He was on the trip of a lifetime. Now he’s in a biocontainment unit in Nebraska while hantavirus cases rise

CNN

By Lex Harvey, Deidre McPhillips, Emma Tucker, CNN

(CNN) — Dr. Stephen Kornfeld was taking the trip of a lifetime aboard a cruise sailing across the Atlantic Ocean when he was called on to care for other passengers who fell ill. Now, he’s the only MV Hondius passenger in a biocontainment unit at the University of Nebraska Medical Center after initially testing positive for Andes hantavirus.

Before the world became aware of the hantavirus outbreak on board the Hondius, several people on the ship developed “a flu-like illness” in early April, the oncologist told CNN’s “Erin Burnett OutFront” on Tuesday. Kornfeld also endured night sweat, chills and mild respiratory symptoms, as well as more than two weeks of severe fatigue, he said.

“At the time, it was felt like this is just some virus. And now, in retrospect, there is a question, could it have been hantavirus? But it’s just speculation. There’s no way to really know.”

Kornfeld says he initially tested “faintly positive” for hantavirus before arriving in Nebraska, but the US Centers for Disease Control and Prevention is awaiting the results of confirmatory tests, expected to come this week.

He warned that “what I hear from the experts who I’m seeing daily is that the lab tests may not be that straightforward to interpret, so it may never be known if that illness – which others also had – was hantavirus or the typical virus that circulates to a cruise boat.”

Kornfeld said his time caring for people who were ill, as well as time socializing with a passenger who later died from hantavirus, “certainly puts me at higher risk.”

Of life in the biocontainment unit, he said, “It’s a little weird being in here by myself, but the nurses come in, the doctors come in. I’m on WhatsApp all the time. It’s really amazing how quickly time flies.”

Most of the other American passengers who boarded the Hondius six weeks ago are in small, spartan rooms with beds and exercise equipment at the National Quarantine Unit in Omaha, facing what could be weeks of isolation.

A little over a week since the World Health Organization reported an outbreak of the rare hantavirus aboard the Hondius, operated by Oceanwide Expeditions, a global repatriation effort is still underway for the passengers and crew who were aboard the ship.

As of Tuesday morning, 122 people — 87 passengers and 35 crew members — had been evacuated, and most had returned to their home countries. Five Australians and one New Zealander are in the Netherlands and set to be repatriated later this week, according to authorities.

As for what he’s looking forward to most after his weeks of quarantine end, Rosmarin said, “it may sound cliche, but I cannot wait to give my fiance and my family and friends hugs, because that’s something that I just really miss. That first hug is going to feel like the best thing in the world.”

The remaining 27 people aboard the ship — 25 crew members and two medical professionals — are now sailing to Rotterdam, Netherlands, where the ship will be disinfected. They are expected to arrive Sunday evening, according to Oceanwide.

Three passengers have died since April 11, and there are several other confirmed or probable cases, according to WHO, which has reiterated that the risk to the general public is low.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus said Tuesday that 11 cases of hantavirus have been reported. That includes the three deaths.

All of the 11 cases are among passengers or crew on the ship, he said, with nine of the cases confirmed as the Andes strain of the virus. The other two are “probable” cases, he said.

Weeks of monitoring ahead

The next few weeks will be mired in uncertainty for those who were onboard the ship, where human-to-human transmission of the Andes strain is thought to have occurred.

In the US, 17 Americans and one British dual-national are being monitored in medical facilities like the one Rosmarin posted from. The ages of the passengers range from late 20s to early 80s, with older people and those with underlying health conditions at higher risk of severe outcomes.

Sixteen of those people are at the University of Nebraska Medical Center. Kornfeld is in the biocontainment unit, and the remaining 15 are in the quarantine unit. All continue to be asymptomatic, according to a social media post from HHS on Tuesday afternoon.

Federal public health partners are working with the team in Nebraska to regularly assess passengers for symptoms, Nebraska Medicine said Tuesday. They’re also conducting “in-depth interviews with each passenger” to understand their contact with passengers who were confirmed to have hantavirus.

