ECDC publishes guidance for the management of passengers linked to the Andes hantavirus outbreak on cruise ship

The document includes advice on:

• Defining contact classification criteria based on level of exposure, including close and prolonged contact with symptomatic individuals; 
• The identification, management and monitoring of contacts, including advice on testing; 
• Appropriate infection prevention and control measures for managing repatriated passengers and crew, suspected and confirmed cases and their contacts in healthcare and community settings; and 
• Risk communication, community engagement and the management of misinformation. 

In addition to the ECDC expert already deployed on board the ship, Spain requested support through the EU Health Task Force, leading to the deployment of one additional ECDC expert and two fellows from the European Programme for Intervention Epidemiology Training. The additional expert will support coordination with the fellows and act as a liaison between ECDC and the national and regional authorities in Spain and the Canary Islands, while also providing technical support on preparedness and response activities as needed.

ECDC is collaborating closely with national public health authorities and the World Health Organization, and will continue to provide updates as more information becomes available.

What does ECDC recommend for passengers with symptoms?

Passengers with symptoms should be prioritised for medical assessment and testing upon arrival. Depending on their condition and operational decisions, they may either isolate in Tenerife or be medically evacuated for medical isolation in their home country. If a test is positive, medical care and isolation measures should continue. If negative, quarantine and monitoring measures may still apply for up to six weeks as a precaution.

What does ECDC recommend for passengers without symptoms?

Passengers without symptoms are currently considered to be high-risk contacts as a precautionary measure. They will be repatriated for self-quarantine in their home country using specially arranged transport by their respective countries and the European Civil Protection Mechanism. They will not use regular commercial flights. If symptoms develop, testing and medical assessment should follow. At disembarkation, passengers are still considered high-risk. However, in the last two days, the public health team on board conducted interviews with all passengers. Based on this information, not all passengers will necessarily be considered high-risk upon return to their home countries and could expect less stringent isolation measures.

What protective measures are recommended for responders and healthcare workers?

ECDC recommends transmission-based precautions to protect staff from droplets, including gloves, gowns, respirators (FFP2) and eye protection during medical interactions. Medical masks, ventilation, cleaning and disinfection measures are also recommended. All passengers will also be asked to wear a medical face mask.