a problem when you're in a very enclosed space, such as a cruise ship, but it is not as high as a lot of other things, like measles, which is three to 15 people per infected individual. So we need to understand that this is not avian flu, this is not measles, and at one point during the pandemic, this is not COVID. So just bring that home with you and understand that this is not as concerning as the media and maybe online misinformation, disinformation grifters are pushing. You have a right to be concerned, but this is, you know, important information for you to know and navigate the situation. All right. So we have a foundation in the background. Let's walk through what's actually happened since April 1st. I am going to be talking about it almost every day since April 1st. So at any point, stop me, Maddie or Ariel, and I will stop. Um, but before we walk through this timeline, I want to pause because every number you're about to hear represents a real person, someone with a life, family, dreams, emotion either have passed away from this, are in isolation while after being confirmed, knowing that they have Honda virus, or waiting potentially to develop symptoms of one of the more dangerous and scary viruses. And so whether we're talking about passengers, crew members, or healthcare workers, these are people, they're not data points. And so please hold on to that as we go through that. And just remember that as you go to post about it online, et cetera. Um, all right, so it all starts on April 1st. The Dutch flagged cruise on April 1st, MV Hondius, not a part of a conspiracy, departs from Ushuaia at the very tip of Argentina. And the voyage is scheduled to include stops in Antarctica and remote South Atlantic Islands, and they're really interested in birds. So, like for those bird watchers, maybe find a different hobby or stay on land. April 6th rolls around and a 70-year-old Dutch man begins feeling ill. He has a fever, headache, mild diarrhea, and his wife has been recently sightseeing in Ushua. Did I say it right? Ushuaia.

unknown 33:47

Ushuwa.

Speaker 3 33:48

In Ushuaia and traveling through Argentina, there's not a there's a solid chance I just messed this up. Traveling through Argentina and Chile. Chile. Um, this date becomes significant later as it marks the beginning of a 42 exposure window we discussed earlier. April 11th rolls around, five days later, this Dutch man goes into respiratory distress and dies on board. At the time, the cruise company cannot determine the cause of the death, and well, they're out there in the ocean. And April 14th or 15th rolls around, three to four days later, the ship stops at a remote Tristan de Kunha. Arch archipel I can't say that word. Archipelago. Oh my god, guys.

Speaker 34:27

You got it, Olivia.

Speaker 3 34:28

I don't because nobody taught me how to pronounce things. Archipelago?

Speaker 34:32

Archipelago.

Speaker 3 34:33

Archipelago? Archipelago. Guys, I have a doctor's degree and no one told me how to pronounce things. Well, when are you talking about archipelagos in public health school, though? Like, that's what I'm saying. No, but like I've been in school for a long time and you think I would know how to pronounce things. The ship stops at a remote archipelago. Tristan de Kunha, a British territory in the South Atlantic specifically, the Dutch man's body remains on board at this time. The ship stops there 10 days later. The body is actually finally removed from the ship. I can't even imagine what this woman was going through. His wife, like, he died, and then she was just like on the ship with his body for 10 days. It was removed from the ship and at this island of St. Helena. And his wife and roughly two dozen other passengers depart as well from the ship. Around the same time, a British man on board begins developing symptoms. April 25th, the next day, this Dutch woman, the wife of the 70-year-old man that died on board, the widow, develops symptoms of her own. She boards a commercial flight from St. Helena to South Africa. And I looked it up, a roughly a five-hour flight or 4.5 hours. The plane carries about 88 passengers and crew members. Don't worry, I'm not trying to scare you. They're contact traced. They have been identified. However, it does occur. April 26th, the next day, she arrives in South Africa and collapses at the Johannesburg airport while attempting to board a flight home. And she's taken to a clinic where she dies in Johannesburg. The next day, back on the ship, which is now still in St. Helena, the British passenger who felt pretty ill a few days earlier has worsened. His condition has worsened. He's evacuated to Ascension Island and later transferred to South Africa, where he's placed in intensive care with a high fever, shortness of breath, and signs of pneumonia. And that same day, the ship guide on the ship began showing symptoms. So at this point, we have two people dead, two other people sick or showing symptoms, right? The next day, a German woman, woman passenger on the ship is now sick. The ship is en route to Cape Verde off the west coast of Africa. And separately, a man who disembarked disembarked at Tristan de Cuna on April 14th reports the onset of symptoms. So we have four more people, other than the two people that have died. April 30th, two days later, and the ship's doctor begins showing symptoms. Finally, May 1st, a man leaves the ship at St. Helena a few days earlier. He had flown back to Switzerland through South Africa on guitar, and he begins experiencing symptoms. He self-isolates immediately and then he is later hospitalized, but he notifies officials. Good job, man. From solid behavior. We love to see it.

