Thread by @Ayjchan

New York🇺🇸-based MV Hondius cruise passenger who disembarked on Apr 24 went to a Hanoi🇻🇳 conference last week for extreme travelers (150 guests who've visited 100+ countries), potentially passing through Hong Kong🇨🇳 Bangkok🇹🇭. Her current location is unknown @JSweetLI reports...

@JSweetLI ... previous hantavirus outbreaks didn't have this kind of opportunity to race around the world.

"MV Hondius is a pricey, adventurous expedition—costing passengers between $8,500 to $17,000—and so it attracted world travelers crossing bucket list sights"
jacquelinesweet.substack.com/p/a-second-wom…

@JSweetLI Hantavirus-exposed cruise passengers going on world tour are not breaking any laws. @WHO had said they were low-risk contacts, only changing to high-risk around May 9 or 10.

@JSweetLI @WHO A worst case scenario is one of the extreme traveller passengers becoming infectious at another extreme traveller event where dozens to hundreds of people are exposed and jet off to dozens of other countries.

All of these jetsetting passengers have to be tracked. The 2nd patient was symptomatic before the first disembarkment on Apr 24.

“All of the other passengers were giving her hugs and everyone was talking to her.

At every meal, someone else was sitting beside her and we had open buffets, we had group activities, lecture sessions, we had meetings in lounge area.

On a ship like Hondius, there isn't much to do other than socialising.”
uk.news.yahoo.com/passenger-says…

Experts are correct that the Andes hantavirus is not likely to cause a pandemic (at least not quickly). But it could still cause a sizable outbreak like 2003 SARS (also driven by chance superspreader events) where thousands of people worldwide are infected and hundreds die.

Given the nature of the MV Hondius cruise and its appeal to extreme travelers, it's not unlikely that a scenario like the 2003 Metropole Hotel SARS superspreader event could unfold.
cnbc.com/2020/02/14/hon…

Unlike 2003 SARS (incubation 2-10 days), it will be much harder to stamp out/contain Andes hantavirus because of its up to 8 weeks incubation time and potential to infect rodent populations (how do you quarantine rodents?).

More from @JSweetLI's report about the extreme traveller (I recommend reading her entire article):

"Sources alleged they heard from attendees at the conference that a MV Hondius passenger was at the conference dinner and that they were reportedly evading testing."

@JSweetLI It's not possible to understand what's happening in the minds of exposed cruise passengers. Maybe it's denial, downplaying any exposure they might've had on the cruise/flight. Maybe it's fatalism, living out your bucket list before you succumb to hantavirus.

@JSweetLI While it's very sad to be in that situation, I don't think dozens to hundreds of people should continue to be put at risk by MV Hondius cruise passengers who are not quarantined, self-isolating, or even tracked by the authorities.

@JSweetLI Here's the link again to the article published yesterday:
"Efforts to contact the woman were unsuccessful. Organizers of the [Hanoi] conference did not respond to inquiries."
jacquelinesweet.substack.com/p/a-second-wom…

@JSweetLI The Hanoi conference organizers should send an alert to all attendees that they may have been exposed.

The cruise passenger must also be tested for an active infection as well as antibodies to hantavirus to determine if conference attendees were exposed.

@JSweetLI "The best way to keep people from panicking about hantavirus is to do everything possible to ensure there is nothing to panic about."
vox.com/future-perfect…

@JSweetLI The advice from a hantavirus expert who studied the 2018 Andes hantavirus outbreak was very measured and clear.

There is a small window of contagiousness but it has to be handled correctly to prevent further waves of transmission.
transcripts.cnn.com/show/ebo/date/…

@JSweetLI Right now the decision is relatively simple: do you quarantine the cruise passengers and close contacts?

But once cases unlinked to the cruise appear, the decision balloons up to city or country-wide policies.

@JSweetLI Some experts consider the 2003 SARS to be the first pandemic of the 21st century. It infected more than 8,000 people across 29 countries and regions.

Andes hantavirus could achieve this if facilitated by extreme travelers.

Details on another cruise passenger who sat 2 rows behind the woman who died from hantavirus:

"The man had then flown on to Italy, where he had spent 17 days touring Rome, Florence, Venice and the Cinque Terre near Genoa."

"The man, in his 60s, was stopped at the guesthouse where he was staying in the Pasteur area of Milan, along with a 50-year-old man who had joined him in Italy.

Officials in Milan said they had been alerted by the UK Ministry of Health and had traced the men to their B&B late on Tuesday night"
msn.com/en-in/health/h…