Straight talk
Hantavirus? What is it and how does one get it?
Public awareness of hantavirus grew after it was found to have caused the deaths of actor Gene Hackman and his wife. Classified as a zoonotic disease, it is a rodent-borne virus that manifests either as a hemorrhagic fever with renal syndrome or as hantavirus cardiopulmonary syndrome (HCPS, also called HPS). While exposure to urine, feces, or saliva of infected rodents is a primary risk factor, person-to-person transmission has been documented for the Andes virus, a species of hantavirus. The incubation period—from the time of exposure to the onset of symptoms—ranges from as short as seven days to as long as eight weeks and may vary. In endemic areas, human infections are seen to peak in late spring and summer, though they can occur at any time of the year. Currently, there is no available cure or vaccine. Early recognition is imperative for timely intervention and supportive management.
Recently, you may have read and heard about an outbreak that occurred on a cruise ship. As of May 12, three individuals have died, and subsequent reports have documented several confirmed and suspected cases. The unfolding of events points to two possible routes of infection. First, affected individuals may have engaged in activities that exposed them to infected rodents prior to boarding the ship. Second, there is the possibility of human-to-human transmission.
The World Health Organization was quick to clarify that this does not constitute a public health emergency and that the global risk to the general population is low. Perusing their Disease Outbreak News page was a reminder of how we—as medical professionals and those involved in public health—should take the matter of risk communication more seriously. While I have a fair amount of knowledge about some of its guiding principles and some experience in their application, there is always room for improvement.
Drawing on the lessons learned from the pandemic, both as an observer and an active participant, what follows will hopefully be of help to those tasked with this responsibility.
First, keep your eye on the end goal: sharing information. In going about the process, it would be helpful to be as transparent and truthful about the situation. Provide swift and timely data on what is both known and unknown, including the gaps or challenges that hinder a better understanding of the disease. I recall a time when we were seeing a rise in the number of pertussis cases and how it took months before a public advisory was issued. As a medical society, we had already released our own position statement, but the news only gained traction after a local government released data that there was an upsurge in cases.
Second, choose the right people to be your key messengers. People still regard doctors as the most trusted source of health information. In their absence, identify the most credible and respected leaders in the community. While this piece of advice is so easy to give, implementation can be tricky in a country such as ours, where politics plays a major role in the success of health programs.
Third, tailor your messages to enable better understanding across all segments of the population. Health literacy is not the only factor to be considered. Cultural background, local beliefs, and community practices heavily influence how health messages are perceived and acted upon. Provide statistics if you can, as people are still readily impressed by numbers. This also helps them assess their own level of risk.
Fourth, provide practical, readily available solutions to the problem that could help the public protect themselves. This also encourages more people to be more proactive.
Fifth, be ready and available to address rumors and correct false information. Do not assume that people have prior knowledge of the disease. Have a semblance of monitoring in place, so that you can assess how effectively your messages are coming across and adjust accordingly based on the feedback received. Nowadays, the quickest way is to monitor social media channels. Stay current, as diseases will always have the tendency to evolve.
Sixth, engage in respectful dialogue. Acknowledge fears and uncertainties. Show empathy. Do not fall into the trap of overexplaining or over-reassuring. The simpler and more direct your answers are, the more you show that, as the messenger, you have a firmer grasp of the situation.
Last but not least, commit to continual growth as a communicator. People have short memories and limited attention spans, and will always be impressionable. This is why it is important to remind ourselves that how we communicate is as important as what we communicate.
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