Hantavirus nearly killed me

0:00This BBC podcast is supported by ads outside the UK.

0:30Make your travel dollars work harder. Follow Smart Travel on your favourite podcast app.

1:00Listen to Choiceology at schwab.com slash podcast or wherever you listen.

1:10Hello, I'm James Reynolds. Welcome to the documentary from the BBC World Service. This time in BBC Conversations, we bring together survivors of Hantavirus. It's now just over six weeks since the ship MV Hondias left Argentina for a cruise, visiting remote islands in the South Atlantic. A month on, three passengers had died. The World Health Organisation identified the probable cause as Hantavirus. That's a rodent-borne disease that the victims most likely contracted in South America. Later, we'll hear more about the virus itself from health experts, but we begin with a conversation between two people who've had the virus themselves.

1:53Christian in Stuttgart in Germany was infected in 2019. We brought him together with Lorne. He lives in Whistler in the Canadian Rockies. It was March three years ago. I just started feeling unwell. COVID-type symptoms, body aches, chronic headache, fatigue. I was doing COVID tests daily to see and that always came back negative. So we decided to go to Mexico for a week during spring break. All was great, came back and the symptoms started to get worse. And then I left work on a Wednesday. I blacked out I don't remember the Wednesday the Thursday or the Friday I don't remember anything at all and I woke up Saturday morning just drenched in sweat and couldn't breathe so my wife drove me to the local clinic in the town we live in they ran some blood tests and they found out I had sepsis and my lungs were full of fluid so they flew me down from Pemberton where we live down to North Vancouver.

2:49Once I arrived to North Vancouver, my heart failed and I apparently died for 11 minutes and I got my heart going again. And the hospital in North Vancouver couldn't do anything to save me. So they put me in the ambulance and drove me to downtown Vancouver to Vancouver General Hospital where they hooked me up to an ECMO machine, which pumps the blood out of your body and cleans it and lets your organs rest and recover. And then eventually I got to go home and it took me a year and a half to recover to rebuild my body back to full strength how are you now i'm great i'm back to work the only issue is that um i have atrial fibrillation and my heart is not sinking the chambers aren't sinking properly so when they got my heart going again i have a strong heart but it's not um in proper rhythm so i'm on some daily heart medication other than that i'm i'm great When I hear long, I can say I was lucky.

3:46I had like a summer flu for three days. As it doesn't disappear, I went to the doctor, blood check, nothing unremarkable. So I went home again. Another two days later, I had to vomit and some dizziness came along. So it felt like a strange flu now. I went again to the doctor and then we did luckily another blood test because it was Friday before of the weekend. And then the doctor called the hospital as the kidney functional markers were exploded. So it was a kidney failure and I had a sepsis as well. So I got up in the intensive care ICU for a couple of days with a neck catheter to establish dialysis access.

4:42And I had this for eight days. And then another week I could go home. But I really appreciated again. I could go to the toilet, the little things. You say you were lucky in comparison to Lorne, but you had sepsis, blood poisoning, which can lead to fatality. So it was still a pretty serious case of the disease. Oh, of course. Yeah, I think the most worrying point was exactly the sepsis because I heard that they had the virus itself. And the kidneys, they recover normally, but it was the coincidence of a bacterial and a viral escalation at the same time that was a bit worrying for a couple of days for sure how is your health now oh i'm perfectly fit no damages from that one and carpe diem carpe diem sees the day and what about you with your uh 11 minutes experience i i was wondering how deeply impressive this must be it must feel like an an accident like the the time before and how did life change for you like i said it just you don't take things for granted and enjoy the small details in life that most people won't even acknowledge and just like drinking water i remember i didn't drink fluids for two weeks when i was in icu and i I just remember having that sip of fresh, clean water.

6:14It was the best thing I ever tasted in my life. And, for example, most people would take drinking water for granted, but that was the best experience, being able to drink water. Or go to the toilet. Brilliant. You were able to. Yeah. Well, I'm glad you're well and back to normal life and health. And do they have a hypothesis as to how you contracted it? having time to think about it we come to realize that it's probably from being up in my attic because we went to mexico i went up my attic just to check a couple things out and um obviously there's lots of dust up in an attic and um potentially mice droppings and i shook an old rug to clean it off and i might have airborne some mice feces and contracted it that way how do you think you contracted the virus oh there was a biologist commissioned by the city they found a positive sample in our garden and i remember my little son he was 60 years he showed me a death mouse a few days before but i'm not sure if it if it was this occasion and it can happen everywhere but there was some positive sample in our garden we're speaking to you both of course because the hantavirus is in the news and give the news of a number of cases on a on a cruise ship i wonder if your family and friends have been messaging you asking for your thoughts yeah some of them called me and remembered seven seven years ago but i I told them that the South American virus type is much worse than the one I had because I think it's 30 to 40 percent of mortality.

