“Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina
https://www.nejm.org/doi/full/10.1056/NEJMoa2009040#t2
Key point:
“The outbreak of ANDV hantavirus pulmonary syndrome in Epuyén in 2018 and 2019 shows evidence of person-to-person transmission of an orthohantavirus. The outbreak involved up to four generations of infections in humans and resulted in more cases than previous person-to-person outbreaks of ANDV.16 Previous studies have used partial ANDV genomic information and contact tracing to reconstruct person-to-person transmission chains.10,17 We used next-generation sequencing technologies to analyze ANDV transmission patterns on the basis of full genomic information from most of the cases in this outbreak (82%), which produced a more complete transmission network. On the basis of both the epidemiologic and genomic investigations of person-to-person transmission events, it appears that inhalation of droplets or aerosolized virions may have been the routes of infection.”
The genetic sequence of the new outbreak has been found to be closest to the outbreak referred to in this paper, which infected 34 people, originating in a small rural town in Argentina. It appears not to be a typical outbreak pattern for ANDV, although a similar one did happen many years before in 1996 and the genetic sequences of the two are similar.
“Before the discovery of ANDV in 1996, the route of orthohantavirus transmission was considered to be strictly zoonotic, resulting in dead-end human infections.9 However, in 1996, an outbreak of hantavirus pulmonary syndrome caused by ANDV occurred in the small city of El Bolsón in Argentina and then expanded to other cities; the outbreak involved 16 epidemiologically linked cases. This outbreak became a focal point for orthohantavirus research because molecular and epidemiologic evidence suggested person-to-person transmission.6,10,11 Although cases of hantavirus pulmonary syndrome caused by ANDV and its close relatives have been reported in Argentina and surrounding countries over the past two decades,8,12–15 limited person-to-person transmission has been reported and has been observed mostly in southern Argentina and in Chile.”
Perhaps that is why many scientists are still thinking it requires sustained exposure. It does not appear that sustained exposure is necessary with the particular genetic sequence causing the most recent cruise ship outbreak.
#Hantavirus #Andes #ANDV #Superspreaders #Outbreak #InfectiousDisease #PublicHealth #MVHondius
