Don’t panic. The recent Hantavirus outbreak on an Argentine cruise ship that killed three people won’t turn into a mass pandemic like Covid-19. It may lead to isolated outbreaks of human-to-human transmission, the way Ebola did. But no repeat of the Covid pandemic that upended all our lives for years. The lethal Andes strain on Hantavirus, which caused the MV Hondius cruise ship outbreak, hasn’t mutated the way Covid-19 strains did and doesn’t spread fast the way Covid did. That said, do wear gloves and an N95 mask when you clean rodent droppings at your house. Just to be safe. Even though there’s perhaps not even a tiny chance you’d die otherwise. Feel better? All the above advice comes from Scott Roberts, a Yale School of Medicine infectious disease specialist. He dispelled concerns while offering up-to-the-minute information — and warnings about the public health system’s ability to deal with a more dangerous future viral outbreak — in a conversation Thursday on WNHH FM’s “Dateline New Haven.” “It is certainly not Covid and spreads very differently. It’s just not nearly as contagious,” Roberts said. “I would not freak out in any way. I think this will ultimately stop after isolated pockets are contained.” That’s the upshot. Interested in the details? Read on for an edited transcript of the “Dateline” conversation. Slow Mutation, Systemic Worries Dateline: Do you get to go to the grocery store or a family event these days without people descending on you and immediately asking: “Should I worry? Is this a pandemic?” Roberts: That’s a very common question I’m getting from all facets of my life right now. Hopefully I can provide some reassurance that it is certainly not Covid and spreads very differently.We really haven’t seen this in Connecticut yet, but we are absolutely aware of this, following it closely and preparing if we do have a case. We lived through Ebola.  We lived through SARS 1. We worried it [was] going to disrupt everything, and it didn’t. Is [the Hantavirus] more like Ebola and SARS 1, where it was a deadly, horrible virus, but not a mass event? Yes, this is much more similar to Ebola than something like Covid. The main reason is that it just doesn’t spread that well. Covid, we think if you pass somebody in the airport, you could get infected. Based on what we’re seeing, [the Hantavirus] is just not nearly as contagious. Nobody has been infected so far, who was not on that cruise ship, really highlighting that you probably need some degree of close, prolonged contact for a longer period of time to have a transmission to another person. In contrast to Covid. What is the deal with the Andes strain of Hantavirus? How is it different? This is a very common virus in rodents. The U.S. has some 50 to 100 odd cases of this every year. Mostly it’s centered in the southwestern United States. Connecticut actually did have a case back in 2014 but it was not acquired in Connecticut. It was somebody who went to Vermont, to a log cabin, swept a bunch of rodent droppings and got infected and came back to Connecticut. So we actually haven’t had any locally acquired cases here. The common scenario we hear about is somebody was cleaning out a crawl space and they weren’t wearing a respirator, and they got exposed to some rodent secretions or dropping or urine, and they got infected. But all the strains in the U.S., and everywhere in the world except Argentina, don’t spread person to person. When somebody comes in, they might be sick, but there’s no risk to anybody seeing that patient or coming in contact with that infected individual. The one exception to that rule is this one specific strain of Hantavirus called the Andes Virus, which circulates in rodents in Argentina. Since the mid-’90s, when this was discovered, there have been a handful of isolated outbreaks, these clusters where there has been some degree of human-to-human spread. But it’s never really gotten that far. It hasn’t ever broken out of Argentina. Can that change when viruses mutate, the way Covid did? Absolutely. One of the outstanding questions here was: Has the virus mutated, and now is it easier to spread person to person? Somewhat reassuringly, we already have data showing that the sequence of the virus, looking at basically the code of the virus infrastructure, is relatively unchanged. So it seems like it has not picked up any new mutations. This is probably more than anything similar to those prior outbreaks in Argentina, where there’s just limited clusters of positivity and infections, which might have been facilitated by a cruise ship. Cruises lend themselves to all sorts of spread. Anytime you get a lot of people in a closed space that’s cramped, you’re going to facilitate the spread of anything. The Andes strain, you said, is different, because that can have limited human-to-human contact spread. Is it also different in its lethality? I’ve read that 40 percent of the people who get this virus die. Is that people who get the Andes strain, or any version? It’s really any type of