GEORGIA (WALB) — Health officials are monitoring two Georgia residents after they returned home from the MV Hondius cruise ship, which has been linked to a rare hantavirus outbreak.

The Georgia Department of Public Health (DPH) said the two individuals are currently in good health and showing no signs of infection. DPH declined to provide the exact location of the two Georgians being monitored.

WALB’s sister station in Savannah, WTOC, reported that a Brunswick-area woman was one of the two Georgians being monitored.

The outbreak has reportedly killed three people.

The woman declined to comment on the situation or confirm whether she is being monitored for hantavirus. Photos posted on the woman’s social media appear to show her time aboard the cruise ship.

Charlotte F. Griffin, an infection prevention nurse at Tift Regional Medical Center, said hantavirus is rare, and it can cause serious health conditions.

“It was first identified in 1978 in the Hatan River area of Korea, thus its name,” Griffin said. “Then the virus was carried by rodents, so it was known in that area.”

The first outbreak in the United States came in 1993 in the Four Corners area of Arizona, Colorado, New Mexico and Utah.

“From 1993 to 2023, that’s 30 years of recording, there’s only been 890 cases in the United States,” Griffin said.

Griffin said most people in the United States who have contracted hantavirus have survived, and the key is getting treatment early. The majority of cases are from exposure to rodents or their waste.

“But there is one strand of hantavirus that is in Argentina and Chile, called the Andes virus, that has been known to spread person-to-person,” Griffin said.

How hantavirus compares to COVID-19

Griffin said hantavirus is not a novel virus like COVID-19.

“This is a virus that’s been around since 1978,” Griffin said. “We know a lot about it and know how it works and know how to treat it. So, it’s different than COVID was, which was something brand new that nobody knew what was going on and what to do.”

Griffin said hantavirus is very rarely spread among people.

“So, it’s not the threat that COVID was,” Griffin said.

Symptoms to watch for

Griffin said symptoms can appear two to three weeks after exposure, or they can take up to eight weeks to show up.

“Those [symptoms] are fatigue, fever, deep muscle aches,” Griffin said. “And these are deep muscle aches in your big muscles like your thighs or your back or your calves. You know, different from just your normal flu ache and pain.”

Other symptoms reportedly include headaches, chills, nausea, vomiting, diarrhea or abdominal pain.

“These are also symptoms of a lot of other things,” Griffin said. “So, it’s at that point hard to diagnose because it could be flu. It could be Legionnaires. It could be COVID. We don’t know at that point.”

Griffin said the disease becomes more serious four to 10 days in, when patients start having shortness of breath and fluid developing in their lungs. Patients can also develop heart and kidney problems from the virus.

“At that point, they really, really need to be in a hospital somewhere,” Griffin said.

Griffin said exposure history is important for diagnosis.

“It looks like flu or COVID, but have you been exposed to rodents or their feces?” Griffin said. “Have you been exposed to somebody who’s traveled to Argentina where it can be?”

Treatment options

Griffin said there are blood tests to identify the virus and some antivirals that seem to help with symptoms.

“But the majority of what we do is just treat the symptoms,” Griffin said. “We’re going to treat the fever. If they’re dehydrated, give them fluid. If they need oxygen, support with that.”

In later stages, patients with fluid in their lungs may need to be on a ventilator, or if their kidneys are failing, they may need dialysis.

“But being in America where we have these types of medical treatments available makes the big difference,” Griffin said.

How to protect yourself

Griffin said the main protection is keeping rodents out of homes.

“So you want to seal up your food,” Griffin said. “Look for gaps where mice could come into your home.”

When fresh urine or droppings or materials of an infected rodent are stirred up, people can breathe that in, officials said.

“So if you have to clean up areas where there’s a rodent infestation, wear a mask, wear gloves and always wash your hands,” Griffin said.

For the Andes type that spreads person-to-person, Griffin said protection includes masks, controlling droplets and hand washing.

Previous U.S. case of Andes strain

Griffin said there was one documented case of Andes strain hantavirus in the United States in 2018. The person had traveled to the Andes region of South America and became sick after returning to the United States.

“This person was treated, did get well, but they also monitored all her contacts, people who were with her on the plane, her family members, people that treated her at the hospital,” Griffin said.

Griffin said officials monitored contacts for almost two months to make sure no one became sick, and no one did.

“So, even though it was the Andes strain, it could be person-to-person,” Griffin said. “It didn’t happen.”

MV Hondius outbreak details

Griffin said there were a few hundred people on the ship, and only eight became sick. The first two cases were a husband and wife who had been birdwatching in the Andes Mountains prior to boarding the ship.

Griffin said the couple could have been exposed there.

The investigation is still ongoing, Griffin added, and the source of exposure is under speculation.

“These people have been in very small space with each other for a long period of time,” Griffin said. “We don’t know for sure if it’s person-to-person. You know, there could be infected rodents on the ship. There could be infected food on the ship. They’re still looking right now. We don’t know this.”

Griffin said cruise ships can be a source of outbreaks, including flu, norovirus and COVID-19.

“You get a large number of people in a confined space, and it leads itself to spreading an infection if it comes on board,” Griffin said.

Griffin said basic precautions remain important.

“Wash your hands, contain your body fluids and support your body’s own immune system to stay as healthy as possible,” Griffin said.

According to the CDC, hantaviruses are a family of viruses mainly spread through contact with rodents, especially through exposure to rodent urine, droppings or saliva. The viruses can cause serious illnesses including hantavirus pulmonary syndrome, also known as HPS. The CDC says the Andes virus is currently the only known hantavirus capable of spreading person-to-person, and transmission is typically limited to close contact with an infected individual.

WALB will continue following updates connected to the outbreak and ongoing monitoring efforts.

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