Speaker 1 37:15

I want more people like this man existing in this world. What a what a A plus, A plus.

Speaker 3 37:20

Honestly, like this is even before the WHO announces it to the media as a like outbreak. They may, I don't know the background if they had already notified the passengers at that time, but yeah, no, those it's good behavior. Model citizen right there. Model citizen. So May 2nd, that German woman that I talked about who started showing symptoms a few days earlier, she unfortunately dies on board. So this is our second death on board. It's a hell fucking cruise, honestly. Not a vibe. I can't wait to see the Netflix special. So German woman dies on board, and roughly this is three weeks after the first case, or what we call the index case, of that 70-year-old Dutch man passed away. And she is later confirmed post-mortem testing to have had Andes Virus. That same day, South African health authorities received the first laboratory confirmed positive result from that British man I talked about earlier in intensive care. He was in intensive care in South Africa. We're at a lot of different people going on right now. But they were all originally on the ship. So that's very important. They're all primary cases. May 3rd, the WHO announces that it's actively responding to a suspected hontivirus outbreak aboard the MV Hondius, and now it's in Cape Verde waters. May 4th, the next day, South Africa confirms a second positive case. The Dutch woman, and this is post-mortem, the Dutch woman who died in Johannesburg. The WHO formally declares this as a Hantavirus outbreak. Cases two confirmed by PCR, five suspected, which means they've had actual known exposure with somebody that is confirmed and is suspected to potentially have Hantavirus, along with the three deaths, one critically ill patient and three individuals with mild symptoms. So those would be probable cases. May 5th, the cruise ship, the cruise ship and Cape Faraday authorities are like at an impasse right now. This is what I remember when the media was really like, oh, they're trying to come to land and they're all sick. It's gonna kill everyone. Cape Faraday sends health workers aboard, but allows nobody to come off the ship. And two crew members are seriously ill, the ship's guide and also now the ship's doctor. And a third is being monitored. The man who flew through South Africa via Qatar also receives that positive result, as I mentioned. May 6th, the next day, the two seriously ill crew members and third person are being monitored and evacuated and are flown to specialized hospitals in Europe. There's a standoff, but it's resolved, and the ship begins sailing towards Spain, Spain's Canary Islands, because they're invited there. They have the protocols in place to be able to disembark the individuals, and they have agreed to accept it. Switzerland. Switzerland reports a positive result for the man who left at St. Helena that I mentioned earlier, bringing the confirmed cases to five. And both South Africa and Switzerland confirmed the strain as Hantavirus, the only Hantavirus capable of human-to-human transmission, as I've mentioned, found primarily in Argentina and Chile. All right. So May 7th, people who left the ship before the outbreak are identified and now being quarantined. So contact tracing is doing its job. We love to see it across Switzerland, Britain, the Netherlands, France, Singapore, South Africa, and elsewhere. And May 8th, the WHO releases a formal outbreak summary that you can find on their website, which indicates eight confirmed cases, three deaths of those confirmed cases, which means a case fatality rate of 38%. Two days later, on May 10th, the MV Hondius arrives in Tenerife, the largest of Spain's Canary Islands. I just got a nod because I said it correctly, and Maddie's like, yes. And anchors offshore. A carefully coordinated disembark. No. Disembark.

Speaker 1 40:58

Disembarkation.

Speaker 3 41:00

Guys, I can't do words that have multiple syllables. We'll know that.

