The day's biggest revision comes out of Atlanta. The U.S. Department of Health and Human Services confirmed at a May 12 press conference that the symptomatic Emory University Hospital patient tested negative for Andes virus; the asymptomatic partner travelling with him has no public positive result either. Both members of the Georgia couple are now under contact monitoring at Emory through the 42-day window rather than being treated as confirmed cases. The cluster's tracked totals stand at 11 cases (9 confirmed plus 2 probable) and 3 deaths, in line with the WHO Disease Outbreak News and ECDC's May 13 surveillance update.
The other major resolutions earlier today still hold. The Italian Ministry of Health confirmed all four people under observation in Italy tested negative - including the 25-year-old Calabrian sailor whose biological-sample analysis at Rome's Spallanzani Hospital was the day's most-watched result. A multi-laboratory genetic analysis published on Virological.org (with partners in South Africa, Senegal, Switzerland and the Netherlands) shows the cruise-cluster virus is a typical naturally-circulating Andes lineage from the Chile/Argentina rodent reservoir, with at most one nucleotide change between sequenced patients - 'a single zoonotic spillover event.' This affirmatively answers yesterday's open mutation question: not a new variant.
The clinical picture remains mixed. The French patient at Hopital Bichat-Claude Bernard in Paris has deteriorated to the most severe cardiopulmonary form and is now on ECMO (a heart-lung machine), described by her physician Dr Xavier Lescure as 'the final stage of supportive care.' Health Minister Stephanie Rist called her condition 'grave'; President Macron called the French situation 'under control.' The Spanish patient at Gomez Ulla in Madrid had a confirmatory positive PCR on May 12 and is on oxygen therapy with mild symptoms; Spanish Health Minister Monica Garcia described his condition May 13 as having 'improved slightly.' The British patient in the Sandton ICU near Johannesburg remains in critical condition. The UK Health Security Agency began first releases from the Arrowe Park cohort today - six members of the British/German/Japanese group going home after negative PCR tests to complete the 45-day window in home isolation.
What we are watching: with the ledger now matching WHO and the mutation question affirmatively answered, the open questions narrow to clinical trajectories and the 42- to 45-day surveillance windows running across every receiving country until mid-to-late June. We are particularly watching the French ECMO patient, the Spanish patient's response to oxygen therapy, the South African ICU patient, and the asymptomatic American and dual-citizen cohort at the Nebraska Quarantine Unit.