8:06So it's one, two, three gone. So very hard. And flashbacks, of course, and especially if it goes from human to human, I think it's a different story, a bit of scary. Has either of you ever spoken like this to another person who's had hantavirus? No, there's very few of us on the planet. I've been told it's one of the rarest viruses in the world. And I believe in Canada, there's zero to three cases per year. And to survive is rare also. So we're very lucky people. So it's for me the first time to think to someone who had it even worse than me. Christian and Lorne, both survivors of Hantavirus. We'll hear more from them later on about the lasting impact that the disease has had on their lives.

9:01I'm James Reynolds. You're listening to The Documentary from the BBC World Service.

9:15102 miles ago, the oil light came on. 100 miles ago, you noticed. Now, it's time to head to Take 5. This oil change, fall in love with your car all over again. In just 10 minutes, your dream technician will check your tire pressure, top off fluids, change your oil, and verify with Carfax exactly what your car really needs. All while keeping you in the driver's seat. Take 5, the Stay in Your Car 10-Minute Oil Change. Save up to 30 % on your next oil change to Take 5. $15 value, valid at participating locations, terms and conditions apply. She was the sister who went unnoticed. noticed a daffodil might look plain next to a lily but on its own there is much to be admired now her greatest chapter is yet to come the most important thing is to be yourself from the world of jane austen's pride and prejudice comes a new britbox original drama barry you will flourish based on the best-selling novel the other bennett sister now streaming only on britbox Watch for the free trial at BritBox.com.

10:42Wallet's Smart Money podcast on your favourite podcast app.

10:48This week, the final tourists were evacuated from the MV Hondias cruise ship and as we record this programme on Friday lunchtime, eight people from the ship are being treated for Hantavirus. Other passengers are being monitored in quarantine at several locations around the world. Crew members remaining on board are being accompanied by medics. What a journey. The World Health Organisation says there is no sign, though, of a larger outbreak of the disease. But as we heard from Christian and Lorne, the early symptoms of Hantavirus can be very similar to COVID-19. With the pandemic still fresh in people's minds, many around the world have understandably been worried about the wider risk of infection.

11:34No one wants to have to go through all that all over again. To find out more about hantavirus, earlier in the week during our live Outside Source programme, my colleague Rahul Tanden brought together Angela Rasmussen, a virologist at the University of Saskatchewan in Canada. Emma Hardcroft from the University of Basel in Switzerland. She got the nickname the virus hunter during the Covid pandemic. And Michelle Hawkins from the University of New Mexico Hospital, an expert on the illness. Well, most of the people that actually get contovirus, it's a rodent-borne disease. So they may get it from exposure to mouse urine or feces.

12:13It's even possible to get it by a bite from an infected mouse, but that's much less common. The most common way is to get it from aerosolizing the excreta of the mouse. So you go in and you may see some mouse droppings. You may sweep them up and, quote, aerosolize them and then inhale them. Usually it's contact with a rodent and you are breathing in some of their excrement, the urine, etc., or from the saliva or from a bite of a rodent. That's the most common way to get this. How dangerous is it and how transmissible is it between humans? Well, the hantavirus, the new world, or the viruses in the Americas, particularly the Andes virus and the Sonombre virus, are much more serious than the old world viruses.

13:06They cause higher morbidity and higher mortality. In general, 35 to 40 percent mortality or death from infection if you don't get medical attention. It is usually rat-borne or mouse-borne, so the rodents carry it. Your exposure and interaction with the rodents is the most common way to get it. However, the Andes virus is the only one of the Hanta viruses that has been documented to have person-to-person transmission. It is not common, but it does occur sporadically over the last near 30 years. and it's with close contact with an individual that then got it from a rodent. Emma, we know that you are the virus hunter.

