A cruise ship is currently experiencing an outbreak of hantavirus. According to the World Health Organization, the type of hantavirus infecting people on the ship is called the Andes virus and unlike most hantaviruses it has been reported to spread from person to person. Human-to-human transmission is unusual.

Why Hantavirus is a serious cleaning hazard

Hantaviruses are carried by infected rodents (rats and mice). Cleaning areas infected with rodents poses a high risk for hantavirus infection, a serious respiratory disease caused by breathing in virus particles stirred up from rodent urine, droppings, or nesting materials. Key risks include sweeping, vacuuming, dry-dusting, or touching contaminated surfaces.

The greatest hazard is not simply touching surfaces. It is aerosolization during cleaning activities.

Key cleaning hazards and risks

• Stirring Up Dust: Sweeping or vacuuming feces or urine creates aerosols (tiny particles) that can be inhaled. Do not vacuum or sweep rodent droppings.
• Contaminated Spaces: Enclosed rooms with inadequate ventilation can concentrate infectious particles.
• Handling Nesting Materials; Cleaning up rat or mice nests or picking up dead rodents without protection can lead to infection.
• Skin Contact: Virus can enter the body through cuts or abrasions in the skin or by touching the mouth, nose, or eyes after touching contaminated surfaces and materials.
• Cleaning Up Patient Diarrhea and Vomit and Respiratory droplets.
• Improper PPE Use: Not protecting your eyes, nose, and mouth and allowing contact with virus-laden urine, droppings, or nesting materials from infected rodents.

Case study: Andes Virus “super spreader” outbreak and implications for the cleaning industry

A study published in the New England Journal of Medicine examined a 2018 outbreak of Andes virus hantavirus in Argentina and documented clear evidence of person-to-person transmission at crowded social events such as at a birthday party. The findings have important implications for professionals responsible for cleaning, infection prevention, environmental hygiene, transportation, hospitality, healthcare, and indoor environmental safety.

Key findings from the 2018 outbreak investigation

Researchers analyzed 34 confirmed cases linked to an outbreak in Patagonia, Argentina. Using epidemiology and viral genome sequencing, investigators demonstrated that:

• Human-to-human transmission occurred repeatedly.
• Several infections were linked to prolonged close indoor contact.
• One infected individual acted as a “super-spreader,” transmitting the virus to multiple people.
• Viral spread appeared associated with respiratory secretions and close interpersonal exposure.

Why the 2018 outbreak matters to the cleaning industry

The findings reinforce that cleaning and environmental hygiene professionals may be exposed during outbreaks involving Andes virus hantavirus.

Worker’s cleaning areas occupied by infected individuals may encounter contaminated respiratory droplets, bodily fluids from vomit and diarrhea, dust, or rodent-related contamination.

Important cleaning industry message

The primary way to prevent hantavirus infection is to avoid exposure to rodents and their droppings and using safe cleaning methods.

The safe approach includes:

• Conduct a visual inspection of the surface you are about to clean.
• Assess risk. Is there evidence of rodents, droppings, urine, nesting, food being eaten? Is or was there a sick person in the room?
• Minimize aerosolization in how you clean and by the equipment you use.
• Use wet methods for cleaning. Use water, detergents, sanitizers, disinfectants to prevent aerosolization.
• Wear appropriate PPE based on the hazards identified and your risk assessment. Protect your eyes, nose, mouth, and skin.
• Follow biohazard-informed cleaning protocols that are evidence-based and decrease risk.

Hantavirus cleaning should be treated as a serious occupational health and indoor environmental quality issue requiring infection prevention and exposure control expertise.

Reference:

Martínez VP, Di Paola N, Alonso,DO, Pérez-Sautu U, Bellomo CM, Iglesias AA, et al. Super-spreaders” and person-to-person transmission of andes virus in Argentina. New England Journal of Medicine. (2020) 383:2230–41.