Speaker 1 41:03

The only reason I know that is because I come from a cruise family, unfortunately. So disembarkation. You used to go on cruises. Girl, I went took on a cruise to Australia last year. You do cruises? My family. I come from a cruise family. I'm telling you, that's how that was the preferred Cass Day travel method. My parents are literally, this is actively going on. And my parents text me, they're like, oh yeah, we're going on a cruise with our besties next year. And I'm like, can you read the fucking room? Also, there's a massive neurovirus outbreak happening right now in France. I know. I know. I know.

Speaker 3 41:35

Cruises, I got like a Royal Caribbean email today, and I was like, first of all, I've never been on a cruise. How did you find me? Like, they must be fucking reaching to get people because I have never been on a cruise. You there's no reason I should be on your list. And they're like, we need to find anybody that will come on a ship right now.

Speaker 1 41:50

Honestly, though, you're probably gonna get some sick deals on cruises. Just don't have the ice. That's a good start. Wash your damn hands, is all I'm saying. I wash my hands so many fucking times. Okay, I want rubbing alcohol all over my body. Just wash your hands. Soap and water, 30 seconds.

Speaker 42:11

Warm water. It's great. I'll do you want better vodka because you can drink it and use it to clean yourself. Yeah, but don't drink it off your hands. Drink it from a glass.

Speaker 3 42:20

Yeah. Okay, so carefully they get people off the ship. We're just not gonna use that big word. And the health workers are in full protective gear, which is some of the photos that you might have seen. People are kind of freaking out about that. But just remember ultra-conservative approaches to protect healthcare workers because if you haven't noticed, we're already at full capacity and there's not a lot of us. So we got to protect ourselves. They're escorting these passengers to shore. Military planes began transporting people home. So we're not sending home people on like commercial flights, obviously, and that's to more than 20 countries, including Spain, France, Canada, Denmark, Britain, Ireland, Turkey, and the United States. So what's left on board at this point is fewer than 60 passengers. We will talk about what that means, who those people are. But May 11th, the next day, a French woman tests positive after being flown home. An American receives what news reports are calling a mildly positive result. This was an HHS actual direct communication on X, mildly positive. Okay, I just want to be clear. I tested mildly positive for what the actual fuck am I reading right now? Because this is insane.

Speaker 1 43:23

You are either negative or you're positive. This is a binary system with maybe an inconclusion, but like this is a A or B. This is not like a maybe A. Yes, this is not a spectrum. This is binary. They tested mildly positive for fucking stupid because what? Stupidity. Straight up stupidity. Oh, it smells like pizza right now. I gotta finish this episode. Kyle's making gnocchi and it smells really good.

Speaker 3 43:47

Did you say Nokia? That was really cute and not Italian of you, and I liked it. Okay. It's gnocchi. It's gnocchi.

Speaker 2 43:55

This needs to be a real for this episode. It's gnocchi. It's not gnocchi! He's making new.

