The unprecedented and deadly cruise ship hantavirus outbreak, explained
The unprecedented and deadly cruise ship hantavirus outbreak, explained
详解前所未有的致命游轮汉坦病毒疫情
An unprecedented outbreak of hantavirus has rocked a luxury cruise ship off the coast of West Africa, triggering a tsunami of news stories and a flood of post-pandemic anxiety. So far, eight cases have been reported, including three people who have died. The Dutch-flagged ship, MV Hondius, which began its journey from Ushuaia, Argentina, on April 1, is still carrying 147 passengers and crew. To date, those remaining on board are showing no symptoms and have been asked to sequester themselves in their cabins. 一场前所未有的汉坦病毒疫情震动了西非海岸的一艘豪华游轮，引发了铺天盖地的新闻报道和后疫情时代的焦虑浪潮。目前已报告了8例病例，其中包括3名死亡病例。这艘悬挂荷兰国旗的“洪迪乌斯号”（MV Hondius）于4月1日从阿根廷乌斯怀亚出发，船上目前仍有147名乘客和船员。截至目前，留在船上的人员均未表现出症状，并已被要求在各自的客舱内进行隔离。
At the time of publication, the ship is sailing on a three- to four-day journey that began the evening of May 6 from Cape Verde to the Canary Islands, where Spanish authorities have agreed to assist the imperiled vessel. With the ship en route, experts assembled by the World Health Organization are now racing to create a novel step-by-step procedure to allow the remaining passengers and crew on board to disembark safely. Meanwhile, authorities are tracking down and monitoring 30 former passengers who disembarked the ship onto the remote island of St. Helena on April 24—before the outbreak was identified but nearly two weeks after the first passenger had died on board on April 11. Those 30 passengers hail from at least 12 different countries, including six from the US. 截至本文发布时，该船正处于从佛得角前往加那利群岛的航程中，预计耗时三到四天，航程于5月6日晚开始。西班牙当局已同意为这艘陷入困境的船只提供协助。在船只航行期间，世界卫生组织召集的专家们正争分夺秒地制定一套全新的分步程序，以确保船上剩余的乘客和船员能够安全下船。与此同时，当局正在追踪并监测30名曾于4月24日在偏远的圣赫勒拿岛下船的乘客——当时疫情尚未被识别，但距离4月11日船上首名乘客死亡已过去近两周。这30名乘客来自至少12个不同的国家，其中包括6名美国人。
“Extremely low” risk
“极低”风险
The situation evokes chilling memories of the early days of the COVID-19 pandemic, especially the Diamond Princess nightmare, in which over 700 people were infected with the never-before-seen virus while locked down on a luxury cruise ship docked in Japan. But in the wake of discovering the hantavirus aboard the Hondius, health officials and infectious disease experts have been quick—and virtually unanimous—in trying to quell fears. While the situation within the ship certainly is an emergency requiring careful and prompt response for those on board, the risk to the outside world is low, and the outbreak is expected to stay relatively small. 这种情况唤起了人们对新冠疫情初期令人不寒而栗的记忆，尤其是“钻石公主号”的噩梦，当时有超过700人在停靠于日本的豪华游轮上被感染。但在“洪迪乌斯号”上发现汉坦病毒后，卫生官员和传染病专家迅速且几乎一致地试图平息恐慌。虽然船上的情况确实属于紧急状态，需要对船上人员进行谨慎且迅速的应对，但对外界的风险很低，预计疫情规模将保持在较小范围内。
“This is not COVID. This is not influenza. It spreads very, very differently,” Maria Van Kerkhove, WHO’s acting director for epidemic and pandemic management, emphasized in a press briefing Thursday. Given the nature of this virus and the precautions and monitoring already in place, “the risk of widespread transmission to the general public is extremely low,” Michael Marks, an infectious disease expert and professor at the London School of Hygiene & Tropical Medicine, said in a statement Thursday. “这不是新冠，也不是流感。它的传播方式非常、非常不同，”世卫组织流行病和疫情管理代理主任玛丽亚·范·克尔霍夫（Maria Van Kerkhove）在周四的新闻发布会上强调。鉴于该病毒的特性以及已经采取的预防和监测措施，伦敦卫生与热带医学院教授、传染病专家迈克尔·马克斯（Michael Marks）在周四的一份声明中表示：“向公众广泛传播的风险极低。”
Hantaviruses
汉坦病毒
