1131: Tracking Emerging Threats & Global Accessibility Awareness

JOHN SHEEHAN:

This is Public Health Review Morning Edition for Thursday, May 21, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials.

Today, we get the latest on the ongoing monitoring response tied to an outbreak of the Andes strain of the hantavirus linked to the cruise ship MV Hondius. ASTHO Vice President of Health Security Meredith Allen tells us why health officials say the risk to the public remains low, how quarantine and monitoring efforts are working, and why this situation is very different from the early days of COVID-19. Later, Emily Lapayowker, assistant director of web content at ASTHO, talks about Global Accessibility Awareness Day and why digital accessibility is a core public health issue. First, here's Meredith Allen with the latest on the hantavirus outbreak.

MEREDITH ALLEN:

This is a continually developing situation, so the information I share today will be as of May 18. An outbreak of Hantavirus on the cruise ship MV Hondius was reported to WHO on May 2. It was later confirmed that the specific strain responsible for the outbreak was the Andes virus, a type of hantavirus that can lead to hantavirus pulmonary syndrome. It is also the only type of hantavirus that can be spread person to person. On May 10, CDC met U.S. passengers of the MV Hondius in the Canary Islands to conduct a medical evaluation, as well as interview them about their potential exposures on the cruise ship. 18 passengers were transported back to the United States to the Federal Quarantine Center in Nebraska. Two passengers were then taken to Emory University Hospital in Atlanta for further medical evaluation, but have since returned to Nebraska to rejoin the other passengers at the Quarantine Center. Passengers will be able to stay for their entire 42-day monitoring period in Nebraska, but at a minimum will stay for 21 days prior to being able to complete their monitoring at home. None of the passengers have tested positive for the Andes virus. In addition to the passengers that came home from the MV Hondius, there were several passengers who disembarked the cruise ship prior to the outbreak being identified. Some of these passengers returned to the U.S. on their own. These passengers are being monitored at home by public health officials and will continue to remain at home for their 42-day monitoring period. Public health officials are also monitoring passengers who are potentially exposed on two different international flights. It's important to remember that risk to the population is very low at this point, and none of the passengers who are being monitored have tested positive.

SHEEHAN:

Okay, and health officials have also been careful to point out that this is not the next COVID pandemic. So why is this different?

ALLEN:

It's a really important point to make. Hantavirus is not a new virus. This is a known virus, and while we're always learning more about it, it's not completely unknown and new the way COVID was when the COVID-19 pandemic began. The Andes strain of hantavirus, the strain we're seeing in this outbreak, is the only strain that can transmit person-to-person. However, it does not spread as easily as COVID did.

SHEEHAN:

Okay, and you mentioned that health departments are monitoring the passengers who were exposed. What else are our health departments doing?

ALLEN:

State and territorial and local public health agencies play a central role in the infectious disease response, such as this one, especially when the exposed travelers cross jurisdictional boundaries. For this response, agencies coordinated contact tracing, symptom monitoring, health care, communication, preparation, laboratory coordination, and also communication. State and local health authorities translate the national guidance in a coordinated, jurisdiction-specific way. Many of the preparedness and response activities are supported by the Public Health Emergency Preparedness, or PHEP, funding, which has helped health departments across the country strengthen their ability to respond to infectious disease outbreaks such as this one. PHEP supports surveillance, emergency coordination, epidemiology staffing, and risk communication capabilities, all while helping jurisdictions build flexible and adaptable preparedness systems. Events like this hantavirus cluster demonstrate how preparedness investments made before emergencies help jurisdictions respond more quickly, cohesively, and effectively, especially when a threat emerges.

SHEEHAN:

And the public has been told that they're not at high risk for contracting hantavirus. What does that exactly mean, and is anyone at risk?

ALLEN:

At this time, the risk to the general public is low. Based on the science and what we know about how hantavirus spreads, specifically the Andes strain, unless you have direct contact with someone who has the virus and is symptomatic, you are not at risk. So, people that are not directly exposed to any of the passengers from the cruise ship are not at risk at this time.