Speaker 3 44:03

Gnocchi. It's like New York, but you're like unable to say New York, so gnocchi. All right. I'm gonna get Italians and epidemiologists coming for me. Sorry, please continue. Okay, so there's not a a thing called mildly positive. You're either positive or not, right? That's what I found out afterwards. Is that person had two tests? One was positive and negative, and both of the tests were from different laboratories. So put that all together. Apparently, HHS calls that mildly positive. All passengers have now left the ship, and more than 30 crew members, as I mentioned, some people have remained, are left on the ship and they're going to the Netherlands. They will be disinfected, they will be quarantined, and that's where the voyage will officially end. Those poor people are still like on the clock. That's the craziest thing. That 42-day monitoring countdown begins for all contacts as of May 11th, because they've all left the ship at that point. They are doing it per person, but it's easier to kind of just base it off of May 11th. So where do we stand? As of May 13th, today, 11 cases total. We have eight confirmed by PCR tests, two probable, which means that they've had exposure. They were on the ship and they are also showing symptoms. One inconclusive that American Who was mildly positive, and three deaths from the confirmed, giving a case fatality rate of 27% among confirmed cases. So as you get more people that are confirmed and less deaths, you're going to have a drop, right? We have one confirmed case symptomatic in France, one confirmed case, symptomatic in Spain, one inconclusive result, asymptomatic, conflicting results in America. And then we have everybody else we've talked about. All individuals so far are those that were on the ship. These are primary cases. That's really important for us to mention, right? If it was secondary cases, which is defined as a primary case that was on the ship, then has contact with somebody that was not on the ship, and that person ends up getting Andes Virus, that's a concern, right? We're seeing this expand. It's all a concern, but we're seeing it expand beyond, and that's a different situation. So at this point, there's roughly 200 people that are currently under daily health monitoring in hospitals, military facilities, or restricted quarantine at home. When I say restricted quarantine, which is another thing that's like blowing up on the internet right now, people are like, how can we trust, you know, Jim to stay home right now when nobody wore a mask during COVID and everybody just like hung out with each other? Well, the thing is they're in restricted movement quarantine. There's only a few people, and those individuals are checked in like multiple times a day. They're monitored on where they go, and they have to report as soon as they start having symptoms because every day they're talking to someone multiple times, right? So there is actually some things in place to prevent this from expanding and causing secondary cases. Can't promise though, because again, there's some individuals that flew home on commercial flights, right? So you just have to trust public health officials, which I know is very hard, especially after COVID. So at this point, what are we going to expect in the coming weeks? There's some things that I want to be clear about, and the WHO has been very clear about it. You should expect more cases in the short term. Likely into this week and into the following week, this is not going to be alarming as long as they're primary cases, right? Because it's expected. It's been roughly 30, 40 days since that first individual, that Dutch man had symptoms. And what we know about the Andes Virus and the incubation period, which is an average of three weeks, you will potentially hear about new cases in this week or next. If not, that's fantastic. But if you do, please don't be alarmed. That's a normal part of how this outbreak is unfolding. And yeah, so that's what's happening right now. Olivia, do you have any?

Speaker 47:45

I don't want to say guesses. Have you heard anything about maybe how many more cases we can expect? Is there an estimate?

Speaker 3 47:53

No, I think you're being conservative in their estimates because they don't want to alarm people, which just makes sense in the communication style. Like I wouldn't want to say, like, oh, we'll only see like a few, because you just don't know where people are passing each other on the ship, right? You don't know droplet transmission exposure, that kind of thing. But I mean, like I said, there's 200 people under contact tracing right now that might expand because as people are self-quarantining at home, that means their families that they're exposed to also need to self-quarantine. My hope is, of course, that those people aren't home. But if they are, they also need to be in interactive monitoring. So there's things like that that they need to be on top of. But yeah, there are some dates that I'm gonna mention that are good dates to keep an eye out for that give us insight to like good news on this outbreak versus bad news on this outbreak, right? So there's some key dates to watch. May 19th. That marks exactly 42 days from April's April 6th, which is that day that that Dutch man, the index case, first became symptomatic. Anyone exposed during that earliest window should be showing symptoms by this time, maybe a few days after May 19th. New cases appearing before May 19th are expected. Cases appearing in people with no documented ship exposure after May 19th, that's when there's concern, right? There's those secondary cases. That would suggest that contacts were missed during the initial investigation and potentially we have a secondary outbreak occurring. Late May through June is the window epidemiologists are watching most closely. This is when we expect to see secondary cases. If there are any meaning transmission that has occurred in people weren't on the ship, did any returning passengers infect a family member, a healthcare worker, or somebody in their community? That's the critical question, and we won't have a clear answer until we move through that window. Mid-June is when most quarantine periods should be completing, and later June is when we'll have a clearer picture of whether containment has been successful. What success looks like though is no new cases in people without documented ship exposure, no transmission to household contacts or healthcare workers, and no community clusters in any of the 23 plus countries involved. It's possible, it could still happen, but it doesn't mean that those things can't be contained either, because like I said, the reproductive number is low, the likelihood of transmission is different than if it was COVID or something else.

Speaker 50:05

Okay, Olivia said. Do we know if the first case was infected on the ship or before boarding the ship? Is that something that's been determined?

Speaker 3 50:17

They think that this individual was infected on land in Argentina. They believe that this individual went to some sort of landfill and was exposed to rat secretions or mice secretions during that time. And so that person would have come onto the ship while infected, hadn't shown symptoms, and then showed symptoms and passed away on the ship, and that's how it started.

