// This is a machine generated transcript. Please report any transcription errors to will-help@illinois.edu.

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Brian Mackey: From Illinois Public Media, this is The 21st Show. I'm Brian Mackey. You've no doubt heard by now about the hantavirus outbreak on a Dutch cruise ship in the Atlantic Ocean. It was first documented last month. The situation has continued to escalate. We now know it's the Andes form of the virus, and as we go to air this morning, there have been 3 deaths linked to that outbreak. Countries from across the world have picked up their citizens and put them in quarantine. According to the Centers for Disease Control, there were 18 American passengers. Sixteen were taken to the University of Nebraska Medical Center in Omaha, and 2 others — someone showing mild symptoms and their partner — they were taken to Emory University's regional [emerging] pathogen Treatment Center in Atlanta, Georgia. That patient has not tested positive for the Andes form of the virus, and that's going to be important in a moment.

Because meanwhile, here in the 21st state, the Illinois Department of Public Health says it's investigating someone in Winnebago County that has contracted hantavirus. According to a news release from the state, it's believed that this person is carrying the North American strain of that illness, which does not spread from person to person and is not linked to the Andes variant that afflicted passengers on that cruise ship. Nevertheless, with the COVID-19 pandemic still in the back of many people's minds — especially in the minds of people who produce newscasts — it's raised concerns that hantavirus could become a greater threat, [though] many experts are doubtful about that. So, for the first part of the program today, we hope to put some of those concerns in context and get a better understanding as to how your local health officials respond to actual hantavirus threats, which are associated with local rodent populations.

Joining us now to talk more about this is Dr. Vidya Sundareshan, professor and chief of infectious diseases at the Southern Illinois University School of Medicine in Springfield, and also medical advisor to the Sangamon County Department of Public Health. Dr. Sundareshan, welcome back to The 21st Show.

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Dr. Sundareshan: My pleasure.

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Brian Mackey: Also with us is Dr. Mamadou Tounkara, administrator for the Champaign-Urbana Public Health District. Dr. Tounkara, welcome to The 21st Show to you as well.

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Dr. Tounkara: Thank you for having me.

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Brian Mackey: And listeners, you can join us today: 800-222-9455. We're only on this topic for about the next 14 minutes or so, so don't wait if you have questions about hantavirus — 800-222-9455. So, Dr. Sundareshan, I'm gonna start with you. Can you just tell us in a little more detail, what exactly is hantavirus? Symptoms, that sort of thing?

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Dr. Sundareshan: Yeah, hantavirus belongs to a group called [Orthohantaviridae]. There are about 40 different species, 22 of which can actually cause human disease. This is not new. It was first recognized in the 1930s and 1940s here in the United States. The first time it was really consolidated as a notifiable disease was in 1995. Before that, in 1993, they did have a few cases of hantavirus that was not really the Andes type. Andes type is also not new. It is prevalent in South America, predominantly in Argentina and Chile, and that's where this originated. And what is different about this type of virus is that there is a potential human-to-human transmission. Typically, of the other types of hantaviruses, rodents are the main carriers of the virus. They don't get sick themselves, but could cause human disease. But here with Andes, there's potential human-to-human transmission risk.

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Brian Mackey: What is it about this particular variant that makes it human-to-human transmissible where the others aren't necessarily?

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Dr. Sundareshan: It's just the way the transmission and the epidemiology of the virus is — it can vary from one type to another. And again, when we say human-to-human transmission, this is also with direct human contact with saliva or bodily fluid of humans, and then also with prolonged contact. So there's a difference. With the others, we know that there's aerosolization of the rodent feces or urine or saliva, which could potentially cause that. But in this case, we have seen — also particularly with the cruise ship scenario — there's more that we need to understand in terms of the epidemiology and the risk of transmission, which we're seeing in real time now.

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Brian Mackey: Dr. Tounkara, I wanna come to you now. How typical is hantavirus in the U.S., and especially in Illinois?

