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Euan Arnott
@Nucleocapsoid

Just simplifying Andean hantavirus epidemiology for my own clarity... Cluster of 7 people were infected on cruise ship by initial zoonotic passenger (onset 6th April) with Serial Interval SI = 22 +/- 4 days French lady was SI = 34 d *or* onward transmission from 1st cluster

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Euan Arnott
@Nucleocapsoid

If *onward* transmission from 1st cluster of 7 cases were to follow similar timing, we wouldn't EXPECT peak of any 2nd cluster until ~May 15th, with likely window extending out to ~May 27th. Unfortunate French lady in ICU extends *monitoring* timeline still further to mid-June.

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Euan Arnott
@Nucleocapsoid

So coming 2 weeks will reveal whether there was significant onward transmission from 1st cluster of 7 patients. This will alarm / re-assure about behaviour of this particular Clade-3 virus. But actual elimination of onward transmission will require further patience until JUNE.

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Euan Arnott
@Nucleocapsoid

Above, I have ignored US passenger with weak +ve (& now -ve follow-up) PCR, but timing of French lady's potential contagiousness at *point of evacuation* (🚨) has same effect on timeline as US person being truly positive.

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Euan Arnott
@Nucleocapsoid

Sick person on Tristan da Cunha doesn't affect timeline either, but does extend number of people exposed.

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Euan Arnott
@Nucleocapsoid

Which reminds us there are further *potential* COMMUNITY chains of transmission from Cluster-1 to watch out for in: 1) St Helena & Ascension 2) JOHANNESBURG, S Africa 3) GENEVA, Switzerland Two big, connected METROPOLISES there... Good luck all.