Speaker 50:39

Okay, thanks for clarifying.

Speaker 1 50:41

But it makes sense, like with the time, like how long it takes hontivirus to show up, that if he got sick so close to getting on the boat, it would make sense that he got it off the boat and then became symptomatic on the boat. Yeah, that makes sense. Definitely. Based on the latency period of it.

Speaker 50:57

Yeah, and I've never been on a cruise and I don't know much about cruise ships. Do you see mice on board? Are they clean? I don't know.

Speaker 1 51:05

You shouldn't. I also had that thought too of like, I was like, okay, well, it seems like a cruise ship is like a perfect place for Hantavirus to thrive because if there for some reason are mice on the cruise ship, everybody is there and you're stuck like in one confined space.

Speaker 3 51:22

Yeah, definitely. I mean, that could have been a potential. I think they tracked it down to his movements in Argentina, though. We'll have to confirm that. Maybe we could talk about that in the next episode. So, in and all, what should be really raising concerns is if there's cases in people without a ship connection, healthcare worker infections, which there's potential. There was some mistakes that were made, which is natural. We're human by some healthcare professionals, but they are under quarantine at this time and or household transmission despite quarantine measures. And there's one more thing, a question that we've been seeing a lot was, or I've been seeing a lot online, at least, is that people are asking, like, how did strangers on the same ship end up infected if this is not quote unquote airborne or air slized through vents, et cetera, like COVID or lingers in the air, it's more like through droplet transmission. Is how is this close contact? Well, they weren't really strangers in the way that the word implies. They shared the same dining rooms as I mentioned, the same bathrooms, the same corridors day to day for weeks. And you can pass the same person a dozen times on a ship that size, um, and it's sustained repeated close contact, which is exactly the condition which this virus transmits and thrives under. There's also something important about when people are most infectious, which I've talked about. And Dr. Lupin of the WHO has mentioned that people are the most contagious at the very very start of the illness, when the symptoms are mild. That low-grade fever, the fatigue, easy to dismiss. That early window is when the most exposure likely happens and before you worry about it. But there is potentially, and this is not confirmed, there's some indication that transmission may also be possible in the days before symptoms appear. At this time, in this episode, I feel confident to say that when you have symptoms in that early in those early days, you are infectious. It's just not yet confirmed through research and history and this potential outbreak to say that it also could happen right before your symptoms occur. So that would be asymptomatic transmission.

Speaker 1 53:14

We call that the prodromal phase. I have not heard that word since my master's training. I you just like you just like pulled out a core memory of mine. That's what that was. You reacted like I said it wrong, but it was like one of those, it was like such a visceral reaction of like, I haven't heard this word used or used correctly in so long. It was just like busted out, like my epidemiology 101 class. Oh man, throw back.

Speaker 3 53:39

Um, officials are taking a cautious approach to this, which is why close contacts are being quarantined outright rather than simply monitored and waited, right? Yeah. So that's where we're at. I know I've gone pretty long, but the last thing I want to kind of talk about is the public health response and what it's looked like to this. Because when you don't know what's going on and what the coordinated effort looks like, it's definitely scary and it's concerning. It can be concerning even knowing this as well. And so it's worth taking a moment to acknowledge what's happening behind the scenes because it feels chaotic without knowing this. But there is a substantial coordinated international public health response underway. This comes from the WHO's May 8th outbreak report, which we will put in the show notes. From the moment this outbreak was identified, WHO has been direct ongoing and in contact with national focal points, essentially the official outbreak liaisons of every country managing their own citizens and these close contacts or cases or contacts. The coordination is happening through what are called IHR channels, so the International Health Regulation Framework, regulations framework, which is a legally binding global agreement that governs how countries share information and respond to public health emergencies. And WHO has been requesting regular updates on the contact monitoring and the health status of high-risk contacts from all involved countries. On the ground, WHO and the ECDC, the ECDC, love that. We should make a sticker of it. The European Center for Disease Prevention and Control, also they have a great threads account, I love them, deployed experts directly onto the MV Hondius to support epidemiological investigation and provide public health guidance before people were disembarked in the Canary Islands. Two Dutch medical doctors boarded the ship in Cape Verde to conduct health monitoring and provide care. And one disembarked in Tenerife, where a Dutch nurse boarded to continue supporting the crew members still on board. The crew members remaining on the ship who will sail to the Netherlands for disinfection have been advised to practice physical distancing, stay in their cabins as much as possible for the duration of the journey, and will also quarantine upon leaving the ship. And perhaps most notably, the director of WHO traveled personally to the Canary Islands on May 9th to meet the national authorities, including government ministries, and support coordination for the people that later disembarked. And he met with the Prime Minister of Spain on May 12th. International contact tracing remains ongoing. Epidemiological investigations are continuing to map the connections between cases and better understand the exposure factors on the ship, including critically trying to trace back to the original source of infection. And that includes anybody that went on a commercial flight that may have potentially been symptomatic or infectious, like that individual, the Dutch woman. On the laboratory side, WHO has been coordinating across multiple experienced labs to ensure timely testing with ongoing work in serology, molecular diagnostics, and genetic sequencing. And it's the metagenomics that's also being done is a broader approach to identifying what pathogens may be present beyond just testing for what you already suspect.

