A woman from Alicante, isolated due to suspicion of hantavirus after having been in contact 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 was on the plane for a few minutes with the passenger of the hantavirus cruise who died in Johannesburg. 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 has now returned to his country of origin. A flight attendant also worked there, who, despite having compatible symptoms, has tested negative for microbiological tests. Thus, for now, 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 a mild 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 to take all the "necessary precautions" to avoid putting anyone at risk. Biological samples have been taken from the patient with a PCR and she has undergone blood and serum analysis, which are now being analyzed at the National Microbiology Center. Results are expected within the next 24 hours.

If she tests negative, but the symptoms continue, the diagnostic test will be repeated, and if the situation remains the same without a diagnosis, it will be done every 48 hours, as explained at a press conference by the Secretary of State for Health of the Spanish government, Javier Padilla, who expressed 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 "of very short duration."

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 tranquility, 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 now, 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 from the southern country, international gears for patient follow-up and epidemiological surveys have been activated. When asked by journalists, Padilla was emphatic in ruling out a wave of hantavirus contacts: "We have contemplated 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. A sign of this cooperation is the action protocol for the outbreak approved by "unanimity" by all the 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 hospital in the community, despite the fact that the Gómez Ulla is owned by the Ministry of Defense. "We all have an interest in everything going perfectly and being our country's pride," she 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 in 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 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 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 that we get closer to low probability areas" of new contacts, said Padilla, who also emphasized that since April 28, there has been "no record" of new cases.