The North Carolina passenger currently in quarantine is expected to remain at the University of Nebraska Medical Center through June 21, according to the North Carolina Department of Health and Human Services (NCDHHS).
The NCDHHS told WRAL News on Monday that the extended stay will allow the passenger to complete the recommended 42-day quarantine period following their last potential exposure to the virus.
Some passengers from other states may be allowed to return home as early as June 1 to complete the remaining three weeks of quarantine, according to CNN.
As health officials continue monitoring people tied to a rare hantavirus outbreak, researchers at Duke University say understanding rare diseases may require looking beyond rodents and into the environments where they thrive.
James Herrera, Conservation Director for the Duke Lemur Center, has spent years working in Madagascar studying wildlife, conservation and disease ecology.
Herrera works with teams in both Madagascar and Durham, North Carolina. While much of their work focuses on endangered lemurs, the research has expanded to explore how environmental changes may influence disease spread.
“When I first came to Duke University, it was through an opportunity to conduct research on infectious disease,” Herrera said. “I joined a specialized lab with Charlie Nunn. We came up with this project together to investigate not primates, but small mammals, especially rodents.”
Herrera continued, “We know that rodents are one of the main species that can be a reservoir for diseases. They can carry a lot of these pathogenic organisms and maybe not even be sick themselves, but then could be a cause of spread to people.”
More than a year before the current rare outbreak made headlines, Herrera and his team studied more than 1,000 rodents and small mammals in Madagascar. The rodents and small mammals were collected from villages, homes, and agricultural areas.
Researchers found that about 10% of black rats carried hantavirus. All of the infected animals identified in the study were black rats.
“That was really interesting because we thought that there might also be some spillover from the black rats to the native species, but we didn’t find any of the native species infected,” Herrera said.
The strain was not identified as the Andes, which is the rare type of hantavirus that has recently caused human-to-human spread in connection with MV Hondius passengers.
The research found that infected rodents were more common in agricultural areas than in villages, while no infected animals were found in mature forests.
“In the more intensively human-transformed landscapes, that’s where you see much more of the black rats, and that’s where you see much more of the disease prevalence,” Herrera said.
Madagascar is home to large agricultural regions that produce crops including rice and much of the world’s vanilla. Researchers say those working landscapes provided an opportunity to study how land use may affect disease-carrying rodent populations.
The study does not suggest farming causes hantavirus outbreaks. Instead, Herrera said the findings point to a broader lesson: the way people shape the environment may influence where disease-carrying rodents thrive.
In short, researchers believe adding more trees around farms and rice fields may help support native wildlife and restore natural controls on rodent populations.
“That means that restoring landscapes, bringing in more native species, can actually reduce disease transmission,” Herrera said.
Herrera stressed that the current hantavirus outbreak remains rare and that most Americans are highly unlikely to encounter the virus.
As of May 27, 13 hantavirus cases have been reported in connection with former passengers of the MV Hondius, including three deaths.
Eighteen Americans were taken into U.S. quarantine sites, including 16 who went to Omaha, Nebraska. The North Carolina Department of Health and Human Services confirms one of those passengers is a North Carolina resident.
Some American passengers who have not tested positive for hantavirus may be released from the Nebraska quarantine this week, so long as they continue to quarantine in their own home states for the remaining three weeks. It is unclear when the North Carolina passenger will return home.
State health leaders say North Carolina is among 13 states with a designated special pathogen unit designed to quarantine people exposed to rare viruses, like hantavirus. The unit, called SPARC, is located at the University of North Carolina at Chapel Hill.