Hantavirus Outbreak Sparks Global Concern: Should India Be Worried?

As passengers begin disembarking on Sunday from the hantavirus-hit cruise ship anchored off Tenerife in Spain’s Canary Islands, nations worldwide are closely monitoring their return to their home countries, wary of the public health risks these nationals may pose. 

Currently, none of the more than 140 passengers aboard the ship is showing any symptoms of the virus reported World Health Organisation, the cruise company Oceanwide Expedition and Spanish authorities. 

While Spanish Health authorities, in collaboration with the WHO, are practising every health measure concerning the Hantavirus-stricken cruise, the world that still remembers the pandemic from COVID-19 remains cautious. The deadly virus has claimed three lives since the outbreak, and five passengers who left the ship are infected with hantavirus, which can cause life-threatening illness.

Should India be worried? 

While none of the passengers on the cruise was Indian citizens, it was revealed that two Indians citizens were a part of the support staff on the Oceanwide Expedition cruise. 

The two Indian nationals have been confirmed to be asymptomatic and under observation as per international health protocols, Union Health Ministry sources said on Friday.

Reassuring that the duo remains under close observation, the Ministry said that they received information through International Health Regulations (IHR) channels and that they are maintaining close coordination with the World Health Organisation (WHO) and other international partners.

Director of the ICMR's National Institute of Virology, Dr Naveen Kumar, told PTI that the cases appear to be isolated ones and there is no immediate public health threat to India. Additionally, he claimed that there is no evidence of community spread as of now.

Explaining the rodent-borne virus, the director said that the virus is transmitted via contact with infected rodents or their excursions.

"The reported hantavirus cases appear to be isolated ones, and there is no immediate public health threat to India," he said.

Comparing COVID-19 to Hantavirus, Kumar stressed that it does not spread easily among people.

"Human-to-human transmission is extremely uncommon. Most hantaviruses, especially those reported in Asia and Europe, do not spread between humans. Limited person-to-person transmission has only been documented with some South American strains such as Andes virus," he explained.

Speaking on India's preparedness to manage an outbreak, Kumar said the country has adequate laboratory surveillance capacity to identify suspected cases.
"India has diagnostic capacity for hantavirus infection through the ICMR-National Institute of Virology and the nationwide Viral Research and Diagnostic Laboratory Network of 165 labs, where RT-PCR facilities are available for confirmation of suspected cases," he said to PTI.

Elaborating on the same, Dr Puneet Mishra, Head of the Department of Community Medicine at AIIMS, Delhi, told PTI that hantavirus behaves very differently from highly transmissible respiratory viruses such as COVID-19.

"There are many types of hantaviruses, of which the Andes strain is causing the ongoing cruise ship outbreak. Hantaviruses circulate freely among rodents and only occasionally infect humans," Dr Mishra said.

He added, "The Andes strain is known for limited human-to-human transmission through prolonged close contact with respiratory secretions. This explains the spread of the virus on the cruise ship, which essentially is a closed environment where many individuals remain in prolonged close contact over an extended period of time."

Dr Rajeev Jayadevan, Co-Chairman of the National IMA COVID Taskforce, said there is no indication of any immediate outbreak risk in India.

"The types of hantaviruses found in India and other parts of the Asian subcontinent are not the same as the ongoing cruise ship outbreak. Hantaviruses in Asia and Europe generally cause kidney disease with lower mortality, unlike the Andes strain, which primarily affects the lungs," he said to PTI.

While asymptomatic exposure to hantaviruses has been documented in India, Dr Jayadevan noted, serious outbreaks have not been reported.

"Climate change and faulty garbage disposal are factors that increase rodent population. However, from India's perspective, leptospirosis remains a far bigger rodent-borne threat,"

The National Centre for Disease Control (NCDC), Integrated Disease Surveillance Programme (IDSP), WHO and other international health authorities are monitoring the situation.

On the global front, WHO Director General Dr Tedros Adhanom Ghebreyesus, who briefed the media on the virus, said "While this is a serious incident, WHO assesses the public health risk as low".

Given the incubation period, he said, "it is possible that more cases may be reported".

Senior officials from IDSP and IHR-NFP India attended a high-level review conference called by the Public Health Emergency Operations Centre (PHEOC) under IDSP and NCDC in order to evaluate preparedness measures and appraise the situation in light of the changing circumstances.

As it stands, the centre and virologists agree that the Hantavirus poses very low risk to the Indian population, however, more details on the conditions of the two Indian crew members is yet to be disclosed.