Tjandra Yoga Aditama, former Director of Infectious Diseases at the WHO South-East Asia Regional Office, has urged countries—including Indonesia—to remain vigilant against the spread of Hantavirus. This warning comes in light of concerning data from the Indonesian Ministry of Health, which reported a 13% Hantavirus mortality rate in the country last year.
“The 13% mortality rate in our country is a serious cause for concern. For comparison, the Hantavirus mortality rate across the rest of Asia typically remains below 5%, with some regions reporting figures as low as 1%,” Aditama stated on Saturday (May 9). While the Ministry of Health attributed these deaths to comorbidities and underlying health complications, Aditama emphasized that patients in other countries often face similar health challenges, yet they maintain significantly lower mortality rates.
Public concern regarding Hantavirus has spiked following a recent outbreak on a cruise ship. Aditama noted that this incident underscores the international nature of the threat, as the cruise ship carried passengers representing 23 different nationalities.
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Five Latest Developments
The World Health Organization (WHO) recently issued a Disease Outbreak News (DONs) alert regarding a cluster of severe respiratory illness cases identified on a cruise ship. To provide clarity on this global health concern, here are the five latest updates regarding the Hantavirus situation:
1. As of May 8, laboratory testing has confirmed six cases of the Andes virus (ANDV) strain through specific polymerase chain reaction (PCR) and sequencing. Including two probable cases, the total number of infections associated with the cruise ship stands at eight.
2. Of these eight confirmed and probable cases, three have resulted in death. This yields a case fatality ratio of 38%, a statistic described as both high and alarming.
3. Medical evacuation flights have been conducted twice, transporting patients from the ship’s docking location in Cabo Verde to the Netherlands. Currently, these patients are receiving care in Johannesburg (South Africa), the Netherlands, and Zurich (Switzerland). A case initially transported to Germany was later cleared of Hantavirus following negative PCR and serology test results, indicating that the initial cruise ship passengers have since dispersed to various parts of the world.
4. The WHO’s working hypothesis suggests that the index patient was likely infected with Hantavirus prior to boarding the ship, following environmental exposure during travels in Argentina and Chile. This was subsequently followed by human-to-human transmission aboard the vessel, a theory supported by the timing of symptoms and the virus’s known incubation period. Epidemiological investigations and sequencing studies remain ongoing to confirm this hypothesis.
5. Recent reports indicated that a KLM flight attendant was being observed for potential infection after contact with a confirmed patient. However, laboratory results as of May 8 confirmed that the flight attendant tested negative for Hantavirus. Surveillance of other contacts continues. It is important to note that the cruise ship carried passengers from neighboring ASEAN nations, specifically the Philippines and Singapore.
Summary
Tjandra Yoga Aditama, former WHO Director for Infectious Diseases, has raised concerns over Indonesia’s 13% Hantavirus mortality rate, which significantly exceeds the typical 1-5% seen elsewhere in Asia. This warning follows a recent outbreak on a cruise ship involving 23 nationalities, highlighting the potential for international transmission. While health authorities attribute the local fatality rate to comorbidities, experts stress that global standards suggest a need for improved vigilance.
The WHO has confirmed eight cases of the Andes virus associated with the cruise ship, resulting in a 38% fatality rate and requiring international medical evacuations. Current investigations suggest the virus likely spread via human-to-human transmission after an initial infection occurred in South America. Although surveillance of contacts remains active, recent testing of exposed individuals, including a flight attendant, has fortunately returned negative results.