SHEEHAN:

And you also mentioned that passengers are being asked to stay home or go to the quarantine unit in Nebraska, but they're not testing positive. So why are they being asked to stay?

ALLEN:

There are really two reasons. The first is to ensure that they have limited contact with others. This helps ensure that the virus does not continue to spread. Additionally, by monitoring the passengers who have been exposed, we are more likely to catch any early symptoms of illness, allowing that person to receive medical evaluation and supportive care and treatment very quickly.

SHEEHAN:

And lastly, Meredith, I'd like to switch gears to another scary virus. We're hearing about the outbreak of Ebola. What's happening there?

ALLEN:

It is also a rapidly developing situation. As of May 16, there are eight lab-confirmed cases, over 200 suspected cases and 80 suspected deaths reported in the Torii province of the Democratic Republic of Congo. In addition, two lab-confirmed cases have also been reported in Uganda. This specific outbreak is being caused by the BVD type of ebola disease that does not have specific treatments or vaccines. WHO has declared this outbreak a public health emergency of international concern. And the CDC has announced the use of a Title 42 order, which prevents all non-U.S. citizens from entering the country for the next 30 days if they've been in the DRC, South Sudan or Uganda in the previous 30 weeks. CDC is working to assess a small number of Americans who are currently directly impacted by the outbreak, including a doctor who was tested positive for the disease that you may have seen in reports lately. It is early in the international response. However, CDC is working with state and local public health departments to coordinate information flow and specific guidance. And as the situation develops, more information should become available.

SHEEHAN:

Meredith Allen is ASTHO vice president of health security.

Relatedly, on May 18, CDC issued a Health Alert Network Health Update to inform clinicians and health departments about testing available for patients with suspected Hantavirus infection to include Andes virus. CDC first issued a health advisory about this outbreak on May 8. Then, on May 19, CDC issued a Health Alert Network Health Advisory to alert clinicians, public health practitioners and travelers about a new outbreak of ebola disease in the Democratic Republic of the Congo and Uganda caused by the Bundibuja virus. The risk of spread to the United States is considered low at this time. Read more about these CDC notifications by clicking the link in the show notes.

Now, let's hear from Emily Lapayowker, assistant director of web content at ASTHO, to explain the importance of Global Accessibility Awareness Day.

EMILY LAPAYOWKER:

Yeah, so Global Accessibility Awareness Day started in 2011. So, this is actually like its 15th birthday, which is pretty incredible. And it started really just as like a blog post in a dream to have a whole day dedicated to raising awareness about digital accessibility techniques and the importance of inclusion. So, a lot of people are still unfamiliar with the need for digital accessibility, let alone how to create those accessible spaces online. So, that's really why Global Accessibility Awareness Day matters. The mission is really to get the word out about both of those things.

SHEEHAN:

And how does ASTHO view digital accessibility as fundamental so that people can really access all the information they need to regardless of circumstance?

LAPAYOWKER:

It's a central part of who ASTHO is to kind of meet people where they are. And I think digital accessibility is a big piece of that. And at ASTHO, it's really a cross ASTHO effort. So, you know, we're still figuring things out, we're still refining our processes, but we really do take or try to take a holistic approach to accessibility. So, our entire staff went through document accessibility training, which was fantastic. We have a very talented graphic designer who tries to build accessibility in whenever he creates a product. Our web team does try to make sure we're following best practices when we build new web pages or publish HTM- based products. Our meetings team makes sure recorded events all come with transcripts and closed captions. And they build accessibility accommodations into our live and in-person events as well. And I know that our communications team tries to keep accessibility front of mind when they edit or they promote ASTHO's work. So, it really is an org-wide effort.

SHEEHAN:

Yeah. And I think transcripts and captions are a great example of sort of some of the more common types of accessibility options, ones that I think most people are pretty aware of. But there are so many other options and inaccessible places on the web that I think are not necessarily on the radar. Can you talk about some of those barriers and what are some of the most common barriers that people don't think of?

