Breaking Ground: The Urgent Quest for a Test to Combat the Andes Hantavirus

The Race Against Time

As passengers return to the United States from a recent cruise ship outbreak of the Andes hantavirus, a significant concern arises: how do we efficiently identify and treat potential infections before they escalate into severe cases? In response to this health crisis, a lab at the University of Nebraska Medical Center has stepped up, becoming possibly the first in the nation to roll out a PCR test specifically for this rare virus.

The Importance of Early Detection

Peter Iwen, director of the Nebraska Public Health Laboratory, highlighted the vital role of early detection in managing infectious diseases. “Our PCR test is designed to identify very small amounts of the virus even before patients start showing symptoms,” he explained. This capability was crucial during the COVID-19 pandemic and remains essential in the fight against the Andes hantavirus, which has a staggering fatality rate of around 35%.

“These folks are going to have a very low concentration of blood in their system once they are early on in the stages of their disease,” said Iwen. “That's why early testing is critical.”

A Novel Approach to Testing

With the U.S. lacking a comprehensive testing infrastructure for the Andes hantavirus, Iwen's lab moved rapidly to develop the necessary diagnostic capabilities. When notified that they would receive 16 American passengers potentially exposed to the virus, they contacted the Centers for Disease Control and Prevention (CDC) only to discover that they lacked readily available tests for specific diagnosis.

While the CDC can perform serological tests to detect antibodies, these tests require the patient to be actively ill. In contrast, PCR tests can catch the virus earlier in its life cycle, leading to quicker diagnosis and treatment. Unfortunately, Iwen found that the only PCR tests available from the CDC were still in the research phase and not suitable for patient management.

Collaborative Efforts

Undeterred, the Nebraska lab reached out to experts nationwide to obtain the important strains of the Andes virus required for validation. They partnered with Steven Bradfute at the University of New Mexico, who had developed an Andes virus PCR test during his PhD research. Bradfute's team provided the necessary genetic materials, enabling Nebraska to validate its diagnostic test swiftly.

The Validation Process

In just two days, the Nebraska team assembled their test, running approximately 300 validations to ensure accuracy. The process involved adding genetic material and comparing the results against control samples. “We now have the capacity to conduct a few hundred tests on real patient samples,” noted Iwen.

Implications for Public Health

With the ability to conduct early tests, the Nebraska lab anticipates identifying cases promptly, significantly improving patient outcomes. Although there are no direct antiviral treatments available for the Andes virus, supportive care can make a meaningful difference in survival rates.

Kelly Wroblewski, director of infectious diseases at the Association for Public Health Laboratories, emphasized that the testing landscape remains fragmented nationwide. “Capacity varies greatly by state, with only a few able to handle PCR testing for hantavirus,” she said. In a time when we've faced unprecedented health challenges, the lessons learned from past pandemics, particularly COVID-19, can guide our current strategies.

Preparing for the Future

The swift action taken by the Nebraska lab illustrates how vital it is to prepare for public health emergencies before they arise. Wroblewski remarked, “What Nebraska did to stand up a test is one of those lessons learned—get ready before you even need to test.” This proactive approach can be instrumental in responding to future health crises.

Conclusion

As we continue navigating the complexities of public health responses in real-time, the efforts showcased by the University of Nebraska's dedicated team highlight the importance of innovation, collaboration, and timely intervention in mitigating the impacts of emerging infectious diseases.