“One of the things that’s nice is, it’s just a good change of scenery, and it’s much more spacious than my cabin was,” passenger Jake Rosmarin told CNN’s Anderson Cooper on Tuesday from his room in the quarantine unit.

The passengers were allowed to leave the ship with only one large plastic bag of belongings, he said. “It was really hard to choose what we would be bringing with us to here to Nebraska, since a lot of us had a lot of clothes. … So I chose to take my technology, my camera equipment, my computer, as we were told in advance that we’d be able to get packages delivered here. So I already actually got some clothing delivered.”

As for what he’s looking forward to most when his weeks of quarantine end, Rosmarin said, “it may sound cliche, but I cannot wait to give my fiance and my family and friends hugs, because that’s something that I just really miss. That first hug is going to feel like the best thing in the world.”

Two other people — a couple — were transferred to Atlanta’s Emory University, where they are being held in a biocontainment unit, because of capacity limitations at UNMC. One “mildly syptomatic” person at Emory has tested negative for the Andes virus, HHS said Tuesday.

After assessing the passengers for a few days, authorities will decide whether each should complete their 42-day monitoring period at home or in the medical facilities. People whose last exposure was May 10 will be quarantining or monitored until at least June 21, WHO’s Tedros said.

“Decisions around how best to strike a balance between monitoring in these facilities and monitoring at home is something that is an ongoing conversation,” Dr. Mara Jana Broadhurst, clinical laboratory director for the emerging pathogens and biocontainment unit laboratories at the University of Nebraska Medical Center, said Tuesday at a briefing held by the College of American Pathologists.

Generally, testing is an “individualized decision between between the clinicians and the individual who’s had an exposure,” Broadhurst said.

In addition to these 18 passengers, at least 15 others are being monitored across nine states. Passengers in Arizona, California, Georgia, Texas and Virginia had previously disembarked from the ship, and people in California, New Jersey and Maryland were exposed to a confirmed case while on international flights. Kansas officials are monitoring three people who were not on the cruise but had “high-risk exposure to a person with confirmed Andes hantavirus,” and the Minnesota Department of Health is monitoring one person “who may have been exposed overseas” to a Hondius passenger who tested positive for Andes virus.

Global containment efforts

As the American passengers undergo observation, authorities continue to test and observe people who were on board the hantavirus-hit ship and those who have come into close contact with confirmed cases.

The ship, which departed Ushuaia, Argentina, on April 1, made stops in remote territories including St. Helena – where more than 30 passengers disembarked – and Tristan da Cunha before it was forced to anchor off Praia, Cape Verde, near western Africa, while authorities scrambled to manage the outbreak.

On Sunday, it anchored near Tenerife in Spain’s Canary Islands, where medical teams boarded the ship to run tests and passengers were evacuated alongside medical staff.

A French woman, one of five French nationals who were evacuated from the ship, tested positive during her return from Tenerife and is being treated in a specialist hospital, French Health Minister Stephanie Rist told radio station France Inter.

And a Spanish passenger who is in isolation at a hospital in Madrid has tested positive for hantavirus after a preliminary test, according to Spain’s Health Ministry.

Tedros said Tuesday that he expected “more cases” to emerge among passengers due to the incubation period of the virus, which can last up to eight weeks. However, he stressed that all passengers were in “good hands” with access to excellent medical care.

Risk remains low

Authorities across nearly two dozen countries are working to contain the spread of the virus, which can cause severe and deadly respiratory disease.

Hantavirus, a rare disease typically caused by exposure to infected rodents’ urine or feces, can cause headaches, fever, gastrointestinal issues and respiratory problems.

Still, the American public should not panic, HHS official said.

“Let me be crystal clear: The risk of hantavirus to the general public remains very, very low,” said Dr. Brian Christine, the HHS assistant secretary for health.

“The Andes variant of this virus does not spread easily, and it requires prolonged, close contact with someone who is already symptomatic.”

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CNN’s Aditi Sangal, Holly Yan, Brenda Goodman and Katherine Dillinger contributed to this report.