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Dr. Tounkara: Yeah, so that's a great question. Not very common. So from 1993 through 2023, we have a total of 890 laboratory-confirmed cases of hantavirus that were reported in the U.S. But, you know, the recent outbreak really pushed people to think about it more, and then we have an associated case in northern Illinois. So it's not very common, but I think it's extremely important for people to know that the risk to public health in the United States is considered extremely low at this time. Because of, you know, the two medical centers — one in Nebraska and Emory — they are built specifically to contain this type of infectious disease. And there is collaboration from local public health departments, state public health departments, and the CDC, so I think this is a holistic response. And also, you know, with collaboration with the World Health Organization, the risk here locally remains low. But, you know, any time that cases occur, the public needs to know that the risk is low, and also reassurance that we are monitoring the situation closely.

So this is a notifiable disease. Like someone else said, any time that cases occur, we'll be notified and we will monitor the cases closely to make sure that our residents and our community are safe in case we need to respond.

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Brian Mackey: Dr. Sundareshan, when these cases do come up, who is most at risk of severe illness from hantavirus?

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Dr. Sundareshan: Hantavirus can occur in anyone that is exposed to the virus, and the exposure to the virus — like we said earlier — is with saliva, urine, or droppings of rodents, or nesting material. So people that are high risk for exposure to this [are on] farms, [in] areas where there's heavy rodent infestation. So there is higher risk for that in people that are exposed in these environments.

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Brian Mackey: All right, let me remind listeners — this is The 21st Show. We're talking about hantavirus, a disease carried by rodents: rats, mice. It can be transferred to humans through exposure, as we've been hearing, from their feces or urine or saliva. It's been on the minds of a lot of people lately following an outbreak on a Dutch cruise ship in the Atlantic Ocean and a separate case here in Winnebago County in Illinois, though that has no relation — as far as we know — to the strain on the cruise ship. It's a different version of the virus. We're talking about this with Dr. Vidya Sundareshan, professor and chief of infectious diseases at the SIU School of Medicine in Springfield, and Dr. Mamadou Tounkara, who is public health administrator of the Champaign-Urbana Public Health District. 800-222-9455 if you have a question about this.

So, Dr. Tounkara, when we were preparing for this conversation, we were looking at, you know, trying to get a sense of rat populations in different Illinois cities. And every year, Orkin, the pest control company, they release — for marketing purposes, I'm sure — a list of the top 50 American cities with the worst rat populations, based on the amount of calls they get for rodent services. Chicago's No. 2 on the list, which I think is understandable. The only other Illinois city, though, is Champaign at No. 37, ahead of cities like Phoenix, Nashville, New Orleans, and Richmond, Virginia, which are much bigger. So I mean, this could just be that people in Champaign are more likely to call Orkin, so it's not like a scientific survey. But I don't know — what does that say? And what does the Champaign-Urbana Public Health District do to keep track of the local rat population?

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Dr. Tounkara: Yeah, so that's very interesting. I'm happy — if you can send me that survey — to look more closely at that data. But really right now, we work closely with our animal control. You know, any type of animal that can potentially carry diseases — we call them vector-borne diseases, because the animal is the vector and they will carry the disease to humans — so we really work closely with our animal control. And if there are any suspected, suspicious cases, they reach out to us and we'll do investigation and do testing, just to make sure that we don't see anything that will take us by surprise. But, you know, in terms of controlling rat populations, I think that's more in the domain of animal control, and I think that they're doing a really great job in Champaign County in general.

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Brian Mackey: Well, can you talk about what you would do if — we had this case in Winnebago County — what is the protocol for a local health department if there is an outbreak?

