The deadly hantavirus outbreak aboard a Dutch-operated cruise ship with passengers of 23 nationalities is precisely the type of public health crisis the World Health Organization is designed to tackle. But the U.S. formally left the WHO in January, after 78 years of membership.
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As a result, health experts say, the U.S. might not get immediate access to surveillance data about the virus and contact tracing information about cases linked to the ship, which could help prevent additional infections.
“The access that we got as being members and as being important donors to WHO is gone,” said Amira Albert Roess, a professor of global health and epidemiology at George Mason University.
Ordinarily, Roess said, Centers for Disease Control and Prevention experts would have been part of the teams sequencing the virus. Now, the U.S. might have to learn about results secondhand.
When asked about those concerns, the Department of Health and Human Services referred NBC News to a statement on the CDC website, which says that the State Department has been in direct contact with cruise ship passengers and that the government is “working closely with our international partners to provide technical assistance and guidance to mitigate risk.”
“The White House continues to work with the CDC and State Department to monitor and respond to a recent outbreak of the Andes virus,” White House spokesman Kush Desai said in a statement. “While possible risks to the American public remain low, the CDC has convened leading experts on Andes virus to assist in this effort to ensure Americans are protected. The entire Administration remains vigilant.”
WHO officials said in a Thursday news conference that they were exchanging information with the U.S. thanks to international health regulations that require countries to report public health threats of international concern.
“We have very positive, regular interaction almost every single day,” said Anaïs Legand, WHO’s technical lead for viral hemorrhagic fevers.
But Stephanie Psaki, who was the coordinator for global health security during the Biden administration, said that when the U.S. was a WHO member, it often received advanced updates about disease outbreaks.
“By the time the information is shared publicly, certainly — but sometimes even through the [International Health Regulations] networks — the experts at WHO and CDC often already knew it for days or weeks,” Psaki, now a senior fellow at the Brown University School of Public Health, said.
President Donald Trump announced his intent for the U.S. to leave the WHO soon after taking office last year, citing what he described as “the organization’s mishandling of the COVID-19 pandemic” as a main reason. Until then, the U.S. had been one of the organization’s top donors.
With its departure, the U.S. terminated all funding to the WHO, pulled its staffers from WHO offices and severed participation in WHO committees and working groups.
Some experts now worry that the WHO can’t draw fully from the CDC’s resources and expertise to respond to the outbreak.
“Even when there are lots of actors involved who have the capacity and willingness to contain the threat and respond to the threat, it happens more quickly — and often more effectively — when the U.S. government is involved,” Psaki said.
Nearly 150 people remain on the cruise ship, confined to their cabins and monitoring for symptoms of the deadly virus. The ship is headed for the Canary Islands and evacuations could begin on Monday.
Three passengers have died. The first two were a Dutch husband and wife who had visited sites on a bird-watching trip in Argentina where a species of rat known to carry the Andes strain was present. Then a German woman died on May 2, just days after developing symptoms.
In total, five current or former passengers have been confirmed to have been infected. Three more cases are suspected. The virus’ incubation period can last up to six weeks, so more cases may still emerge.
More than two dozen passengers from 12 countries disembarked from the cruise ship on April 24 in St. Helena, a British territory. That included six Americans, according to the cruise ship’s operator, Oceanwide Expeditions. Some of those passengers are now in Arizona, California, Georgia and Virginia, according to authorities in those states.
Seventeen American passengers remained on the cruise ship as of Monday.
“This is a critical example of why the U.S. needs global public health partnerships. The withdrawal from the World Health Organization (WHO) puts people in the U.S. at higher risk and raises an important question: Are countries still sharing information with the U.S. quickly enough to keep us safe?” the National Public Health Coalition, a group of current and former Centers for Disease Control and Prevention employees, said in a statement.
Hantavirus, which causes fever, fatigue, nausea and trouble breathing, is typically contracted through contact with rodents or their urine, feces or saliva. Infections are rare — around 230 cases were recorded in the Americas last year — but the fatality rate for the virus in that region is up to 50%, according to the WHO.
The strain involved in the cruise ship outbreak, known as the Andes strain, is primarily carried by the pygmy rice rat, found in South America. It’s the only version of the virus known to be transmissible between humans, though that’s not the primary route of transmission. When it does spread between people, it’s usually among those who have had close, prolonged contact. The virus has no known cure, so doctors try to manage symptoms.
Psaki said it’s unusual that the CDC has not held a public briefing about the outbreak yet.
“It doesn’t inspire confidence when it’s already public that people have traveled back to the U.S. before there’s any information shared by CDC. That’s not the order that it should go,” she said.