LAPAYOWKER:

Honestly, a lot of it is like really easy to fix stuff. So, you know, using color alone to convey important information. You know, like, don't do that. And ignoring or not knowing about, probably. Color contrast ratios, using poor linking practices. I would say another really big one, though, is keyboard accessibility. It's a little harder for individuals to fix. It's definitely something people should keep in mind, though, when they're testing out new platforms. Try to navigate through a demo page using just your keyboard. Make sure you don't get stuck anywhere or miss anything because not everyone can use a mouse. So, keyboard navigation is really important to accessibility.

SHEEHAN:

Yeah. And another stat that I found was pretty shocking is that a majority of homepages fail basic accessibility standards. Missing alt text or the low contrast you mentioned, which I think is a little bit inside baseball for a lot of people who aren't necessarily web developers. Can you explain how those missing standards, Rick, really can have dire effects?

LAPAYOWKER:

Yeah, roughly a third of American adults identify as having a disability. So, organizations are potentially shutting out like a third of their audience when they ignore accessibility best practices or when they're just uninformed about them. And for public health, that means like 30% of your population being served might be missing crucial information about things like outbreaks, restaurant closures, emergency responses to natural disasters, things like that. So, when you look at all the areas that public health touches, it's clear that leaving people out of the loop can have serious consequences because it's a lot of people.

SHEEHAN:

And for public health agencies or for IT professionals within those agencies who are responsible for managing their websites and keeping their social media up to date and current and accessible, what are some changes that can be done that they can make today to improve that accessibility?

LAPAYOWKER:

Yeah, that's a great question. As you said, we touched on some of this earlier. I would say using styles and structure correctly. Headings are an aesthetic. They're the framework of your content. So, use them and use them correctly, which is to say in order and without skipping levels, only having one H1 per page, but also using things like built-in lists for numbers and bullets. Don't just use a hash mark and call it good. So, use good color contrast. There are a ton of color contrast checkers out there that you can use. WebAIM has a really good one. I really like it, and it's not that hard to check your work on color contrast. Your digital content should have a color contrast ratio of at least 4.5 to 1. And just to put that in context, like your classic black text on a white background has a color contrast of 21 to 1. So, 4.5 to 1 shouldn't be too restrictive. It really does leave you a lot of flexibility color-wise. And I would say the third one is actually, you know, something you mentioned before, which is transcripts on recorded video and audio and including synced captions on videos. That's huge.

SHEEHAN:

On this Global Access Awareness Day, what would be your final takeaway for how we think about digital access moving forward?

LAPAYOWKER:

I would say that accessibility is inherently tied to public health. So, I think as awareness about the subject rises and as people become more familiar with best practices, we're going to start incorporating them right from the start, which is really the goal. But, you know, when you're learning about this, it all seems kind of intimidating. The truth is, though, for most digital content creators, so not necessarily those people running the websites, but for people who are writing emails or documents, it's really more like small tweaks to their current practices that are going to make a huge difference. So, you know, try not to get overwhelmed. Just try to be a little bit better about using best practices and being a little more inclusive every day because it's not as scary as you think, and it will make a huge difference.

SHEEHAN:

Emily Lapayowker, thanks so much.

LAPAYOWKER:

Thank you.

SHEEHAN:

Emily Lapayowker is assistant director of web content at ASTHO. Earlier, we heard from Meredith Allen, ASTHO vice president of health security.

ASTHO is accepting applications for the Implementing Pharmacist-Prescribed Contraception Learning Community. This opportunity will support state and territorial health agencies with technical assistance to develop sustainable pharmacist-prescribed contraception programs, including workforce capacity, reimbursement pathways, and patient awareness efforts to improve access to contraception. The deadline to apply is May 31, 2026, by 5 p.m. Eastern. Find more information at the link in the show notes.

What if the biggest barrier to public health is buried in outdated policies? Austin Public Health faced that challenge; an overloaded, hard-to-navigate system that slowed staff down and made it harder to do their jobs. With support from the Public Health Infrastructure Grant and hands-on technical assistance, they set out to fix it. Find the link to the article, “Leveraging PHIG to Advance Policy Infrastructure at Austin Public Health,” in the show notes.

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.