CDC Largely Absent in Global Hantavirus Outbreak Response

NEW YORK (AP) — No quick dispatching of disease investigators. No televised news conference to inform the public. No timely health alerts to doctors.

In the midst of a hantavirus outbreak that involves Americans and is making headlines around the world, the U.S. government’s top public health agency, the Centers for Disease Control and Prevention, has been uncharacteristically missing in action, according to a number of experts.

President Donald Trump told reporters Friday evening, “We seem to have things under very good control.” But health experts note the situation aboard the cruise ship hasn’t spiraled primarily because hantavirus doesn’t spread easily like COVID-19, measles, or influenza. It’s been health authorities in other countries, not the United States, who have taken the lead in managing the outbreak over the past week.

“The CDC is not even a player,” said Lawrence Gostin, an international public health expert at Georgetown University. “I’ve never seen that before.”

Only late Friday did CDC actions accelerate. Health officials confirmed they would deploy a team to Spain’s Canary Islands, where the affected cruise ship was expected to dock early Sunday. A second team will travel to Offutt Air Force Base in Nebraska as part of a plan to evacuate American passengers to a University of Nebraska quarantine center for evaluation and monitoring. The CDC also issued its first health alert to U.S. doctors, advising them of the possibility of imported cases.

At their first briefing on Saturday, held by telephone for select reporters only, officials pledged transparency in updating the public but said media could not cite speakers by name under rules set by aides to Health Secretary Robert F. Kennedy Jr. They did not directly answer whether American passengers could leave the university medical facility voluntarily.

The CDC’s diminished role in this outbreak indicates the agency is no longer the international health leader or domestic health protector it once was, some experts warned.

The hantavirus outbreak is “a sentinel event” that speaks to “how well the country is prepared for a disease threat. And right now, I’m very sorry to say that we are not prepared,” said Dr. Jeanne Marrazzo, chief executive officer of the Infectious Diseases Society of America.

How the Outbreak Unfolded

Early last month, a 70-year-old Dutch man developed a feverish illness on a cruise ship traveling from Argentina to Antarctica and islands in the South Atlantic. He died less than a week later. More passengers subsequently became sick, including the man’s wife and a German woman, both of whom also died.

Hantavirus was first identified as the cause in one of the cases on May 2. The World Health Organization quickly mobilized and by Monday had officially declared an outbreak. Approximately two dozen Americans were on the ship, including about seven who disembarked last month and 17 who remained on board.

WHO Taking Center Stage

For decades, the CDC partnered closely with the WHO in such situations. The CDC routinely served as a mainstay of international outbreak investigations, providing staff and expertise to help identify causes, develop control measures, and communicate essential information to the public.

Such actions built the CDC’s reputation as the world’s premier public health agency.

But in this outbreak, the WHO has been center stage. The international organization has made the risk assessment that informed the public that this is not a pandemic threat.

“I don’t think this is a giant threat to the United States,” said Jennifer Nuzzo, director of Brown University’s Pandemic Center. But how this situation has unfolded “just shows how empty and vapid the CDC is right now,” she added.

Tumult Under Trump

The current situation follows 16 tumultuous months during which the Trump administration withdrew from the WHO, restricted CDC scientists from communicating with international counterparts at times, and embarked on plans to build its own international public health network through bilateral agreements with individual countries.

The administration has laid off thousands of CDC scientists and public health professionals, including members of the agency’s ship sanitation program.

Throughout these changes, Health Secretary Kennedy stated he was working to “restore the CDC’s focus on infectious disease, invest in innovation, and rebuild trust through integrity and transparency.”

Waiting to Hear from the CDC

The CDC has not been completely silent on hantavirus. The agency issued a brief statement Wednesday saying the risk to the American public is “extremely low,” and described the U.S. government as “the world’s leader in global health security.”

Nuzzo criticized this approach: “Not only was that not helpful, it actually does damage because a core principle of public health communications is humility.”

The CDC’s acting director, Dr. Jay Bhattacharya, posted on social media that the agency was lending expertise in coordinating with other federal agencies and international authorities. Arizona officials this week learned through the CDC that one of the Americans who disembarked—a person without symptoms and not considered contagious—had already returned to the state. WHO officials confirmed the CDC has been sharing technical information.

Bhattacharya wrote that the CDC is “monitoring the health status and preparing medical support for all of the American passengers on the cruise.”

However, federal health officials have been largely tight-lipped, declining interview requests. Bhattacharya’s first on-camera appearance came Saturday morning on Fox News, where he said, “My message to the American people is please don’t worry.” Critics noted he made factual errors during the appearance, incorrectly stating that two passengers in their 80s had died after contracting the virus while bird-watching in Argentina. In reality, the travelers were a 70-year-old Dutch man and his 69-year-old wife, and while Argentine health officials believe they may have been infected during a bird-watching excursion, this has not been definitively established.

COVID-19 Comparison

Experts draw stark comparisons to the 2020 incident involving the Diamond Princess, a cruise ship docked in Japan that became the setting for one of the first large COVID-19 outbreaks outside China.

In that case, the CDC sent personnel to the port, helped evacuate American passengers, managed quarantines, shared genetic data, coordinated with the WHO and Japanese authorities, held public briefings, and rapidly published scientific reports “that became the world’s reference data on cruise ship COVID transmission,” according to Dr. Tom Frieden, a former CDC director.

While some aspects of the international response to the Diamond Princess were criticized, and it didn’t stop COVID-19’s global spread, experts note the CDC was actively engaged in response efforts.

“The CDC was right on top of it, very visible, very active in trying to manage and contain it,” Gostin said, contrasting with the agency’s current delayed and subdued approach.

Instead of working with most of the world’s nations through the WHO, the Trump administration has pursued bilateral health agreements with individual countries for information sharing, public health support, and what it describes as “the introduction of innovative American technologies.” About 30 such agreements are currently in place.

Gostin believes this approach is inadequate: “You can’t possibly cover a global health crisis by doing one-on-one deals with countries here and there.”