No visits. No intermingling. Staff with protective gear.
This is the reality at the Nebraska-based National Quarantine Unit for more than a dozen Americans who were on the cruise ship at the center of a hantavirus outbreak and arrived back in the United States early Monday.
Patients can call and videoconference with family and friends, access exercise equipment and watch large TVs, officials said. The rooms’ ventilation system is designed so that the virus cannot leave the room, and it is separated from the rest of the building with HEPA air filters.
U.S. officials on Monday laid out more details on how 18 passengers from the Hondius are quarantining after returning to the U.S. In Nebraska, there are 16 people: 15 are in the quarantine unit and another, the first American who tested positive for hantavirus while abroad, is in the biocontainment unit. An additional two passengers were sent to an Atlanta biocontainment facility because one of them was showing symptoms, officials said.
“Quarantine is sort of like a very well-managed, air-handled hotel room, and the biocontainment unit is like a very well-managed, air-handled intensive care unit,” said Jeffrey P. Gold, president of the University of Nebraska, where the patients are being housed. The National Quarantine Unit is a federally funded facility that has previously received patients with Ebola and covid-19.
The American passengers, who were originally on a polar-rated expedition ship that set off from Argentina on April 1, range from their late 20s to late 70s and early 80s. Officials say the quarantined passengers are doing well, though tired after they were evacuated from the ship off the coast of Tenerife, Spain, as part of a coordinated global repatriation and monitoring mission.
Since there are no therapeutic options to treat hantavirus, early intervention and care is vital, officials said. Three passengers from the cruise ship previously have died.
Passengers who have returned are being monitored for symptoms including fever, headache, nausea, vomiting, diarrhea, muscle aches, respiratory issues and dizziness.
Although the quarantine is 42 days, officials said, some patients may be escorted to complete monitoring at home, depending on their conditions.
“No one who poses a risk to public health is walking out the front door,” said Nebraska Gov. Jim Pillen (R).
Two passengers were sent to a biocontainment unit at Emory University in Atlanta to be evaluated. Authorities identified the passengers as a couple and said one was symptomatic.
Officials said some passengers were sent to Atlanta because they want to maintain space in Nebraska’s Biocontainment Unit in case quarantined passengers test positive for hantavirus. The specialized part of the Nebraska facility can house two to three seriously ill patients, an official said.
Life inside the biocontainment unit
Journalist Ashoka Mukpo, 45, was a freelance cameraman working for NBC News in Liberia when he became ill with the Ebola virus in 2014 and was evacuated to the University of Nebraska Medical Center’s Biocontainment Unit for treatment.
At first, he said, he was confused why they would take him to the Midwest and not somewhere like Harvard or Johns Hopkins, but he quickly learned that “it’s the best place in the country you can be,” because of the clinical expertise of the staff.
Mukpo was in “sick, but stable” condition when he arrived, and had to be fed intravenously through a tube as he was treated with blood transfusions and experimental antiviral drugs.
“There’s no question I was very sick and very infectious at that point,” he said. “It must have been a very frightening experience for the medical staff, but it never showed.”
In fact, they were so friendly, he joked, “that it almost annoyed me at times, as this East Coaster sitting there wondering if I was going to die.”
He stayed over two weeks at the facility, in a secure room that felt like a “normal hospital room,” spending time video-chatting with his family and then-fiancee, who is now his wife.
When he was finally ready for solid food, he said, he wanted a Big Mac, but the staff brought him a Runza instead – the savory dough pocket filled with ground beef that’s a Nebraska staple.
“They were very nice, totally sweet,” he said. The current passengers “couldn’t be in better hands.”
‘This is not another covid’
As of Monday there are nine total cases of hantavirus, seven of which are confirmed, as well as one inconclusive case, World Health Organization officials said in a briefing. They noted that more cases could appear over the next few weeks, and that quarantine was essential as people could be contagious before full-blown symptoms appear.
Every passenger on the Hondius was evacuated from the ship, WHO Director General Tedros Adhanom Ghebreyesus announced Monday afternoon from Tenerife, an island of Spain where the ship was docked. A total of 125 passengers and crew members from 23 countries were evacuated between Sunday and Monday, officials said. A smaller number of crew members and some health workers will take the ship to Rotterdam.
Tedros said the time on the ship was very difficult for many of the passengers, some of whom had mental breakdowns after weeks in a contained environment. He noted that some passengers are elderly with chronic conditions.
Health authorities have continued to stress that hantavirus is not the next pandemic, with Tedros saying that “the risk is low; this is not another covid.”
On Monday, French Health Minister Stéphanie Rist told the France Inter radio broadcaster that a French passenger who had started to exhibit symptoms on the flight back to France had deteriorated overnight and tested positive for hantavirus. Tedros described her status as “very critical” Monday afternoon and said he was very glad she had been quickly removed from the ship.
A team of six paratroopers and two military clinicians parachuted into the British overseas island territory of Tristan da Cunha in the South Atlantic to deliver medical support for a British national who was unwell with suspected hantavirus, the British government said.
“The risk of hantavirus to the general public remains very very low,” said Adm. Brian Christine, U.S. assistant secretary for health. In six states, authorities are monitoring at least seven previously returned passengers and others that may have been exposed to the virus. California’s state public health official Erica Pan said Monday they are monitoring a person who was not a passenger on the ship but was exposed to a person on a commercial flight who tested positive for hantavirus. These people had flown before the severity of the threat was known and before the government organized flights for cruisegoers to return to their home countries.
Pan said the CDC guidelines her department is following is to notify people if they are within two seats or the row ahead or behind a person who was ill on a flight for at least 15 minutes. Maryland announced Monday they are monitoring two residents who were on a flight with a passenger infected with hantavirus.
Questions still are swirling on how much contact is required to spread the virus. Officials said in the news conference Monday that it typically it requires prolonged contact. However, they said the situation is evolving. Exposure occurred on a cruise ship, which by nature leaves people in closer quarters.
Response amid U.S. health turmoil
The federal response is happening while the Centers for Disease Control and Prevention does not have a confirmed permanent director. President Donald Trump picked Erica Schwartz to lead the agency in April after a period of turmoil at the CDC, but she is not confirmed. Federal, state and local officials have stressed they have engaged in a coordinated response.
The U.S. also officially withdrew from the WHO this year, a decision Trump said he stood behind Monday because “on covid, they were totally wrong.”
As for hantavirus, Trump said that “I hope it’s fine,” going on to note that “it seems like it is not easy to spread.”
“We think we’re in very good shape. We’re very careful,” he said.
Health officials disputed that the government’s sweeping cuts to the Department of Health and Human Services may have affected the response.
“We have this under control, and we’re not worried about it,” Health Secretary Robert F. Kennedy Jr. said.
(c) 2026, The Washington Post · Lauren Weber, Annie Gowen