13:53You track viruses. Tell us what you've been doing with this one. So one of the things that can be really useful when a new virus outbreak is detected is looking at the genetic sequences of that virus. So some listeners will remember this from the pandemic, for example. They may have heard about us looking at the RNA or DNA of the COVID virus and using that to track how the virus was spreading and how it was changing. And perhaps most importantly, at the very beginning of the pandemic, to understand that it was a new coronavirus and that it was different from what we had seen before. We can do the same thing with the new hantavirus, with the new hantavirus outbreak.

14:30There have been four sequences submitted from four different countries. and so we're looking at those now to see what those can tell us about this outbreak and about this particular virus. So what is it telling us at the moment? Because you know we all lived through the pandemic now this is nothing like it at the moment but you can understand can't you Emma you were such a an important part of our coverage of that why people get so worried. Absolutely and I do think that with the pandemic being so near in memory with a cruise ship being involved there's a lot of things that are triggering those memories but I do want to emphasize that this is a very different scenario and a very different virus, even though we can use the same techniques to study it.

15:09So from what we've seen in the sequences so far, it actually looks like this is a closely related virus to one that's been sampled previously. So there hasn't been a lot of mutations. There's not a lot of changes. And this is in some ways comforting because it means that we're not dealing with a completely new variant of the Andes virus. This isn't something that's unlike anything we've seen before. It's actually very similar to what we've seen before, which hopefully really means that this will be just as containable as earlier outbreaks have been. I completely agree with Emma. We shouldn't really expect a lot of surprises in terms of how to contain this outbreak.

15:46And indeed, epidemiologically, you know, we are still seeing people testing positive. An American who was being evacuated was reported to be positive. We do expect to see some cases like that, But we don't expect to see wider spread in the population because even though antivirus can spread, it's not as contagious as COVID. Well, that is good news for everybody, but people still get worried. So if people have it, how are they treated for it? And is there anything that can prevent it? Are there vaccines around that have been developed for this? Angela on this one. This is a fantastic question. Now, in terms of the treatment, I would actually defer to Michelle Harkins because she is actually a clinician who has handled patients who have had synnome brae virus infection, which is the North American very close relative of Andy's virus.

16:37But there are no antivirals available for this virus. There are also no vaccines. And I am the co-editor-in-chief of the journal Vaccine. I'm very enthusiastic about vaccines, but I actually don't think that we really need to be making a vaccine for Hantavirus. There are some in preclinical testing, in early stage experimentation, but there are not very many people who actually get hantavirus. And because it isn't very contagious, we don't actually expect to see huge outbreaks. So hantavirus vaccine development is a really large use of resources for a disease that actually is pretty rare. And so for that reason and the fact that you can really mitigate transmission, because as Michelle said, most of this comes from exposure to rodent feces.

17:23So if you take care of that, if you wear respiratory protection, if you disinfect when you're dealing with any place that has a rodent infestation, you're going to really minimize that risk of transmission to begin with. So it's easy enough to prevent. I don't think we actually need to devote the resources to develop a vaccine for it. So when patients with hantavirus begin to exhibit symptoms, it's almost like an influenza-like illness. So they have fever, headache, muscle aches. A lot of times patients have had abdominal pain and nausea, vomiting, diarrhea. And it's very hard to distinguish if this is truly hantavirus just based on their symptoms because it's so similar to other viral infections.

18:05There are some that then progress into respiratory distress. and basically respiratory failure. Fluid fills up in the lungs, the heart doesn't work as well, and those patients can get very, very ill. And so we take all the patients with suspected Hantavirus into our ICU at the University of New Mexico to monitor them. There's no specific treatment, as was previously mentioned. We don't have antivirals that actually work in this condition. Corticosteroids don't work in this condition, so we just monitor their symptoms. We restrict giving them fluids because if they do progress into that next phase, we call the cardiopulmonary phase where you are in respiratory distress and respiratory collapse, all of that fluid will end up in the lungs and can promote failure of the heart.

18:56So we observe them closely. If they do progress into that worse syndrome, we have ECMO, extracorporeal membrane oxygenation that we use to treat these patients to support their heart and lungs while the virus runs its natural course. OK, I know you've dealt with cases. How common are they? I mean, how often are you seeing cases like this? It is very rare. In all of North America, we have maybe 30 cases a year. In New Mexico, we do have a higher percentage of those cases, but 95 % of the cases are in the west of the Mississippi. And we may have five to 10 cases a year at New Mexico. And not all are very ill, but some do progress and require that ECMO treatment.

