What kind of virus is it?
Hantaviruses are a group of viruses that are spread by rodents. The group includes the virus that causes bat fever. The current outbreak on a cruise ship was caused by the Andes virus, a variant found in South America.
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How do you get infected?
Hantaviruses are usually spread to humans through contact with urine, feces, or saliva from infected rodents. The Andes virus can also be spread between people, but it requires close contact with an infected person who has symptoms.
It is believed that it is mainly spread through the respiratory tract, says Magnus Gisslén, chief physician and professor of infectious diseases at the University of Gothenburg.
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How could the infection have come on board?
It can take anywhere from four days to eight weeks before someone infected with the Andes virus develops symptoms.
It is conceivable that a person was infected shortly before traveling, became ill during the cruise and could have been contagious on board, says Gisslén.
It is theoretically possible that an infected rodent got on board.
Of course, it cannot be completely ruled out, but it is much more likely that someone was already infected when the ship left port.
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What happens to the infected?
Those affected have experienced fairly nonspecific cold-like symptoms such as fever, headache, and stomach and respiratory problems. If the disease worsens, coughing, breathing problems, and fluid in the lungs can occur.
You can't get enough oxygen, because the lungs are simply destroyed, says Magnus Gisslén and continues:
- The mortality rate is as high as around 30-40 percent in those who develop severe disease.
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How are the infected treated?
There is no vaccine against hantavirus and no specific treatment.
Those who become seriously ill receive supportive treatment, intensive care and in some cases may be placed on a heart-lung machine, known as ECMO. But even with intensive care, the mortality rate is high, says Gisslén and continues:
This shows very clearly that we lack specific treatment for many serious viral infections.
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How big is the risk of continued spread?
"The risk is very small. It's not a scenario where you think this is the beginning of a new pandemic," says Gisslén.
But there is some risk, for example, a seriously ill woman (the wife of the first fatality) flew on a plane to Johannesburg. After landing, she was taken to the emergency room, where she died. It cannot be ruled out that those who were closest to her on board have been infected.
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Are Swedes affected?
Argentine authorities have informed the Public Health Agency that a Swede was on board the ship, which in turn has notified the home region. Blood tests are normally only taken if symptoms occur.
This person will be or has already been contacted by infectious disease control doctors and the follow-up is handled entirely regionally, says Klara Sondén, deputy state epidemiologist at the Swedish Public Health Agency.
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How is Sweden acting?
Sweden is prepared to care for infected patients, and care takes place in the high-isolation units in Linköping or Huddinge. Sweden is also the EU reference laboratory for hantavirus.
We are both ready to receive samples for the Swedish lab and to assist other EU countries with technical advice, says Sondén.
