2 Singapore residents on hantavirus-hit cruise ship isolated at NCID and undergoing tests
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The MV Hondius cruise ship reported an outbreak of Andes hantavirus, with eight cases linked to the cluster on the ship so far.
PHOTO: REUTERS
SINGAPORE – Two Singapore residents who were on board the MV Hondius cruise ship, which reported an outbreak of Andes hantavirus, are being tested.
The Communicable Diseases Agency (CDA) said it was notified on May 4 and 5 about the two residents.
Both of them have been isolated at the National Centre for Infectious Diseases (NCID), where they are being tested for hantavirus. Their test results are not ready, the CDA said in a statement on May 7.
One has a runny nose but is otherwise well, and the other has no symptoms.
The first, a 67-year-old Singaporean man, arrived in Singapore on May 2. The second, a 65-year-old Singapore permanent resident, arrived in Singapore on May 6.
Both were on board the MV Hondius cruise ship when it left the Argentinian port Ushuaia on April 1.
They later got off the ship and got on the same flight as a confirmed hantavirus case.
The flight was to the South African city of Johannesburg from St Helena Island on April 25.
The confirmed case did not travel to Singapore, and later died in South Africa, CDA said.
St Helena is an island in the South Atlantic Ocean, about 2,000km off the coast of Africa.
CDA said that if the two Singapore residents test negative for hantavirus, they will be quarantined for 30 days from the date of last exposure, as most hantavirus cases are expected to show signs of infection within this period.
They will be tested again before being released from quarantine. For the rest of the 45-day monitoring period, they will be monitored remotely – for instance, by reporting on their health status daily through tracking apps.
The maximum incubation period for hantavirus exposure is 45 days.
If a test comes out positive, the infected patient will remain in hospital for monitoring and treatment because a hantavirus infection can become serious.
Contact tracing will be done to identify people who were exposed during the infectious period. People who have come into close contact with the two residents will also be quarantined, CDA said.
Eight hantavirus cases, including three deaths, have been linked to the cluster on the cruise ship so far.
Five of eight suspected cases of hantavirus linked to the vessel have been confirmed, the World Health Organization (WHO) said at a press briefing on May 7. WHO assesses the risk to the global population as low, CDA said.
People can become infected with the hantavirus if they breathe in dust contaminated with urine, droppings or saliva from infected rodents, especially when cleaning or disturbing areas where there are rodents.
While hantaviruses do not usually spread from person to person, one species – the Andes virus found in parts of South America – has been linked with human-to-human transmission.
Symptoms of infection with the Andes virus typically include fever, body aches, fatigue, gastrointestinal symptoms and difficulty breathing. It can progress rapidly to shock and death, CDA said.
Treatment includes supportive care and management in hospital, if required. There is no specific antiviral treatment or vaccination.
The mode of transmission for the cases linked to the MV Hondius is still under investigation.
Duke-NUS Medical School’s Professor Ooi Eng Eong, who specialises in emerging infectious diseases, said hantaviruses are a group of viruses that are naturally found in rodents, including urban rats like the brown and black rats in Singapore.
The name comes from the first virus in this group, which was found to be the cause of a Korean haemorrhagic fever epidemic among soldiers operating on the banks of the Hantan River during the Korean War, he added.
Prof Ooi said: “Hantaviruses can be transmitted from rodents to humans via contaminated food, rat bites and scratches. Nevertheless, human-to-human transmission is rare.
“Infection can result in a wide range of symptoms and illnesses, from mild fever to haemorrhagic fever and renal syndrome and hantavirus pulmonary syndrome – a lung disease seen in the outbreak on the Atlantic cruise ship.”
WHO said human-to-human transmission cannot be ruled out. It advised all those who have been on the MV Hondius to monitor their health, and seek medical attention quickly if they experience symptoms.
To reduce the risk of infection, CDA said anyone travelling to areas with known hantavirus infections should take precautionary measures, especially when planning to camp, hike or visit rural areas.
They are advised to:
Avoid contact with rodents and areas contaminated by their urine, droppings, saliva or nesting materials.
Keep accommodation areas clean, seal gaps where rodents can enter, store food securely and dispose of rubbish properly.
Use a damp cloth or mop to clean surfaces instead of dry sweeping to avoid stirring up potentially contaminated dust particles.
Maintain good personal hygiene.
Avoid close contact and sharing of common items with anyone who is unwell or who is suffering from respiratory or gastrointestinal symptoms like vomiting or diarrhoea.
Travellers who become unwell during or after their trip need to seek prompt medical attention and inform the doctor about their recent travel history, itinerary and any possible exposure to rodents or people who were ill, CDA added.
Additional reporting Judith Tan
