Preliminary laboratory results confirmed the Andean strain of hantavirus – a zoonotic virus that is mainly spread through contact with infected rodents. (Photo: Argentine Health Ministry/AFP)
“Why were the first cases of the hantavirus not already identified on the passenger ship or at our country’s borders? Were there serious flaws in the protocols at OR Tambo International Airport and were the lessons we learned from the covid-19 pandemic really applied to strengthen surveillance systems?”
These are some of the questions that members of the portfolio committee on health asked the department of health and the National Institute for Communicable Diseases (NIOS) during an information session by dr. Aaron Motsoaledi, the Minister of Health, stated.
(Photo: Tedros Adhanom Ghebreyesus/X)
During the meeting, members of the committee shared their serious concerns about how a passenger, whose condition later deteriorated significantly, could travel without any precautions being taken. MPs also asked if there was sufficient communication between transport operators and health authorities to prevent such incidents.
Motsoaledi informed the committee that the World Health Organization (WHO) had already been notified on May 2 of the serious respiratory disease cases on board the ship which was carrying 147 passengers and crew members of various nationalities.
Preliminary laboratory results confirmed the Andean strain of hantavirus – a zoonotic virus that is mainly spread through contact with infected rodents.
Although transmission of the virus between people is extremely rare, the Andean strain is the only type of hantavirus that can be spread from one person to another through close contact.
The department emphasized that South African rodents do not carry this specific strain and that there is currently no indication that the virus is present in local rodent populations.
According to the department, 62 people who may have been exposed to the virus have already been identified, of which 42 have already been traced and are currently being monitored.
‘Needle in a haystack’
While the committee was critical of the border controls, there was praise for the clinical expertise that ultimately led to the identification of the virus. According to the committee, the detection of such a rare pathogen within such a short time is “like finding a needle in a haystack”.
Dr. Lucille Blumberg, who works in an honorary capacity at the NIOS, played a decisive role after she received an e-mail from a British colleague on Labor Day.
(Photo: Tedros Adhanom Ghebreyesus/X)
“A disease consultant for Britain’s overseas territories told me that a patient with pneumonia symptoms was transferred from Ascension Island to Johannesburg. I was also told about a Dutch man who died on the ship, the MV Hondius – and that his wife collapsed at the airport in Johannesburg, while she was on her way to Europe,” says Blumberg.
The British passenger initially tested negative for common illnesses such as influenza and Legionnaires’ disease. However, Blumberg insisted on a repetition of the test with a sample of “low from the lungs”.
By Friday at 18:00 it was confirmed that the patient is negative for the common viruses. By that time, she and a few colleagues suspected that it could be the hantavirus, because the passengers had been in Argentina and Chile where the virus is endemic. The test was requested on Saturday morning and by noon the result was positive.
On Sunday morning, Blumberg focused her attention on the Dutch woman who was admitted to a Johannesburg hospital shortly before her death. She had to quickly determine if there were any more blood samples available from the patient.
“I suddenly thought: ‘Hold on, do we have any blood from that patient?’ The pathology laboratory usually only keeps such samples for a week, and it had already been more than seven days. I said to myself, ‘Please, let it be there,’ when I called the lab at seven in the morning.
“Luckily, probably because the Friday was a holiday, it was still there,” she recalls.
These samples confirmed that the woman was the second hantavirus case. A third confirmed case is currently being treated in Zurich, Switzerland.
Blumberg also appealed to people to be patient, so that experts can carry out the necessary tests and collect thorough, reliable information.
Although she has already dealt with numerous breakouts over her long career, Blumberg said she still experiences that initial feeling of surprise and disbelief.
She emphasized that the identification of hantavirus was a team effort within South African institutions and internationally.
“You can’t do it alone,” she said, praising the WHO for playing a key role in coordinating different efforts to track down the virus.
Manuel Schibler, head of the virology laboratory at the University Hospitals of Geneva which analyzed the Swiss patient’s sample, told AFP that “the next step is to sequence the complete viral genome”.
It could potentially “establish a link with the geographic location of the first person infected with this virus,” he said, but he added that such a level of precision “is by no means guaranteed.”