With three people dead and eleven cases linked to a hantavirus outbreak on a cruise ship, an international group of leading public health scientists has called on the World Health Organization to fundamentally change how it responds to emerging respiratory viruses
They argue that precautionary measures to prevent airborne spread should be the default from day one.
The outbreak involves Andes hantavirus, a serious pathogen that can spread between people and carries a high risk of death. While Milton stresses that the risk to the general public remains low, he says the situation demands a more precautionary approach from global health authorities.
Dr. Don Milton from the University of Maryland, said: ‘While the risk is still low to the general public, we are seeing a virus with a high fatality rate transmitting person-to-person. WHO should change its default response – the starting point should not be to downplay the risk of airborne transmission until it is definitively proven.’
The group points to evidence accumulated over nearly three decades showing that Andes hantavirus can spread between people, including a 2018 outbreak in Argentina where a single infected person attending a birthday party led to infections among people seated up to 2.5m away, including at least one person with no physical contact with the infected individual.
The experts argue that the WHO’s response to the cruise ship outbreak sent mixed signals, with one document playing down airborne risk while separate guidance for passengers disembarking the ship recommended respirators, quarantine and improved ventilation, measures that amount to treating the virus as an airborne threat regardless.
The group writes that ‘the starting point should be the immediate adoption of precautionary measures to reduce airborne transmission, such as respirator use by healthcare workers, [infected people] and their close contacts.’
They also call for WHO guidelines to include improved ventilation, a ban on unfiltered air recirculation, and portable HEPA filtration in enclosed quarantine and transport settings.
Their broader argument extends beyond this outbreak. For dangerous pathogens known to spread between people, they say, the burden of proof should lie with those arguing to relax precautions, not those calling for them.
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