US health authorities say 18 Americans from the MV Hondius cruise ship have returned to the US, with one person who has tested positive for hantavirus
A second American on the repatriation flight on Sunday also showed symptoms and has flown to Atlanta, US officials have said
Nebraska Governor Jim Pillen says there is a "strong plan" and "no-one who poses a risk to public health is walking out the front door onto the streets of Omaha"
Officials say the risk to the public is "very, very low"
More than 90 passengers of the MV Hondius ship, currently docked in Spain's Canary Islands, are being repatriated, with a French national also testing positive
Three passengers - a Dutch couple and a German woman - have died after travelling on the vessel. Two of them are confirmed to have had the virus
There is a question about whether authorities can guarantee Americans won't catch hantavirus from the returning passengers.
The CDC's Dr Brendan Jackson responds that "there are no guarantees in life", but the safety of patients and locals is a top priority.
"We're putting as many measures in place as possible to ensure that people are safe and healthy, and we keep the community safe and healthy as well."
There's no plan in place for how frequently asymptomatic individuals will be tested at this time, says Michael Wadman, MD, medical director of the National Quarantine Unit, adding that frequency is being discussed.
He says officials are looking for symptoms similar to any influenza-like illness, such as fever, aches, dizziness, cough, shortness of breath, nausea, vomiting, diarrhoea etc.
Captain Michael Garner, a regional administrator for ASPR says two people being sent to Atlanta is part of a national approach so that patients are "load-balanced across the system".
The two people in Atlanta are a couple, only one of whom has symptoms.
The speakers are now asked about the numbers of passengers, which was originally said to be 17 but then rose to 18.
On this discrepancy, Matthew Ferreira from the Health and Human Services department clarifies the 18th person is a British dual national who decided to come back to the US.
That person remains in the quarantine unit in Nebraska, he says.
Dr Brendan Jackson of the CDC says close contact is usually considered to involve the exchange of bodily fluids like saliva, such as "sharing eating utensils, kissing, touching, those type of things".
"It can also mean just being really really close to that person for a fairly long period of time."
As a rough guide, he explains that means being within six feet for around 15 minutes, although he stresses there's "nothing magical" about those figures.
"It's not a force field, but it's a rough number that gives us a rough sense of how close somebody has been," he adds.
The CDC's Dr Brendan Jackson says state health departments have made contact with all passengers who have returned from the cruise ship.
"The state health departments have been monitoring them on a daily basis for symptoms and temperature checks," Jackson says of people who have travelled back to the US.
"They have plans in place to ensure they can isolate effectively in their homes should they develop symptoms," he adds.
The press conference has now finished, but we will continue to bring you the key lines from what we heard.
The fifteen passengers in Nebraska will stay at the facility for assessment for the next several days, says Brendan Jackson. They are welcome to stay at the Nebraska medical facility longer, if they want to, he says.
Then there will be an individual monitoring plan to determine if patients could stay in isolation at home, or if they should stay at the medical facility for the full 42 days, Jackson says. This depends on each individual's living situation, how their health is and if they have access to high-level health care if necessary.
Jackson says they will "try to do this in the least restrictive way possible to protect the health of the passengers and their communities."
Dr Angela Hewlitt, medical director of Nebraska Biocontainment Unit, is now explaining the facility.
The quarantine unit, she says, is "much more like a hotel than a patient care space".
"We don't have the typical things that you'd see in a hospital room. It's a much more comfortable environment actually, with some things to help keep people comfortable, like exercise equipment."
By comparison, the biocontainment unit is used to house those who are ill, Hewlitt adds, saying there is currently one person in there.
"They are doing well, they currently do not have any symptoms, and have a good appetite, although they're very tired, understandably."
Michael Wadman, medical director of the National Quarantine Unit, says that the 15 passengers welcomed this morning are in "good shape" and "good spirits" with a further patient in the biocontainment facility.
They were "definitely tired and needed some rest", he says.
Now they are focused on "symptom monitoring", but "everyone here is asymptomatic" and no one has a temperature, he says.
They're all resting now, he adds, and will undergo further assessment when they've had a chance to sleep.
Brendan Jackson confirms that sixteen passengers from the hantavirus-affected cruise ship were admitted to the University of Nebraska quarantine unit this morning.
Two other passengers from the ship are in Atlanta, he adds.
A reporter asks what it means for someone to have tested "mildly positive" for PCR if they don't have symptoms.
That patient's specimen was taken on the ship, not in the US, says Jackson.
He adds that there were two specimens collected from that patient, one of which was positive and the other negative.
"With these PCR tests... there's sort of a range in where they can fall. And so for that reason, we just want to make sure there's further testing to evaluate that."
The first question is about the person who is experiencing symptoms.
Brendan Jackson, MD, Centers of Disease Control and Prevention answers that to preserve space at the facility in Nebraska, some passengers were flown to Atlanta, including the passenger who displayed symptoms.
We should expect people to have symptoms, but that doesn't mean that they have this particular illness, he says.
Any symptoms of a mild cold would count as a symptom, he adds, and they are being extra cautious.
Dr Jeffrey Gold, president of the University of Nebraska, is coordinating the news conference and says it's an honour to help repatriate the American citizens.
"There is no place in the country that they could be better cared for," he says.
Gold adds that the university operates on a simple rule: "If we treat our patients the way we would treat our family members and loved ones, we're gonna be OK, and that's the rule."
He then begins taking questions.