The virus spreading on the ship is a member of the large hantavirus family, which is spread out worldwide. These are enveloped, negative-strand RNA viruses whose genomes consist of three segments. So-called Old World hantaviruses (including Hantaan, Seoul, Puumala, and Dobrava-Belgrade) are found in Africa, Asia, and Europe, with hotspots of activity in China, Korea, Russia, and certain European countries. The first awareness of these viruses dates back to the 1950s, with disease in soldiers fighting in the Korean War. These viruses cause hemorrhagic fever with renal syndrome (HFRS), a disease marked by fever, bleeding, and kidney damage. Depending on the specific hantavirus virus involved, mortality rates are roughly between 1–15 percent. 在船上传播的病毒属于庞大的汉坦病毒家族，该家族在全球范围内都有分布。它们是有包膜的负链RNA病毒，基因组由三个片段组成。所谓的“旧大陆”汉坦病毒（包括汉滩病毒、汉城病毒、普马拉病毒和多布拉伐-贝尔格莱德病毒）分布在非洲、亚洲和欧洲，在中国、韩国、俄罗斯和某些欧洲国家有活跃热点。人类对这些病毒的首次认知可追溯到20世纪50年代，当时朝鲜战争中的士兵出现了相关疾病。这些病毒会导致肾综合征出血热（HFRS），其特征是发热、出血和肾损伤。根据具体的汉坦病毒类型，死亡率大致在1%到15%之间。
Then there are the hantaviruses in the New World, which first came to light in 1993 amid a deadly outbreak of an unknown virus in the Four Corners region of the US. That outbreak was caused by a hantavirus now known as Sin Nombre virus. Since then, researchers have identified many other hantaviruses in North and South America, including Black Creek Canal, Bayou, New York, Juquitiba, Oran, and Andes. New World hantaviruses are associated with Hantavirus Pulmonary Syndrome (HPS). Based on genetic testing, the hantavirus behind the cruise ship outbreak is the Andes virus, mainly found in Argentina and abbreviated as ANDV. 此外还有“新大陆”汉坦病毒，它们于1993年在美国四角地区爆发的一种未知病毒疫情中首次被发现。那次疫情是由现在被称为“辛诺布尔病毒”（Sin Nombre virus）的汉坦病毒引起的。自那时起，研究人员在北美和南美发现了许多其他汉坦病毒，包括黑溪运河病毒、巴尤病毒、纽约病毒、朱基蒂巴病毒、奥兰病毒和安第斯病毒。新大陆汉坦病毒与汉坦病毒肺综合征（HPS）有关。根据基因检测，此次游轮疫情背后的汉坦病毒是安第斯病毒（Andes virus），主要存在于阿根廷，缩写为ANDV。
Transmission
传播途径
For both Old and New World hantaviruses, transmission to humans almost exclusively occurs from exposure to rodents—mice and rats of different species, depending on location—especially their urine, droppings, or other excretions. Rodents show no signs of infection or symptoms of illness. In Argentina, the common rodent Oligoryzomys longicaudatus, aka the long-tailed pygmy rice rat, is a known source of the Andes virus, which was found on the Hondius. 对于旧大陆和新大陆的汉坦病毒，人类感染几乎完全源于接触啮齿动物（根据地理位置不同，包括不同种类的老鼠），特别是接触它们的尿液、粪便或其他排泄物。啮齿动物本身不会表现出感染迹象或患病症状。在阿根廷，常见的啮齿动物长尾小鼠（Oligoryzomys longicaudatus）是安第斯病毒的已知宿主，而这种病毒正是此次在“洪迪乌斯号”上发现的。
For hantaviruses, human infections are accidental and almost always dead ends. Transmission to people generally happens when virus-laden rodent excreta gets stirred up in dust and inhaled—for example, a person sweeping out a shed or garage with a rodent infestation闹. Such a scenario made headlines in the US last year when pianist Betsy Arakawa, who was married to actor Gene Hackman, was revealed to have died of hantavirus. A subsequent investigation found an extensive rodent infestation at the couple’s residence. The one exception to this transmission route is from the Andes virus; ANDV is the only hantavirus that has been documented in rare instances to spread from person to person. 对于汉坦病毒而言，人类感染属于偶然事件，且几乎总是“死胡同”（即不会进一步传播）。人类感染通常发生在含有病毒的啮齿动物排泄物被搅动成灰尘并被吸入时——例如，某人在清扫有鼠患的棚屋或车库时。去年，钢琴家贝齐·荒川（Betsy Arakawa，演员吉恩·哈克曼的妻子）因汉坦病毒去世的消息曾在美国引发关注，随后的调查发现其住所存在严重的鼠患。这种传播途径的唯一例外是安第斯病毒；ANDV是目前唯一有记录显示在极少数情况下可以实现人传人的汉坦病毒。