Under Italy’s strict quarantine rules, several people are being monitored for symptoms after being identified as potentially coming into contact with someone who had hantavirus - and so far, none have tested positive.
People in Italy should “rest assured” that health authorities “took immediate action and are constantly monitoring the situation,” Italian Health Minister Orazio Schillaci told La Repubblica on Wednesday.
READ ALSO: British tourist quarantined in Milan tests negative for hantavirus
"The risk is very low, as European health authorities have said, and we at the health ministry confirms,” he said, adding: “Anyone who says we've been at a standstill or are unprepared is lying."
Health authorities also clarified media reports from earlier this week suggesting that one person had been hospitalised after testing positive for the virus - this turned out to be incorrect.
Here’s a closer look at what we know so far about the situation in Italy, what exactly is confirmed and what isn’t.
Quarantined travellers
The four people initially placed under observation last week - in the regions of Tuscany, Veneto, Calabria and Campania - were passengers on a KLM connecting flight from Johannesburg via Amsterdam to Rome on April 25th, the same flight briefly boarded by a Dutch woman who later died of the virus in South Africa.
All four were asymptomatic when identified, the health ministry has said. Two of the four have so far been tested. One of them, a South African man currently in isolation in Padua, tested negative.
Samples from the Calabrian passenger, 25-year-old Federico Amaretti, were meanwhile sent on Tuesday to Rome's Spallanzani Hospital, Italy's main research centre for infectious diseases.
After widespread media reports this week that Amaretti was instead being admitted to hospital with the virus, Spallenzani confirmed on Tuesday that this was incorrect and that it was only receiving samples for testing.
“In light of the latest press rumours regarding the suspected case of Hantavirus, we clarify that at the moment only the arrival of biological samples is expected,” the statement said.
A 60-year-old British tourist placed in quarantine at Milan's Sacco Hospital also tested negative on Tuesday, as did his “travel companion”, Lombardy welfare councillor Guido Bertolaso confirmed in a statement.
The man had been on an earlier St Helena-Johannesburg flight on which the deceased Dutch woman had also travelled, while he reportedly met his companion in Italy after the flight.
An Argentinean woman in Messina, who arrived in Italy on April 30th on a Buenos Aires-Rome flight, was also tested for hantavirus after she was hospitalised with pneumonia. She is not a contact of a confirmed case, but was tested because she travelled recently from a hantavirus-endemic region.
Italian news agency Ansa on Wednesday reported that Amaretti and the Argentinian woman in Messina had both tested negative, attributing the update to the health ministry.
The situation in Europe
A total of 94 passengers of 19 nationalities were evacuated and transferred to Tenerife South airport for repatriation flights home after the outbreak on the cruise ship MV Hondius.
Positive cases have been confirmed among passengers repatriated elsewhere in Europe. A French woman placed in isolation in Paris tested positive on Monday and is now in critical condition, AFP reported.
An American national evacuated from the ship has also tested positive for the Andes virus - the only hantavirus strain known to spread between humans - the US health department said.
READ ALSO: US and French citizens on hantavirus ship that docked in Spain test positive
The World Health Organization (WHO) has so far recorded 11 confirmed cases and three deaths from the outbreak globally.
No vaccines or specific treatments exist for hantavirus, which is endemic in Argentina, where the ship set sail in April.
Italian health officials have insisted that the risk for global public health is low and downplayed comparisons to the Covid-19 pandemic.
"There is no risk of a new hantavirus pandemic. We are not in the same situation as Covid," the head of Italy's Disease Prevention Department, Maria Campitiello, told Rai News on Monday. "There is currently no alarm. It is a different virus than Covid, albeit more lethal and with low contagion."
"Transmission is mainly through saliva, urine, and rodent feces, with only a small amount transmitted through the air and human-to-human. The incubation period is long, so isolation is recommended."
Both the Italian Higher Institute of Health (ISS) and the European Centre for Disease Prevention and Control (ECDC) consider the risk to the general population "very low".
How Italy is handling suspected cases
Italy’s health ministry on Monday issued a circular setting out how regional health authorities should respond to suspected cases and how surveillance works for anyone who has been in contact with a positive case.
Anyone judged to have had high-risk contact with a confirmed case, including airline passengers seated within two rows of them on a flight of six hours or more, must undergo a 42-day quarantine with daily monitoring.
Lower-risk contacts are told to watch for symptoms such as fever, muscle pain and headaches over the same period, but do not have to isolate. The 42 days reflects the longest known incubation period for the virus, as recommended by the World Health Organization.
Testing is reserved for people showing symptoms. The ministry said there is no point in routinely testing contacts who feel well, because tests carried out during the incubation period can return false negatives.
Meanwhile, some reports in Italian media suggested that an official Italian “alert level” had been raised due to the threat of hantavirus, but this was not mentioned in the health ministry’s circular on Monday. The reports mentioning this alert appear to have since been rewritten to remove this detail.
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