Breaking News: MV Hondius passenger at National Quarantine Unit intends to challenge a quarantine order she received on Monday.

Dr. Jay Bhattacharya signed the order, requiring her to stay put, after she and others on board were exposed to Andes hantavirus.

This is a scoop that we are breaking here in Inside Medicine.

The signature of the quarantine order sent to at least one MV Hondius passenger currently at the National Quarantine Unit in Nebraska.

An MV Hondius passenger currently at the National Quarantine Unit in Omaha, Nebraska, intends to challenge a quarantine order she received on Monday, Inside Medicine has learned. The source was a video interview granted to Inside Medicine with Angela Perryman, a passenger now being held in the NQU against her will. She, and the others at the unit, were exposed to patients with Andes hantavirus, and repatriated to the United States for monitoring.

The order, requiring her to stay at the National Quarantine Unit was signed by Dr. Jay Bhattacharya, the current top official at the CDC. Another document establishing the government’s determination of medical necessity was signed by Dr. Nicole Cohen, the Associate Director for Science in the CDC’s Division of Global Migration Health.

The New York Times previously reported that officials had threatened to issue such an order in recent days. However, until now, it was unknown whether any order had been issued, or whether the threat alone was enough to achieve compliance from the passengers.

Perryman points out that the order lacks internal consistency, saying that human-to-human transmission requires prolonged contact with a symptomatic patient. Perryman says that she tested negative on both PCR and antibody blood tests. The negative PCR rules out an infection capable of causing symptoms or transmission to others. The antibody tests (IgM and IgG), rule out a recent infection. Therefore, if she has the Andes hantavirus, it is still in the incubation period, meaning that she poses no risk to others at this time.

However, knowing that this could change, she expressed to officials that she wished to complete her quarantine in a private residence. Having initially been told that her stay at the NQU was voluntary, she was taken aback by a change in tone from officials. After initially feeling that nothing was amiss, she began to feel that officials were intimidating her into staying. Then she received the official quarantine order.

Here’s what she told Inside Medicine on Tuesday afternoon:

“I should emphasize that everybody here is quite reasonable about this. None of us are planning to go to the World Cup. We want to go to home quarantine (for the people that want to leave). We are not going to be out at the football game and the movie theater. Let’s not be idiots here. We do understand this is a dangerous disease and absolutely would not put our communities at risk, Jesus Christ.

So, essentially, I was planning to leave about the 18th, based on some personal risk calculations. And I expressed a desire to leave. We were told it would take 72 hours to arrange flights, because they flew us here on a private plane and have assured us that they will provide us with transportation back to our homes, because they don’t want us on commercial flights.

I’m assuming that offer still stands, but now we’re mandated to stay here until the 31st, at which point they’ll do that.”—Angela Perryman.

Ms. Perryman has a master’s degree in emergency management. “I worked in health and safety and emergency planning for remote locations, including eight years in Iraq, multiple years in Africa and Asia-Pacific before I retired.”

We will have a fuller readout of our conversation with Ms. Perryman later.

Resources:

• WHO Andes hantavirus outbreak page.

• Hantavirus Pulmonary Syndrome overview.

• Hemorrhagic fever with renal syndrome hantavirus.

• WHO facts sheet.

• JAMA patient information page.

• The Evidence Collective epidemiology terms.

Thank you for reading! If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.