Hantavirus infection could lead to a 40-percent death [rate]. Typically what happens is you would start with nonspecific flu-like symptoms Then in some individuals, there’s this second phase of the illness when you have a pulmonary respiratory decompensation, and it leads you to get hospitalized, needing oxygen and going on a ventilator. Is it truly 40 percent [who then die]? Or is it that there’s many more asymptomatic or mildly symptomatic people out there? These are all options, which we need to answer. A couple times a year we have mouse infestation in our house, and we clean up the waste. Even though we don’t have the Argentina strain, you’re saying it is as lethal. Is it important for people to wear a mask when you’re cleaning up after mass droppings in your house? Any cleanup of any rodent-related debris, I would say I would take precautions, which should include not just a mask, but gloves. And the mask, critically, has to be a respirator. So not one of those surgical face masks, but an N95 respirator. What’s the difference? The surgical mask is one that probably people are most familiar with. They hand them out when you walk into a clinic. A respirator is a bit different. It has a much tighter fit. It’s more sturdy with the mass components. It’s called an N95 because it filters 95 percent of particles that are inhaled. The goal of a respirator, in contrast to face masks, is that it filters aerosols. Some diseases transmit by aerosols, which is like exhaled smoke. They just linger in the air, instead of these clunky droplets that fall to the ground very quickly. So measles, for example, spreads through aerosols. The thought is that Hantavirus, when you’re sweeping up rodent droppings, you can aerosolize some of the virus in those droppings and inhale it. If people don’t wear masks and they’ve been cleaning up rodent droppings, how likely are they to get sick from that? Very unlikely. As I noted, there’s not been a single case of this reported in Connecticut ever that’s been acquired in Connecticut. But I think if anybody is unsure, the easy answer would be: wear a respirator when you are cleaning up rodent droppings. Easier still would be to clean everything without sweeping it or aerosolizing, with a wet paper towel, for example, where you wouldn’t run the risk of inhaling any of these particles.  In 2018 there was a birthday party in Argentina. A person got infected. There were 100 guests. Five people in the room got sick, and they weren’t all people in close contact with him. People are paying a lot of attention to that incident, like Joseph Allen. He’s a public health associate professor at Harvard. He [wrote in the Atlantic] that all the advice that the officials are giving us is that only close, prolonged contact is the way this thing can spread. He argues that this is repeating a mistake we made at the Covid pandemic’s start when we got the wrong word out. We said it was done by surfaces or droplets. I’m not blaming experts for that, because we didn’t know. We were trying to figure it out. But he’s saying it was proven in 2018 that it’s not just [through] close, prolonged contact that people can get it. Those people infected others, including their spouses. He called that a super spreader. Is he right that that’s a mistake we’re repeating? Is it, in fact, not close, prolonged contact is the only way it’s spread? He’s right in some degree, in that that’s not where all the transmission occurs. It likely requires, in most cases, close, prolonged contact. But I would not be surprised if there’s certain exceptions to that rule, like this example in 2018 where there was a “super spreader.” We’re still trying to understand, even for flu and Covid, why some people spread these diseases easier than others. That example from that party represented a super-spreader event. So somebody was much more contagious than most people think, and led to the these infections. That doesn’t necessarily mean it’s incredibly contagious. Measles and tuberculosis spread through aerosols in the airborne route. And measles is much more contagious than tuberculosis.  Argentina has been dealing with this strain since, you know, the mid-’90s, if not earlier. It’s not like it’s rip-roaring through Argentinian society. So that’s a powerful point: saying that it’s been over 25 years that this strain has been centered in a place where it has not spread. Correct. There are certainly clusters and pockets. I think most of us are predicting something similar here, where there’s going to be these localized and isolated clusters and pockets. Provided we can implement bread and butter public health strategies effectively, such as isolating, quarantining, testing exposed contacts, we should be able to stop this the way we do every time there’s an Ebola outbreak. Some viruses, by their nature, mutate more than others. Measles does not really mutate at all. It seems so far like Hantavirus doesn’t mutate. Covid will pick up a mutation every two weeks. A lot of it has to do with the viral