Welcome to the Dr. Jo Appreciation Society, Scott, for people who appreciate their facts delivered with a soupcon (or more) of irony, sarcasm, intelligence and wit. Not to speak for the doctor, but one of the themes reflected here aligns with Mark Twain's wry observation: "To succeed in life, you need two things: ignorance and confidence," whether the subject is medicine, science, governance, geopolitics, business, economics, computer science or media, among many others.
I used to live in the United States of Dystopia and well remember the outbreak of the Hantavirus on the Navajo Reservation. As for cruise ships aka petri dishes on the ocean, they just keep building more and more ships that can carry over 6000 passengers. That is 6,000 more people than I can handle. Just stick me on a dinghy on the Pacific. I probably won't survive but I won't catch a virus, get a major case of the shits or go crazy because people. Thanks for the all the very interesting info and putting things into perspective.
The one journal article I skimmed on the Epuyén ANDV outbreak seemed to identify one superspreader event where a person just beginning to show symptoms attended an outdoor music concert resulting in 10 secondary cases. None of those 10 were associated with any tertiary transmission. I must have missed the reference to the second event.
It seems that Hanta virus only has a short window of contagion before people get quite sick even if they don’t subsequently develop HPS.
Interestingly, the same article indicated that medical staff only masked during invasive procedures like intubation and NO medical personnel contracted the illness.
You mentioned Sin Nombre (SNV) but you didn’t clarify that SNV is also a Hanta virus. I recall reading of that outbreak at the time. Once the CDC was involved it didn’t take long before they identified the pathogen as a species/variant of Hanta virus. Frankly, due to my amateur understanding of viruses, I’m not sure how physician-scientists draw the line between a new viral species and a variant.
So far, I conclude, that ANDV makes everyone it infects ill. This is unlike SARS-CoV-2 where, very roughly, 1/3 were asymptomatic, 1/3 had mild symptoms, and 1/3 were markedly ill — though a study from Connecticut published in NEJM estimated the IHR at “only” 6.9%.(*)
I don’t worry about it, but a corona virus exactly like SARS-CoV-2 which exhibited a 10% fatality would seriously test the antivaxxer resolve.
(*) Clearly low level exposure to a specific virus doesn’t result in an active infection. The immune response is fast enough to eliminate the virus before symptoms emerge. It seems there is a balancing point where an exposure is largely enough to, at least transiently, overwhelm the immune response. I’m sure my perspective is overly simplistic with the truth relying on viral kinetics and differential equations.
If there’s a good reference book you might suggest, I would be grateful. I’m one of those odd people who enjoys knowledge simply for its own sake.
You will never get me on a cruise ship, even though I'm the target demographic. I see them regularly at Southampton when I visit the mainland and occasionally they loom on the horizon when I'm walking on a beach on the island. I call them Borg Ships (you need to be a Star Trek fan to get the reference).
When I was much, much younger I got Brucellosis from a rat bite, so I'm always wary of the little buggers. Rats are everywhere. I had a holiday job in a hospital kitchen once which was infested with rats (and cockroaches). At my last house, which was in a semi-rural location, I kept chickens - and rats (and many corvids!). In Britain, it's reckoned that on average, you're never more than 12 feet from a rat. I don't know how true that is; it's one of those pop-science factoids.
I wasn't worried about hantavirus, but thanks for an informative article.
"Dengue" is derived from the Swahili phrase ki denga pepo, describing a "sudden, cramp-like seizure caused by an evil spirit". The term was adopted into Spanish (meaning "fastidiousness" or "prudery") to describe the stiff, "dandy" gait of afflicted patients. It was first documented in the West Indies in 1827–1828
Footnote number 10 made me laugh out loud. I like your style.
And I may be part of the demographic you characterize in cruise ships, but I will never board one.