Speaker 1 56:46

I also wanted to add that there has been that preliminary data is coming out about the genomics of it. And so they have been able to identify, and granted that again, this is all preliminary, but from what is coming out, they have been able to identify that it was like a zoonotic spillover event based on like its genetic sequencing. It's also a very genetically stable pathogen. So with this outbreak, there hasn't been any like big antigenetic like sort of like shift or any sort of um mutation, like how we would see with COVID, like there would be new strains, new um how it's transmitted or or what species it transmits to.

Speaker 3 57:28

So we haven't seen a change in how it might be transmitted because it hasn't shifted genetically.

Speaker 1 57:32

Yeah, it hasn't shifted genetically. Yeah. And it's like sometimes like there would be more strains of COVID that were more contagious than others based on like how it was mutated. That's not being seen in this outbreak thus far.

Speaker 3 57:45

That's really good too, because that, you know, that indicates that it's probably similar. And while it also is similar, it's 98%, it would they found through sequencing it was it's 98% similar to the strains of Andes Virus that were involved in the 2018 and 18 and 1997 outbreaks that happened in various countries. And so knowing that means that we have, you know, information from those outbreaks about how it transmits, the outcome, the case fatality rate.

Speaker 1 58:09

We have information. And with that, it's not likely that it's gonna have this huge shift that's gonna take over the world and kill everybody. Like that's not a high concern.

Speaker 3 58:18

Especially through containment. The more we contain it, the less chance for genetic shift or drift. But it looks like a since it's so stable, that's unlikely. And we say unlikely because we can't promise anything. So um Argentina has a national focal point that's art's been playing a very important role. They're helping reconstruct the travel history of the first two cases in South America and assessing any potential exposure to Hantavirus in the region, giving that it originates there. And WHO, well, Andes Virus originates there. And WHO has published specific technical guidance documents for this event covering how to manage Hantavirus on board a ship, how to handle, you know, getting those individuals off the boat in a containment style and organized fashion, an onward movement of passengers and crew, and how to manage contacts of those that have run into confirmed cases. These are publicly available documents you can find on the WHO website in case you are just like a cruise ship-go-er like Maddie's family, but we'll link to them in the show notes for Maddie's family specifically. The bottom line is that this response has not been happening in silo. And if you haven't noticed, I haven't really mentioned of the American inclusion of what's happening. And you know what? I'm okay with that because the WHO seems like they're doing a fucking fantastic job. And so are all these countries. And you know what? Maybe it's better we're not as involved given our limited capacity. I wish we were. We used to be like the top of the top in our response, but it seems like the rest of the world is doing a pretty good job without us. So that is solid news.

Speaker 1 59:47

Did you all know that our quarantine facilities in Nebraska? Fun fact. I didn't know that until this outbreak.

