Yeah, so Justin, how did patient zero actually get the illness? Do we know?

Yeah, so there's, there's some theories for it.

Initially, when this was starting and they were gathering information, I think the two plausible theories up front would be either that this was human-to-human transmission, in hindsight, knowing that this is Andes virus, or alternatively, the thought was put forward, could there have been a rodent infestation on the ship, knowing that hantaviruses are all spread by rodents? And I think there's a few points in the timeline that people have highlighted that really point to the idea that this is likely human-to-human transmission from Andes virus.

The index patient, the first man who became ill on the ship, had been traveling around Chile and Argentina for three months before the ship embarked, and, um, got sick from when the cruise started, I believe on, like, April 1st.

It was about five days to symptom onset for him, which is pretty quick for direct exposure then.

So, um, based on the incubation period, I think people concluded that he likely had contracted it during some time in that three-month stretch leading up to the ship.

And there's a couple of points in the outbreak investigation that point to a, um, birdwatching experience he had been on with, with rodent exposure there, and then likely brought it on the ship from there.

So how about pathophysiologically? Um-Talk about, I guess, a little bit about hantavirus pulmonary syndrome first, and then maybe we can talk about the, um, the other syndrome.