Dr Matthew Dryden praises an astute doctor and the value of teamwork across continents in averting a hantavirus disaster. In a letter responding to Devi Sridhar's article on the MV Hondius cruise ship, Dryden explains that the real reason disaster was averted was the close communication and strengthened health services provided by the UK Overseas Territories (UKOTs) programme.
The Role of the UKOTs Programme
Funded by the Foreign Office and managed by the UK Health Security Agency, the UKOTs programme supports health services in all UKOTs around the globe. These are small and vulnerable communities with very limited medical services in most cases. The key success of this lean but effective programme lies in close communication and strengthening health services.
Astute Diagnosis on Ascension Island
The astute doctor on Ascension Island recognised a cluster of cases on the MV Hondius when a sick passenger was brought ashore for treatment. Newly developed diagnostic equipment on the island was able to exclude common causes. 'We knew we were dealing with something unusual,' Dryden writes.
Possible causes were reviewed during a meeting across continents between Ascension, the UKOT programme infection doctor, the ship company medical adviser, and a colleague in the National Institute for Communicable Diseases in South Africa, who tracked down samples from two cases medevaced to South Africa. The diagnosis of hantavirus was made.
Averting a Wider Outbreak
It was this that alerted the World Health Organization and national public health organisations, and averted disaster. Without this, the ship would have sailed on to Cape Verde. Passengers incubating hantavirus would have disembarked and travelled to their home countries. The outbreak would have been much wider.
Another Perspective: Global Inequality
Dr Brian Jones adds that the good fortune that was with the hantavirus cruise ship doesn't necessarily apply to those in the Democratic Republic of the Congo or neighbouring countries, like the Batwa pygmies, a highly vulnerable, marginalised and endangered group of people in Uganda currently fighting the Bundibugyo strain of the Ebola virus, a rare variant for which there is currently no approved vaccine or specific treatment. Until all people throughout the world have equal access to public health measures against novel infectious diseases, we will all be vulnerable to the next unexpected product of a world stressed by inequality and a privileged elite.