Speaker 3 59:53

And I was like, weird- I didn't know that either. Yeah. It did bring me back a little bit to the fact that they have some individuals quarantining in Emory, which is where I got my master's and my undergrad. And I was an undergrad when they had the Ebola patients and the doctor quarantined at Emory, and it's what's really got me interested in infectious disease. So it did bring me back to that. If you're a little freaked out about people going to Emory, it's a regional decision because they only have like 10 or 12 beds in Nebraska. And so they had to make a decision on where to send people based on their where they're from, and it's easier to, you know, monitor them in the state that they're from based on the capacity. So kind of interesting. I didn't know about Nebraska either. Yeah. Truly.

Speaker 1 1:00:31

Fun fact. I also think that's where the national stockpile is. Don't quote me on that.

Speaker 3 1:00:36

Well, zombie apocalypse, that's where the three of us are going, and nobody else is invited.

Speaker 1:00:40

Nebraska makes sense for that type of facility. Like there's not much else in Nebraska. We drive through it every year on our way to visit family for Thanksgiving, and it's kind of boring.

Speaker 1 1:00:50

That's so offensive to corn.

Speaker 1:00:53

That's Iowa, right? Or is it Nebraska that's full of corn?

Speaker 1 1:00:56

Yes, but that's the Nebraska corn huskers, but I think the majority of the corn produced in the US comes from the from Iowa.

Speaker 1:01:02

Well, no, I hope I didn't offend any listeners from Nebraska.

Speaker 3 1:01:06

I don't think I don't know if we have any. I will say that I'm coming to you, Nebraska, when we have a major issue and we need to run from like populations. That's where I'm going. That or Wyoming. Okay. So, like I said, publicly accessible documents for Maddie's family online. This has been a coordinated multi-country, multi-agency effort operating through established international frameworks with and without the United States. They're still doing great. And this global response infrastructure is exactly what we're going to be talking in part two of this episode that is being recorded on Friday. And what happens when pieces of infrastructure start getting dismantled, such as the US inclusion? But I don't think that that should make you too worried because they're doing a very great job from so from what we can tell so far. So that is the Envy Hondius Hantavirus Andes outbreak that is occurring. I probably mispronounced multiple things in this episode. Just know that it's because my parents and their inability to correct my clear mispronunciation in my childhood. Why are you dying right now?

Speaker 1 1:02:12

That was actually just that was just such a funny way to say that.

Speaker 3 1:02:19

Love you, mommy.

unknown 1:02:20

Sorry.

Speaker 3 1:02:21

It's actually my dad's fault. My mom is great. Um, yeah, so that's what's happening right now. It might change tomorrow when we publish this. So just know that this is up to May 13th. But we will see you, I guess, in part two coming out where we talk about how the US infrastructure post-Doge, currently in HHS, mismatch hell of leadership that is occurring right now and what it looks like after they dismantled the leading efforts in infectious disease response and what it looks like now. So what do you guys think?

Speaker 1:02:53

It's a lot. Thank you for walking us through that. That was super helpful.

Speaker 1 1:02:58

Yes. I was just gonna say, what a time to be alive.

Speaker 1:03:02

I say that every day, Maddie.

Speaker 1 1:03:03

And I think I will also say, like, I think why a lot of this outbreak is getting so much attention is because of the scare that COVID has put and instilled in the the fear of God in all of our hearts. So I hope this has like helped people kind of realize, like, okay, like, is this gonna be the next pandemic? Not likely. I know more about it. I can't be as afraid of it. But like, yes, I think a lot of where the big scare is coming from is because this is like so fresh from COVID.

Speaker 3 1:03:36

Yeah. I'm seeing two subset of people out there, right? There's one that did what they were supposed to do during COVID, like during lockdown. They were avid, like they wore masks when they were told they followed public health precautions. But it was a novel virus and we were learning things as we went. And so those precautions changed. And some people have a lot of like, you know, PTSD from those changes and mistrust in the government. But they also are disliking the fact that like that some of these people are asked to like self-quarantine at home. They just don't trust other people to follow through what they're supposed to do. And so they're very concerned about that amongst like, you know, a high case fatality rate. And then there's like this second second subset of people who are like, I'm not getting the Hantavirus vaccine, I'm not listening, I'm not doing the lockdown, like we're not doing this again. Like immediately, like, no. And it is nothing like COVID. So you have two people that are just out there freaking out about this, which is totally understandable. But it's just, it's just really interesting to see what this is like post the COVID pandemic, which I guess you can't really say because it's still going on, but you know.

