A woman from Alicante, isolated due to suspected hantavirus after coinciding with one of the cruise passengers

BarcelonaA 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 coincided for a few minutes on the plane that the passenger of the hantavirus cruise who died in Johannesburg tried to board. The cruiser passenger, who was the wife of the man who died from the infection aboard the "Hondius" and who is considered the first affected by the outbreak, was quickly evacuated from the aircraft before takeoff when her condition deteriorated.

On this same plane, which covered the route between the capital of South Africa and Amsterdam, traveled another person with a South African passport, who spent a week in Barcelona and by now has already returned to their country of origin. A flight attendant also worked there who, despite having compatible symptoms, has tested negative in microbiological tests. Thus, for the moment, there are no confirmed cases of hantavirus in people other than the cruise passengers.

The woman from Alicante called the health authorities of the Valencian Community when she began to show mild symptoms of cough, one of the symptoms of hantavirus. From here, the Ministry of Health has activated the protocol and, in coordination with the Valencian Ministry of Health, she has been admitted to an isolation room with negative pressure at the Sant Joan hospital to take all "necessary precautions" to avoid putting anyone at risk. Biological samples have been taken from the patient with a PCR and a blood and serum analysis has been performed, which are now being analyzed at the National Microbiology Center. Results are expected within the next 24 hours.

In case of a negative result, but the symptoms continue, the diagnostic test will be repeated, and if the same situation without a diagnosis persists, 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 head of the ministry, 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 spend the quarantine period once they arrive, this weekend, at the port of Granadilla. If a positive case is detected, admission will be 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 line of transmitting a message of reassurance, 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 tracking with the woman's contacts. Regarding the South African tourist, Padilla has explained that through a European coordination mechanism of the southern country, the international gears for patient follow-up and epidemiological survey have been activated.

The Ministry of Health has emphasized that the tourist "has not had close contact with anyone in the Catalan capital and his stay in the city corresponds to the non-infectious incubation period." Furthermore, at the moment he is in his country in good health and without symptoms. To journalists' questions, Padilla was adamant in ruling out a wave of hantavirus contacts: "We have considered everything that will not happen and this will not happen," he stated.

Mandatory quarantines

After days in which the political dispute has tarnished the work of health technicians, Padilla has valued the climate of "collaboration" he has found. A demonstration 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, even though the Gómez Ulla belongs to the Ministry of Defense. "We all have an interest in everything going perfectly and that it be our national 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 so that they accept the conditions of disembarkation, transfer, and stay at the center, in reference to isolation or mobility within the building or the external visiting regime. This is not the usual informed consent in healthcare 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 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 the contact. "Every day is one more day that we get closer to low probability areas" of new contacts, stated Padilla, who also emphasized that since April 28, "there is no record" of new cases.