The Centers for Disease Control and Prevention has been closely working with states to monitor and respond to the ongoing hantavirus outbreak. Officials just didn’t really start talking about it publicly until this week.

Confusion, misinformation and memes about the potential for a second pandemic have ballooned on social media, even as states say the government’s outbreak response infrastructure operated smoothly.

Representatives from the Texas, Arizona and Virginia health departments — states with residents who were on the Dutch cruise ship where the outbreak began — told NOTUS they’ve been in close contact with the CDC since the news broke that six Americans had disembarked the ship and returned to the U.S. after the first hantavirus death.

“We’ve been on multiple calls with the CDC in the last several days, sometimes a few times a day,” Laurie Forlano, the Virginia state epidemiologist, said last week. The state first became aware of the one passenger who returned home to Virginia from the cruise when that person called their local health department after hearing about the outbreak on the news, Forlano said.

“Shortly thereafter, then information started flowing,” Forlano added.

The states’ accounts of their work with the CDC run counter to some of the concerns from infectious disease experts that the Trump administration was slow to respond to the hantavirus on the ground. They also raise the question: Why didn’t the administration publicly say what it was doing in response to hantavirus sooner?

In recent days, the Trump administration has swatted down any insinuation that it hasn’t been actively responding to the hantavirus outbreak. While hantavirus doesn’t spread like COVID-19, the administration has had to defend its handling of this outbreak compared to its response to the pandemic.

Acting CDC Director Jay Bhattacharya told CBS on Monday that the agency hasn’t been holding daily public briefings like it did during the COVID-19 pandemic because “the epidemiological risk is very, very different.”

“The risk to the public is much, much lower. It didn’t make sense to have a five-alarm fire bell,” Bhattacharya said.

Hantavirus is a rare disease that usually spreads to humans from rodents, though the strain causing the current outbreak can pass from person to person via close contact. The virus can cause severe respiratory issues and death.

Infectious disease experts raised alarm bells last week that the CDC and NIH weren’t running the usual playbook for outbreak response and communications — much like the criticism the agencies faced during the 2025 measles outbreak. Critics said the administration appeared to provide little tracking and guidance for states and didn’t coordinate with the World Health Organization.

However, a spokesperson for the Arizona Department of Health Services, JP Martin, said the CDC held a briefing with the affected states last Thursday and “gave some guidance.” Chris Van Deusen, a spokesperson for the Texas Department of State Health Services, said the agency had been in contact with the CDC “multiple times a day through various channels, including over the weekend.”

As for its global response, the CDC said on Thursday that it was sending a team to meet the ship in the Canary Islands.

Some experts have pointed out that the CDC’s public guidance has been slow — for instance, the agency did not issue a health advisory via the CDC Health Alert Network until last Friday, four days after the WHO released its own alert.

“In a world of rapid global travel and instant information sharing, that delay matters,” Krutika Kuppalli, an infectious disease physician and former WHO medical officer in health emergencies, wrote on BlueSky.

In response to questions from NOTUS, a CDC spokesperson denied that its response to the outbreak was meaningfully delayed, writing via email, “CDC’s Division of Media Relations has the capacity and expertise to manage all activities required to inform the American people.”

On Sunday, the agency posted a list of actions it has taken on X, which included “refined exposure assessment tools and released a hantavirus outbreak toolkit for the public,” a website describing hantavirus and how it spreads.

The hantavirus outbreak began last month on a cruise ship traveling across the South Atlantic. As of Wednesday morning, 11 cases have been reported and three people have died, a Dutch couple and a German national. Eighteen Americans who were onboard the ship were transported to the U.S. by the State Department over the weekend. One American tested positive before returning to the U.S. and is currently quarantining in the biocontainment unit at the University of Nebraska. Another American with mild symptoms is in quarantine at Emory University Hospital in Georgia. That person tested negative after arriving in the U.S.

Many communications professionals at Health and Human Services, including at the CDC, were casualties of the DOGE cuts in early 2025. While some CDC staff were reinstated in June, it’s unclear how many of the communications staffers who were let go rejoined the agency. The CDC did not respond to questions about how many communications employees were still at the agency.

Kevin Griffis, who led the CDC’s communications team from 2022 until early 2025, wrote of the staffing cuts in STAT News last year, “We must now collectively cross our fingers and hope that we avoid a significant, new disease outbreak. We aren’t prepared to deal with it.”

“If human-to-human transmission of the avian flu happened tomorrow, and the agency wanted to hold a press briefing in its studio, they don’t have a full-time employee who can operate the sound,” Griffis added. “Meanwhile, the media relations team that usually answers the phones and the main media email inbox was decimated, too.” Griffis did not respond to a request for comment from NOTUS.

Health Secretary Robert F. Kennedy Jr. has dismissed concerns that the CDC was slow to respond.

“We’ve had CDC teams on it from day one,” Kennedy said during a Monday press conference in the Oval Office. “I was speaking with the University of Nebraska since the second day of the outbreak,” he said, referring to the university’s biocontainment facility where 15 Americans who were onboard the affected cruise ship are currently quarantining.

“We have this under control and we’re not worried about it,” Kennedy added.

David Fitter, the CDC incident commander for the outbreak and the director of the agency’s division of global migration, said in a press conference on Monday — his first public appearance since the outbreak began — that the agency has been moving quickly through a “very dynamic and evolving situation” to identify the American passengers onboard the ship and return them to the U.S. in coordination with the WHO, which the U.S. exited earlier this year.

“The system worked,” Fitter said.

But while the outbreak appears to be under control, other missteps on the public communications front have continued to draw scrutiny.

Public health experts criticized the administration again this week when HHS posted on social media that one American tested “mildly PCR positive” for the virus before traveling back to the U.S.Jeremy Faust, an emergency medicine physician who writes the newsletter Inside Medicine, took issue with that description in a post on the social media site BlueSky.

“Whoever wrote that someone tested ‘mildly positive’ is an idiot. They are PCR positive. They have it,” Faust wrote.