Speaker 1 1:04:37

And the other portion of it too, that I think is important to mention is that just because something changes, like recommendations for the WHO changes, or like your local public health department or whatever, just because that changes, it doesn't mean that it was necessarily wrong and someone was lying to you. It just means we've learned more information and we're trying to give you the best available information and telling you what to do as of now. So I think that is an important piece to mention, which I'm sure for all of our listeners, y'all already know this. I'm preaching to the choir. However, that is like an important part of science is that it changes and we learn more and we're able to give better information. So just because something changes doesn't mean it's a big conspiracy theory against you. It means we just learned more.

Speaker 3 1:05:19

Yep. Exactly. Exactly.

Speaker 1:05:22

Yeah, and Maddie, I want to echo what you say. Trust your local public health department. The people working at local public health agencies are working so hard and they have your best interests at heart. Very different from the federal government, right? We don't have political appointees in our local public health agencies, just people who are qualified and doing a great job.

Speaker 3 1:05:43

They don't take word from RFK. Like that might come down from the federal government, but they're that's not their boss. And at the same time, the people that actually that is their boss, they are still fully experienced public health professionals in the federal government that we should still trust that are the ones that are actually responding to this, right? Not RFK Jr. himself.

Speaker 1 1:06:02

There is no one that wants you healthier more or cares about you more than your local public health department people.

Speaker 3 1:06:09

No one goes into these jobs for money. Let me just be very clear.

Speaker 1 1:06:11

No, I went to it for the fame and the fortune, honestly.

Speaker 1:06:14

Yeah, that's all to start this podcast.

Speaker 1 1:06:16

Really the fame. I didn't really go into it for the money. It was really the fame that came with it.

Speaker 1:06:19

Yeah, Maddie, you're a household name. Did you know that?

Speaker 1 1:06:22

I know basically truly, I am. You know.

Speaker 1:06:24

On cruise ships specifically.

Speaker 1 1:06:26

But at the cruise ships, they loved me, you know? I see your future as a cruise ship doctor. No, please don't. I did. There was like a stint of where like when I was like trying to figure out jobs, I was like, I could just go do EHS on a cruise ship. And then I realized you had to be on the boat for like months at a time. And I was like, absolutely not, never mind. I thought about it. But they have like the um, they have like full EHS departments and stuff like on the boats and things. It's like the their EHS officers. I was like, wow, I could go do that. And then I was like, no, never mind, heart.

Speaker 3 1:06:54

All right. Well, I mean, that is uh the Andes Virus. It is an ongoing situation, it is being monitored. And if you see cases pop up in the next few days or the next week, please, as long as they're primary cases, don't be too alarmed. And if they're secondary cases, just know that if we caught them, that means that the process is doing what it's supposed to. Contact tracing, it's working. So we'll see you at part two of the episode. I don't think we have time for recalls or public health and pop culture. So this is a public health group chat.

Speaker 1:07:25

And um, you can email us at public health group chat at gmail.com. You can find us on Instagram or TikTok at public health group chat. And remember, don't get botulism.

Speaker 3 1:07:38

The best way to support us is to subscribe or give us a rating or send us to your best friend who needs to learn a little bit about Hantavirus.

Speaker 1 1:07:47

And just know there's something out there that probably has undeclared todolophil and cedenophil in it. So just watch, watch it. I don't know.

Speaker 3 1:07:54

Just expect a boner. Support us in public health group chat, just expect a boner. Yes.

Speaker 1 1:08:02

I swear I'm gonna waste my fucking time. Please make that the outro. Gnocchi. Gnocchi. Gnocchi. It's gnocchi. Gnocki. I just really want the reel to be me before you told me how to pronounce it when I'm saying gnocki.

Speaker 2 1:08:19

But it would be it would be like with you with like the cat and the rainbow being like knocky, knocky, knocky, knocky, knocky. Let's make it into a remix. Please.