Scoop: Dutch flight attendant tests negative for Andes virus.

The WHO confirmed the information to Inside Medicine, saying that the flight attendant's symptoms were due to some other cause.

A screenshot from a WHO briefing on the Andes virus situation held today. WHO Director-General Dr. Tedros Ghebreyesus. is second from the right.

<BREAKING NEWS>

A hospitalized flight attendant who worked on a KLM flight that carried a female cruise ship passenger who subsequently died of Andes virus—the hantavirus that has infected several people on a cruise ship—has tested negative for the virus, Inside Medicine has learned. The source was the Director-General of the WHO, Dr. Tedros Ghebreyesus.

Dr. Ghebreyesus told Inside Medicine that a PCR test had provided this information. The flight attendant also tested negative for antibodies (“serology testing”), including some that might be present during an active infection.

The flight attendant was reported to have symptoms and was hospitalized for care and quarantine while viral tests were carried out. There had been some confusion as to whether the KLM flight attendant who was hospitalized was the same employee who also served on the flight with the woman who died of Andes virus. Dr. Ghebreyesus confirmed that the hospitalized flight attendant was indeed the one on board with the woman who subsequently died of the Andes virus—and whose husband also died of the virus previously.

It is still possible that the flight attendant contracted the Andes virus. However, given our understanding of the virus, this information means that the flight attendant’s symptoms are not caused by the Andes hantavirus, but by some other medical illness.

“As you know, the incubation period is long and although she is negative for now, she might turn positive in the future,” Dr. Ghebreyesus said via a text message.

This news is highly reassuring. The transmission dynamics of hantaviruses like the Andes virus have previously been established based on relatively small prior outbreaks. In those outbreaks, the incubation period—that is, the time from exposure until contagiousness—has been quite long, ranging from 9 to 40 days. In these outbreaks, exposures that led to infections were thought to be prolonged and intense (i.e., sharing a dwelling, with high-risk exposures, including sharing of bodily fluids), rather than close contact associated with everyday activities like boarding a flight. For example, the cruise ship doctor who treated the Andes virus patients on board has a confirmed infection. The extent of the doctor’s contact with the Andes virus patients is unknown. It could have been that he spent substantial time with the patients, or that even he was exposed to fluids like vomit.

Therefore, if the flight attendant had tested positive for the Andes virus, it would have implied that everyday interactions might contribute to spread more than previously appreciated. That would have been a major escalation. While that still may be the case, this example is, for now, very good news.

But we still have much to learn. It’s possible that in larger outbreaks, windows of unusually high contagiousness may contribute to spread. That is, superspreaders may defy the averages. Scientists and epidemiologists are studying this closely.

Officials continue to say that the risk to the public is low. While that too could change, the flight attendant’s negative test is among the most confidence-instilling piece of news we’ve received on this front so far. If she had tested positive, the implications for controlling this outbreak would have been enormous.

That’s all for now. I’ll keep following this story closely and keep you updated. If you have information about any of the unfolding stories we are following, please email me or find me on Signal at InsideMedicine.88.