Thanks for the details on this “new” virus
Welcome to the Dr. Jo Appreciation Society, Scott, for people who appreciate their facts delivered with a soupcon (or more) of irony, sarcasm, intelligence and wit. Not to speak for the doctor, but one of the themes reflected here aligns with Mark Twain's wry observation: "To succeed in life, you need two things: ignorance and confidence," whether the subject is medicine, science, governance, geopolitics, business, economics, computer science or media, among many others.
I used to live in the United States of Dystopia and well remember the outbreak of the Hantavirus on the Navajo Reservation. As for cruise ships aka petri dishes on the ocean, they just keep building more and more ships that can carry over 6000 passengers. That is 6,000 more people than I can handle. Just stick me on a dinghy on the Pacific. I probably won't survive but I won't catch a virus, get a major case of the shits or go crazy because people. Thanks for the all the very interesting info and putting things into perspective.
The one journal article I skimmed on the Epuyén ANDV outbreak seemed to identify one superspreader event where a person just beginning to show symptoms attended an outdoor music concert resulting in 10 secondary cases. None of those 10 were associated with any tertiary transmission. I must have missed the reference to the second event.
It seems that Hanta virus only has a short window of contagion before people get quite sick even if they don’t subsequently develop HPS.
Interestingly, the same article indicated that medical staff only masked during invasive procedures like intubation and NO medical personnel contracted the illness.
You mentioned Sin Nombre (SNV) but you didn’t clarify that SNV is also a Hanta virus. I recall reading of that outbreak at the time. Once the CDC was involved it didn’t take long before they identified the pathogen as a species/variant of Hanta virus. Frankly, due to my amateur understanding of viruses, I’m not sure how physician-scientists draw the line between a new viral species and a variant.
So far, I conclude, that ANDV makes everyone it infects ill. This is unlike SARS-CoV-2 where, very roughly, 1/3 were asymptomatic, 1/3 had mild symptoms, and 1/3 were markedly ill — though a study from Connecticut published in NEJM estimated the IHR at “only” 6.9%.(*)
I don’t worry about it, but a corona virus exactly like SARS-CoV-2 which exhibited a 10% fatality would seriously test the antivaxxer resolve.
(*) Clearly low level exposure to a specific virus doesn’t result in an active infection. The immune response is fast enough to eliminate the virus before symptoms emerge. It seems there is a balancing point where an exposure is largely enough to, at least transiently, overwhelm the immune response. I’m sure my perspective is overly simplistic with the truth relying on viral kinetics and differential equations.
If there’s a good reference book you might suggest, I would be grateful. I’m one of those odd people who enjoys knowledge simply for its own sake.
I enjoy your posts. Thanks.
Yes cruises are virtually floating petrie dishes cultivating all kinds of communicable pathogens.
You will never get me on a cruise ship, even though I'm the target demographic. I see them regularly at Southampton when I visit the mainland and occasionally they loom on the horizon when I'm walking on a beach on the island. I call them Borg Ships (you need to be a Star Trek fan to get the reference).
When I was much, much younger I got Brucellosis from a rat bite, so I'm always wary of the little buggers. Rats are everywhere. I had a holiday job in a hospital kitchen once which was infested with rats (and cockroaches). At my last house, which was in a semi-rural location, I kept chickens - and rats (and many corvids!). In Britain, it's reckoned that on average, you're never more than 12 feet from a rat. I don't know how true that is; it's one of those pop-science factoids.
I wasn't worried about hantavirus, but thanks for an informative article.
Nothing that cute could cause an illness
How about this for Dengue etymology:
"Dengue" is derived from the Swahili phrase ki denga pepo, describing a "sudden, cramp-like seizure caused by an evil spirit". The term was adopted into Spanish (meaning "fastidiousness" or "prudery") to describe the stiff, "dandy" gait of afflicted patients. It was first documented in the West Indies in 1827–1828
There are *many* explanations for 'dengue' but nobody seems to have a decent primary reference. Whole articles have been written on this :)
I could read all that, or I could ask ChatGPT that will readily tell me mice can swim for days and spread disease and doom.
Guess which option the head of the local government chose.
Great post, as usual Dr Jo. 👍