19:44I think we can contain this outbreak much like we've contained outbreaks before. But I would absolutely agree. I think this cruise environment does, unfortunately, lend itself to being somewhere where viruses and other pathogens can spread really readily. We remember this from the pandemic. We've also seen headlines about norovirus outbreaks on cruise ships. They're just a little different. People really are in close quarters. They spend a lot of time together. And so it is important to remember that the kinds of transmission that we see on cruise ships are usually not a very good proxy for the kinds of transmission that happen in more normal life, as it were, kind of life on dry land.

20:22They do tend to mean that pathogens can spread a bit more quickly. And we should keep in mind that that isn't a good way of understanding how they will spread once people get off the boat. Angela, we've seen the actions that the authorities have taken and how they're dealing with it. have they done the right thing? Are they dealing with it in the right way? I think it depends on which authorities you're speaking about. So I do think that the World Health Organization has done an outstanding job at communicating the situation, at communicating a lot of these really nuanced details and the context of person-to-person spread versus zoonotic spread or transmission from rodents.

21:01So I think that that has been fantastic and it has varied from country to country in terms of what the response has been for people from those countries or people who have gotten sick and been hospitalized in those countries. And I think it's a bit of a mixed bag. And part of that is something that was recognized during the COVID-19 pandemic. And that is really that we need better coordination of global responses to emergencies like this, because they aren't just limited to one country. Now, if we're talking about past outbreak responses, One big notable difference with this one is that the U.S.

21:37has barely been involved at all. And in the past, the U.S. was sometimes working very closely with the WHO and other involved countries to really lead this response. The take-home message that I have is that we really do need to make sure everybody, every country in the world, is on board with coordinating these responses. And we really need to take advantage of the resources that the WHO provides its member states to coordinate. these respond. True. Again, this is very uncommon and I would not panic. I think following the public health measures as outlined by the World Health Organization and each country specifically is key to stopping the spread of the current outbreak.

22:20And then if you do happen to see rodent droppings, as was previously mentioned, we usually have people decontaminate with Lysol. So spray Lysol, wear a mask, don't sweep up anything for at least 30 minutes, open up and allow ventilation to help protect from the virus. Michelle Harkins, Emma Hodcroft and Angela Rasmussen sharing their expertise on Hantavirus. Let's return now to Christian and Lorne. I asked them how their lives had changed since recovering from the disease. For me, I forget about it, but I don't forget about the medical system, the team of doctors and nurses that help save me and bring me back to life.

23:02And I'm very grateful for that. And for that reason, I've joined our local health care foundation to help raise money to buy, do medical equipment and be able to do renovations to expand our facilities and try and give back to the medical system for helping save me. Actually, I didn't stop something. I started something. I started reading. Since seven years, I'd say every week I read a book. Right now it's autumn, Ellie Smith. So maybe it's a way to spend time for me. Everything's all relative. But the degree of illness, the sickness that I went through, it was hell on earth. It was torture to go through that and to be able to bounce back.

24:00I'd say that one becomes somewhat more humble even with my illness. So it's not that big. It was a hard time, hard days, but many, many people suffering more than me. To each of you, what was the hardest part of your recovery? Good question. And the hardest part would be rebuilding my strengths. There are micro baby steps of recovery where I'd take two steps forward and four steps back. Where, you know, I also had other issues where I created, I had a frozen shoulder after coming home from the hospital, which was extremely painful. So I was trying to rebuild myself, but also first I had to rebuild my shoulder before I could start working on other things.

24:49It was a very, very slow process, very slow. Minute gains daily, if that. I wouldn't say it was hard. It was longer than expected. It took a couple of months, four months, I would say, when you were weak and tired. And doctors told me that the dialysis and all that stuff, it was for the whole body, hard work, two and a half weeks hard work. so it takes a month to recover. That was impressive. But as I'm an optimistic person, I was happy to go through and was patient enough to hold on the three to four months to be fit again. And it was good to have the time. Christian and Lorne sharing their experiences of Hantavirus.

25:42Our thanks so much to them and to all of our other guests this week. I'm James Reynolds. You've been listening to The Documentary from the BBC World Service.