What is the story about?
JOHANNESBURG (AP) — On May 1, South African infectious disease specialist Lucille Blumberg received an urgent email during the Labor Day holiday regarding
a passenger from a cruise ship thousands of miles away in the Atlantic Ocean. The passenger, who had been evacuated and admitted to a Johannesburg hospital with suspected pneumonia, was part of a larger group of sick individuals aboard the Dutch cruise ship MV Hondius. The email came from a U.K.-based colleague monitoring diseases in remote British territories, prompting Blumberg and her team at South Africa’s National Institute for Communicable Diseases to investigate the outbreak aboard the vessel.
Initial Response to the Outbreak
Upon receiving the information, Blumberg and her colleagues acted swiftly, despite it being a public holiday. “Even though it was a public holiday, we moved, we moved really fast,” Blumberg stated. “It was busy. There were many conversations. There were online discussions, and there was laboratory testing happening at the time.” Within 24 hours, they identified hantavirus as the cause of the man's illness, a rare rodent-borne virus. While the patient is recovering, three other passengers have died, and others have reported symptoms.Process of Elimination in Disease Identification
The British man had arrived at a private hospital in Johannesburg seriously ill, but health workers initially struggled to determine the cause of his symptoms. Two elderly Dutch passengers aboard the MV Hondius had already died, yet there was little alarm at that point. Ascension Island health authorities had informed the World Health Organization of a cluster of illnesses on the ship that appeared to be pneumonia.Blumberg and her team initially considered other potential causes, such as Legionella, a bacterium responsible for Legionnaires' disease, or bird flu. “I called my infectious disease colleagues, and we had a caucus, and we discussed the usual ones,” Blumberg explained. Tests for these possibilities returned negative results, as did extensive panels for other respiratory diseases.
Focusing on the ship's origin in Argentina and the passengers' interests in bird watching, the team began to explore the possibility of hantavirus infection, which is known to occur in parts of South America.
Collaboration with International Experts
This new direction prompted South African experts to collaborate with hantavirus specialists in South America and the United States, facilitated by the WHO. “You can get onto a Zoom (call) online and ask your questions and get advice. This is not something every day. So that was quite extraordinary,” Blumberg remarked.By Saturday morning, Blumberg contacted the only laboratory in South Africa capable of testing for hantavirus. “I said, we want to do hanta, and she said, ‘yeah, I’m coming.'” Tests on the patient's blood samples confirmed the presence of hantavirus that afternoon, leading to a second set of tests for verification.
Confirming the Outbreak
The positive test results, which identified the Andes strain of hantavirus, allowed the WHO to alert the cruise ship about the outbreak. While hantavirus is not easily transmitted between individuals, the WHO noted that the Andes virus can be. This prompted Blumberg to collect blood samples from a Dutch woman who had been among the first two passengers to die after disembarking the ship.A posthumous test on her also returned positive for hantavirus. “It was a bit of a wow moment,” Blumberg said. “And at least once you know what you’re dealing with, it’s much easier to respond.” The British man remains hospitalized but is improving, according to South Africa's health ministry. Meanwhile, the MV Hondius has reached the Dutch port of Rotterdam, where it underwent disinfection, and remaining crew members disembarked.
Reflecting on her experience, Blumberg stated, “I’ve been doing outbreaks for 25 years. That’s what we do. We do them every day. I think the important thing was to respond immediately to a question that clearly was urgent and then to take it from there.”