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Dr. Tounkara: Yeah, that's a great question. So first of all, we'll have to define what an outbreak is. It's probably like 2 or more cases for a specific disease. But this is just one case that we have seen so far, and if it's a notifiable disease, one case — depending on how they define an outbreak — will probably be an outbreak. But really, we provide guidance, we provide support in terms of testing, we make sure that a person is in a safe environment, and most likely that would be a medical center where it's biocontained — meaning that it's difficult for the person to transmit it to any other person in that location.

And then also, we'll do multiple testing just to make sure that the person is on track, and we work closely with physicians to make sure that the person is having supportive care. And also do contact tracing to see if there's any person that this individual got into contact with, and potentially try to isolate those individuals also. In the area where it happened, we'll probably push a media release to inform people, and also make sure that people are aware that this is the area that this person got infected — potentially got infected or got in contact with a rodent that potentially has hantavirus.

But that probably would be the protocol to follow: notify the Illinois Department of Public Health, but also notify the CDC. This response usually is a collaborative and holistic response, because at the local health department, our resources are limited. So we would do the initial collections of specimens and so forth, and get guidance from the Illinois Department of Public Health and the CDC.

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Brian Mackey: All right, let's go to the phones quickly. We're short on time. Beth is calling from McHenry County. Beth, I understand you have some tips on safely cleaning up rat droppings — thanks for calling in.

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Beth: Actually, I don't have tips. I had a question about what to wear for protection if you're cleaning up an old house that has a lot of mouse droppings.

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Brian Mackey: Oh, all right. Dr. Sundareshan, do you have advice for — if you do have an old house with a lot of mouse or rat droppings — how to clean that up safely?

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Dr. Sundareshan: Yeah, first off, personal protection with rubber gloves. And to make sure that you are spraying with a disinfectant — if you don't have an effective disinfectant, bleach is a great way to disinfect the droppings. You don't want to sweep them or vacuum them, because that carries a risk of aerosolization if these are infected. And definitely, if it is a heavy infestation, seeking some professional help if possible.

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Brian Mackey: OK, so don't vacuum them, because that just blows the potential germs around the room. That's good advice. We have one other question. I think this is a really interesting one. Lindy is calling from Rockford. Our time is tight, Lindy, but go ahead — I think this is a great question.

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Lindy: Yeah, so my son is looking into getting his first pet, and he was looking at rats. And now that this has all come up, we have questions about what the danger is with hantavirus and pet rats.

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Brian Mackey: All right, thanks for that question, Lindy. Dr. Sundareshan, can you speak to that? Is a pet rat a potential carrier of hantavirus?

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Dr. Sundareshan: Yes, that's a great question. Children under the age of 5, pregnant women, and immunosuppressed, immunocompromised people should definitely [avoid] handling any of these pets — they should try to stay away from them. But if you are looking into getting a pet rat, definitely making sure you're up to date with the veterinary recommendations for those — that are important — keeping it clean, and then just making sure that if there are any signs of illness or sickness, to take the necessary actions.

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Brian Mackey: "The necessary actions" — that sounds ominous, but OK. I think we're gonna have to leave it there. Dr. Vidya Sundareshan is a professor and chief of infectious diseases at the Southern Illinois University School of Medicine in Springfield. Dr. Mamadou Tounkara is public health administrator for the Champaign-Urbana Public Health District. Dr. Sundareshan, Dr. Tounkara, thank you so much for being with us today on The 21st Show.

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Dr. Tounkara: Thank you for having us. Thanks.

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Brian Mackey: And we're gonna come back shortly and move on to a different conversation. But I do want to mention — later this week, we're going to be talking about voting rights in Illinois. There's a lawsuit. As you know, the U.S. Supreme Court basically struck down the last part of the Voting Rights Act. A number of states are seeking to change their district maps before this year's election already, but there's also a legal challenge to Illinois' Voting Rights Act, which was passed in anticipation of that sort of Supreme Court decision. If you have comments or questions about that, we'd love to put them to our panel. That's gonna be on Wednesday's show. talk@21stshow.org. Keep in touch. All right, we'll be right back after a short break. This is The 21st Show.