machinery and how many errors it makes when it reproduces and replicates. Flu is another example. Flu mutates so commonly that we need to update the vaccine every year. Even then, it’s not a great match. Modern life involves dealing with the infinite non-zero chances that a horrible calamity could reach you at any time, right? Like a building could collapse on you. Your knee can bend and you fall into a big hole and die. We want to be smart and not take unnecessary risks or prevent against clear dangers, but you can’t live every minute of your life thinking the worst possible, small chance thing might happen, or else we can’t live right? I agree. This happened in 2018 and nobody cared about it at all. Now it’s happening post-Covid. I think the conditions are right for this information to spread much more rapidly about a new virus. So is the super-spreader in this case, not the Hantavirus, but the fears we have because of the understandable trauma from Covid? I think that’s a great way to put it. What I advise patients to do, is just rely on trusted sources, which historically has been the CDC [federal Centers for Disease Control] and the state health department. My opinion is that the CDC, especially with this Hantavirus situation, has been a bit behind the ball. They didn’t even release anything to clinicians on advising about what to do until a few days ago, weeks into this outbreak. My hope is they’ll continue to update guidance and give instructions for what we need to do at the state and the local level about what we should advise people and how we approach possible cases in the community How much in general does this incident tell us about our public health system nationally and internationally? Do we have sources we can still trust and are we able to handle potential epidemics? I would say we’re less able to handle them now than we were, during or even pre-Covid. Look at just the staffing numbers alone of the CDC and our state health departments; they’re going down every year. If we can identify cases, isolate individuals, contact trace, expose contacts, test them, we can stop this. The question is: Do we even have enough contact tracers on the phones, if this did hit Connecticut to be able to do that? My long-term worry is that if we keep seeing these resources funneled out of public health, we run the risk of not just this virus, but many viruses in the future. I think I’m still hearing that you’re not worried that if we don’t contain it, this isn’t going to be another Covid. But you are worried that it symbolizes that maybe one day there will be another virus … I’m worried about Hantavirus 2.0 or the next virus that jumps from animals to humans next year. The long term-threats of these are only going to increase. We’re an increasingly global society. We can get on a plane go anywhere today. So you run the risk of creating these pandemic-ready scenarios. I would be concerned more long term if we have SARS 3 or whatever the next Covid iteration would be. Because I don’t think we’re nearly as well equipped to handle it. So what are our trusted sources? The main ones I use right now is the state public health department. I know many of those individuals, and I trust what they are putting out. The CDC continues to be reliable in some forms. I’ve not seen any untrustworthy information about Hantavirus right now, although the information posted there is quite limited. I personally rely on a lot of guideline bodies of institutions that I trust. For vaccines, that’s the American Academy of Pediatrics or the Infectious Disease Society of America. These groups of bodies that have sort of risen as the CDC has backtracked. The World Health Organization? Yes, the World Health Organization. I do trust those sources. And if [U.S. Health and Human Services Secretary] Robert F Kennedy Jr. is still in charge of public health, is that going to help us or hurt us? I think it will hurt us. The CDC guidance for many diseases on their website today has not changed in some time, such as malaria. So that I can trust. But if it’s things like the measles vaccine and autism, that information has changed despite really no new data coming out. That’s a scenario where I don’t know if I can trust that. I start to wonder: Can I trust what they say about hepatitis B and chicken pox and name your disease? I think that break in trust will lead to long, lasting consequences. “Don’t freak out”:  That’s kind of what I got from you. I would not freak out in any way. If there is a time to freak out, that will be communicated. But I do not think we should with this. I think this will ultimately stop after isolated pockets are contained. Click on the video at the top of this story to watch the full conversation on WNHH FM’s “Dateline New Haven” with infectious disease specialist Scott C. Roberts. Click here to subscribe or here to listen to other episodes of “Dateline New Haven.” The post Expert: Hantavirus Not A Covid Rerun appeared first on New Haven Independent. ...read more read less