Image source, AFPWe're also hearing from John Knox, who works on strategic preparedness and response at the US Department of Health and Human Services.
He says that 18 US citizens have been repatriated with the coordination of multiple federal agencies.
They were transported from the Canary Islands to Nebraska, and since touching down in the US have been taken to the University of Nebrasha Medical Center.
He says this facility was selected due to its "extensive expertise" as the only national quarantine unit in the country.
Knox says there are trained personnel "ready to safely handle situations like this", and that the operation so far "reflects strength of national preparedness system".
Over the next several days, the passengers will undergo health assessments, he adds.
Next to speak is Admiral Brian Christine, MD, Assistant Secretary for Health, at the U.S. Department of Health and Human Services, who says the risk to the public is still "very, very low".
Transmission takes close contact, he says, emphasising that "transparency has been and is the order of the day".
Nebraska Governor Jim Pillen says those quarantined at the facility will receive "the best world-class care possible".
He says the staff there are "highly trained and compassionate" and will make their stay "as comfortable as possible".
He reassures Nebraskans that there is a "strong plan in place" and local officials are working closely with federal agencies.
"No-one who poses a risk to public health is walking out the front door onto the streets of Omaha," he says.
Image source, AFPThe press conference from US health officials is expected to provide an update on the US citizens who have been exposed to hantavirus and are now back on US soil.
We'll bring you key lines as they happen. Watch live at the top of the page, and stick with us for the latest developments.
Among the passengers aboard the MV Hondius cruise ship were four Canadians, who returned to their home province of British Columbia on Sunday night.
The four took a chartered flight from Tenerife, Spain, where the ship was docked, to Bagotville, Quebec and later Victoria, British Columbia. All are now self-isolating at a "pre-determined location" for a minimum of 21 days, Canadian officials said.
That period could extend up to 42 days days if necessary due to the hantavirus' incubation period, said British Columbia's health officer Dr Bonnie Henry on Sunday.
"At no point during their arrival or isolation period will they be in contact with the public," she said, adding their health will be monitored daily.
Canada is treating its passengers like they have been exposed to the hantavirus out of precaution, authorities said, but none have shown symptoms.
If one of them does test positive for the virus, Henry said there are "secure plans in place" to make sure the illness does not spread.
Image source, ReutersThe cruise ship MV Hondius at the port of Granadilla de Abona in Tenerife
People from all over the world had been aboard the MV Hondius - the cruise ship hit by a hantavirus outbreak - when it set sail from Argentina a month ago.
Dutch and German nationals have died
A dutch couple travelling on the ship have died, with the wife confirmed as having had hantavirus. A German passenger also died.
French, US and British nationals among other cases
A total of seven cases of hantavirus linked to the ship have been confirmed, including an American and a French national, authorities say. French Health Minister Stéphanie Rist said a woman was isolating in Paris and her health was deteriorating, with 22 contacts traced.
Two other British nationals with confirmed cases are currently being treated in the Netherlands and South Africa.
Global evacuations
Spain said on Sunday that more than 90 passengers would have been evacuated and flown home by the end of the day, leaving fewer than 60 passengers aboard the ship.
Fourteen Spanish nationals flown from Tenerife to Madrid face mandatory quarantine at a military hospital in the capital. French and British nationals were also taken to Paris and Manchester respectively, with flights for Turkish, Irish and US citizens also scheduled.
Twenty Britons are isolating at Arrowe Park Hospital in Merseyside, after their chartered flight from Tenerife landed at Manchester Airport on Sunday.
Image source, ReutersThe cruise ship MV Hondius
Unlike diseases such as measles, which are highly contagious and spread easily, the Andes strain of hantavirus behind the outbreak is not that infectious.
Hantavirus typically spreads from rodents, with people infected by breathing in air contaminated with virus particles from rodent urine, droppings, or saliva.
Human-to-human spread is possible but the risk of infections globally remains low, says the World Health Organization.
Experts have observed the Andes strain spreading between human patients in previous outbreaks, through very close contact, and health experts believe that some of the infections on board MV Hondius may have passed between people.
Prof Robin May, chief scientific officer at the UKHSA has previously told the BBC that the risk to those not directly linked to the cruise is "extremely low indeed".
Image source, ReutersThe US charter flight disembarking at Eppley Airfield in Omaha, Nebraska
Out of the 17 US citizens evacuated from the cruise ship, one has tested positive for the virus and one is displaying "mild" symptoms, the US department of Health and Human Services (HHS) says in a post on X.
The two travelled in biocontainment units to the Nebraska facility, out of "an abundance of caution", the HHS said. The US citizen with mild symptoms will be transported to a second location.
The passenger who tested positive for the virus is not displaying any symptoms, reports CBS news, the BBC's US news partner.
Image source, University of Nebraska Medical CenterThe centre opened just months before the Covid-19 pandemic
Seventeen US citizens and one British national who resides in the US arrived in Nebraska earlier, having been evacuated off the hantavirus-struck cruise ship.
They are due to be screened at the University of Nebraska Medical Center in the city of Omaha. It's a state-of-the-art facility and contains the only federally-funded quarantine unit in the US: the National Quarantine Unit (NQU).
The 20-bed facility opened in November 2019, just months before the Covid-19 pandemic began. The rooms are fitted with negative air pressure systems designed to prevent the spread of communicable diseases.
Dr Michael Wadman, director of the NQU, likened living in the facility to "a hotel room with delivery of food".
"They can use their exercise devices in the room, we do daily symptom and monitoring as well as vital sign checks," he said.
