Updates on hantavirus case hospitalised in France and contact cases

Concerns over the threat of a hantavirus outbreak are on the rise in France. 

Yesterday (May 11) health authorities confirmed that one of the five French nationals evacuated from the MV Hondius cruise ship has tested positive for the illness. 

The other four are being quarantined for up to 42 days. 

However, 22 further possible contact cases have been identified in France, with one of these reportedly being transferred to a Brittany hospital.

An emergency decree requires anyone thought to have come into contact with infected individuals to report to local health authorities.

Despite France seeing around 100 cases of hantavirus per year on average, the ‘Andes strain’ at the centre of the cruise ship outbreak has an extremely high mortality rate of up to 50%.

Below, we cover the main updates on the case and France.

Minister schedules a press conference for this afternoon

• A cabinet meeting took place this morning (May 12), and a press conference detailing the government’s next steps is scheduled to take place this afternoon at 16:45, headed by France’s Health Minister Stéphanie Rist. We will update this page with more information after the conference is held.

Contact case taken to hospital in Brittany

• One of the 22 French nationals who came into contact with an infected passenger from the ship has been identified and transferred to a hospital in Brittany, public service broadcaster France Info reports.

• The man was identified in Concarneau (Finistère), and taken to Rennes hospital, where there is a centre for infectious diseases. He does not live in the commune permanently and was only passing through, reports local media France Bleu.

• He is said to have informed authorities himself that he was a contact case, following rules laid out in the new decree. It has not been reported whether he is showing symptoms of the illness. Unlike French nationals on board the ship who have been evacuated back to France, he came into contact with an infected individual on a flight. 

• The wife of the first victim – who was a retired Dutch passenger thought to have been infected during an excursion in South America – initially disembarked the cruise ship, taking a KLM flight from Saint Helena to Johannesburg (April 25) before attempting to board an onward flight, also KLM and also on April 25, to Amsterdam, unaware that she was also infected.

• She fell ill after boarding her second flight and was removed before take-off. She died shortly after in South Africa.

Decree passed requiring contact cases to report 

• In order to limit the potential spread of the Andes-strain hantavirus, an emergency decree has been passed requiring contact cases to declare themselves to the French authorities.

• This applies mostly to any French national who boarded the ship between April 1 and May 10 (and disembarked before the outbreak was known), as well as the 22 nationals who came into contact with the now-deceased Dutch woman on the two flights mentioned above.

• Eight of these contact cases were present on the flight between Saint Helena and Johannesburg, and the other 14 on the Johannesburg - Amsterdam leg. 

• Health Minister Stépahnie Rist reported on Monday that the eight contact cases from the Saint Helena flight had been contacted, isolated, and tested for the virus, and all received negative tests. No information about the passengers on the second plane has been given.

• The decree states that these contact cases must report to local health authorities and observe “a home quarantine measure pending an assessment of their risk of infection.” This takes place “within three days” of the announcement, after which authorities can decide on the next steps (quarantine at a health facility, further home isolation, etc). This latter isolation period cannot exceed 42 days (meaning a total of 45 days isolation in total, the same length facing British nationals on the cruise ship).

• However, the decree also applies to individuals who know they have come into contact with individuals on board the ship on the given dates, or believe they have come into contact with someone infected with hantavirus.

• At this stage, it does not specifically relate to those who have come into contact with the 22 contact cases from the two flights.They should also declare this to local health authorities. The decree – found here – does not cite a specific authority to contact, but in the unlikely event you need to, a good first step is the local prefecture or Agence régionale de santé.

• Failure to observe the required quarantine procedures can lead to fines of €1,500, up to €3,750 for repeated offences. In addition, driving licences may be suspended for up to six months if a vehicle was used to circumvent the quarantine.

‘Risk is low’ - what experts say about the situation 

• Authorities continue to insist there is no need for wider panic.

• France “shouldn't have a large-scale hantavirus epidemic [as it] learned from Covid,” said infectologist Karine Lacombe to RTL this morning. “Hantavirus is a virus we know well, even though this Andes strain is less well-known because it's really localised to specific areas of South America; it's been there for a very long time. “There has never been a major epidemic, (...) so with the protective measures in place, we shouldn't have a large-scale epidemic.”

•  “The risk is low, and we are not anticipating a pandemic,” said head of the World Health Organization Tedros Adhanom Ghebreyesus to BFMTV as part of a press conference. “The danger to the population is also low. This is what we have always said, and what our analyses show. I hope the French people understand this. The risk for them is low.” There is a high chance of more cases being declared in the coming weeks, and “the work of health authorities is not finished,” but this should not change the WHO’s outlook, said Mr Ghebreyesus.

•  However, others note that there is uncertainty over the impact of the Andes strain, which has never reached Europe at this scale. “We have a new hantavirus every year and constant mutations," said head of the infectious and tropical diseases department at Tenon Hospital Gilles Pialoux to BFMTV. "No one can say whether this mutation has an impact on the transmissibility or severity of the disease.”