A woman, first contact of a hantavirus victim living in Catalonia

BarcelonaNone of the cruise passengers still on board At this point, health authorities have three people under surveillance due to the hantavirus outbreak in Spain: the woman with symptoms in Alicante who is considered a suspected case and must remain in isolation, and the two women identified as contacts – and therefore not considered suspected cases –: the woman living in Catalonia and a South African tourist who spent a week in Barcelona but had already returned to her country. Thus, there is only one possible contagion under consideration — that of the woman from Alicante — which will need to be confirmed or ruled out with a microbiology test.

A 32-year-old woman is isolated in an Alicante hospital with symptoms compatible with hantavirus, while the National Microbiology Center analyzes her biological samples. On April 25, she was on the plane for a few minutes with the hantavirus cruise passenger who died in Johannesburg. The cruise passenger, who was the wife of the man who died from the infection on board the

Hondius

and is considered the first affected by the outbreak, was quickly evacuated from the aircraft before takeoff when her condition deteriorated.

On this very same plane that was covering the route between the capital of South Africa and Amsterdam, another woman with a South African passport was traveling, who spent a week in Barcelona and by now has already returned to her country of origin. The Ministry of Health has emphasized that the woman "has not had close contact with anyone in the Catalan capital and her stay in the city corresponds with the non-infectious incubation period." Furthermore, at the moment she is in her country in good health and without symptoms. A flight attendant was also traveling who, despite having compatible symptoms, has tested negative for microbiological tests. Thus, for the moment, there is no confirmed case of hantavirus in people other than the cruise passengers.

and who is considered the first case of the outbreak, was quickly evacuated from the aircraft before takeoff when her condition deteriorated.

In case she tests negative, but the symptoms continue, the diagnostic test will be repeated, and if the same situation persists without a diagnosis, it will be done every 48 hours, as explained in a press conference by the Secretary of State for Health of the Spanish government, Javier Padilla, who has expressed his confidence that it will end up being a negative case, as happened with the KLM flight attendant who was on the same flight. "We believe it is very unlikely that she has been infected," insisted the ministry official, as the exposure to hantavirus was "for a very short time."

Clinical criterion

Padilla has indicated that at all times action will be taken based on "clinical judgment and laboratory tests" to determine when a patient moves from a suspected case, as is the case in Alicante, to a contact. It will then be when the transfer is made to the Gómez Ulla military hospital in Madrid, where the government has arranged for the 14 Spanish passengers from the cruise ship to undergo the quarantine period once they arrive, this weekend, at the port of Granadilla. If a positive case is detected, admission will be made to one of the UATAN centers (High-Level Isolation and Treatment Unit), in the case of the woman from Alicante, at the La Fe Hospital in Valencia.

In this vein of conveying a message of calm, Padilla has indicated that the mere fact of having located the woman from Alicante and the South African tourist demonstrates that "the solvency and capacity" of the existing international tracking and early response mechanisms are working well, also on an international scale. For the moment, the Valencian Generalitat is carrying out contact tracing with the woman's contacts. When asked by journalists, Padilla was emphatic in ruling out an outbreak of hantavirus contacts: "We have foreseen everything that will not happen, and this will not happen," he stated.

Mandatory quarantines

After days in which political strife has tarnished the work of health technicians, Padilla has valued the climate of "collaboration" he has found. Evidence of this cooperation is the protocol of action in the face of the outbreak approved by "unanimity" by all autonomous communities in the Public Health commission. A few days ago there were criticisms from the Canary Islands for "lack of information and disloyalty" by the Spanish government for having accepted the WHO's request to host the ship in the archipelago, while from the Madrid executive, President Isabel Díaz Ayuso refused to accept the 14 passengers of the cruise ship in a community hospital, despite the fact that the Gómez Ulla is owned by the Ministry of Defense. "We all have an interest in everything turning out perfectly and being our country's pride," he stressed.

The protocol establishes what to do from the arrival of the cruise ship off the coast of Tenerife and finally sets mandatory quarantines. Padilla has confirmed that all Spanish passengers have expressed their willingness to voluntarily enter the Gómez Ulla hospital. All of them, however, will be given a document for them to accept the conditions of disembarkation, transfer, and stay at the center, with reference to isolation or mobility within the building or the regime of external visits. This is not the usual informed consent in health activities because, in this case, "consent cannot be revoked nor can voluntary discharge be requested," Padilla clarified.

It remains to be determined what the isolation period should be at the Gómez Ulla or other hypothetical contacts that may arise because the date of the last contact with a positive case has not been determined and work is being done between April 28 and 30. According to Padilla, during the first seven days of stay, a "very strict quarantine" will be established which will end with a PCR, that is, when three weeks have passed since contact. "Every day is one more day we get closer to low probability areas" of new contacts, said Padilla, who also emphasized that since April 28 "there is no record" of new cases.