“I'm not great at the advice. Can I interest you in a sarcastic comment?”

This is what ‘Friends’ actor Matthew Perry’s character Chandler Bing was known for. He was known for being funny. However, he had his own struggles in his personal life and those struggles were acute depression. He was treating it with ketamine infusion therapy which is legal in the US and the UK.

What is Ketamine infusion therapy?

Ketamine is an anaesthetic used to treat depression, anxiety and pain under supervised and controlled medical settings. However, it does have its side effects, which can lead to distortion of sight, sound and time. It can also produce calming and relaxing effects.

Ketamine increases a person’s heart rate and blood pressure. If overdosed, it can leave users confused and agitated and can cause them to hurt themselves without even realising it. It can also lead to liver damage and bladder problems.

However, when used in moderation and under the supervision of medical doctors, it can treat depression where traditional antidepressants have failed.

Prof Rupert McShane, a University of Oxford psychiatrist who runs an NHS ketamine treatment clinic told BBC that ketamine “probably turns off the area of the brain that is involved in disappointment.”

Can Ketamine Infusion Therapy Kill Someone?

In simple terms, it cannot, be if the dosage is given in a controlled setting and as prescribed. Ketamine infusion therapy uses drugs in small doses than those used for anaesthesia. It acts faster than traditional anti-depressants, but the effects also wear off way quickly. Which is why it is important to monitor patients’ mental state for relapsing back into depression and discouraging them from overdosing on it.

There are ways of giving people ketamine. One of the ways is through “infusing”, which means to use an IV drip. However, injections, nasal sprays and capsules are also methods used to give people ketamine.

Since the dosage of ketamine used in the infusion treatment is small, it being the reason of actor Perry’s death was ruled out. The medical examiner also noted that Perry’s last ketamine infusion therapy session happened more than a week before his death, which means by the time he had died, it must have worn off.

So, What Happened To Perry?

Though Perry’s last session was more than a week before, his post-mortem showed that his blood contained a high concentration of ketamine. He had died of the “acute effects” of ketamine.

If it was not his session, then how did he get ketamine?

Prosecutors alleged that his assistant gave him at least 27 shots of ketamine in four days before his death, reported BBC.

Perry has been open about his personal struggles and this is what the doctors and dealers used against him. Martin Estrada, the US attorney for California’s Central District told the BBC that people took advantage of his condition. They charged him 165 times more than what vials of ketamine cost.

Names that have come up include Dr Salvador Plasencia, drug dealers “Ketamine Queen” aka Jasveen Sangha and Eric Fleming, and Perry’s live-in assistant Kenneth Iwamasa.

Who Are These Names And What Did They Do?

Ketamine Queen or Sangha supplied drugs that led to Perry’s death. Her home was a “drug-selling emporium,” said Estrada. More than 80 vials of ketamine, and thousands of pills including methamphetamine, cocaine and Xanax were allegedly found in her house known as the “Sangha Stash House.”

Sangha is known to deal with high-end celebs and was a “major source of supply for ketamine to others as well as Perry,” said Estrada.

Dr Plasencia called Perry a “moron” while charging him $2,000 for vials that cost only $12. He sold Perry 20 vials of ketamine between September and October 2023, costing $55,000.

He was the one who taught Iwamasa, who had no medical knowledge to inject the drug. This is after he knew that “Perry’s ketamine addiction was spiralling out of control,” as per what the investigators told the BBC.

Another dealer Fleming was told by Sangha to “delete all our messages.” While Fleming pleaded guilty to conspiring to distribute drugs unlawfully, he also allegedly messaged Sangha: “Please call...Got more info and want to bounce ideas off you. I’m 90% sure everyone is protected. I never dealt with [Perry] only his assistant. So the assistant was the enabler.”

The court documents also revealed that he asked Sangha on whether the ketamine stays in your system or “is it immediately flushed out.”

Dr Pepper, Bots, Cans

The people who allegedly exploited Perry used coded language for ketamine and called it “Dr Pepper”, “bots”, or “cans.”

Selling overpriced drugs, taking advantage of Perry’s mental condition and falsifying medical records to make the drugs given to him look legitimate by Dr Plasencia is what took Perry’s life.

Iwamasa is said to have administered more than 20 shots of ketamine and three on the day Perry died. Whereas ketamine is only administered by a physician. Authorities also found that weeks before Perry’s death, Dr Plasencia allegedly bought 10 vials of ketamine and intended to sell to Perry.

He also injected Perry with a large dose, two days later. This caused him to “freeze up” and spiked his blood pressure.

When I Die, I Want Helping Others To Be The First Thing That’s Mentioned

Perry had always been open about his drug addictions, struggles with alcohol and his depression. He said that his openness would help others who are also struggling and wanted to be remembered by his quote which also is on the homepage of the Mattew Perry Foundation that helps others struggling with the disease of addiction: “When I die, I want helping others to be the first thing that’s mentioned.”

Five arrests have been made in the case so far.

The MV Hondius cruise ship, hit by an outbreak of hantavirus, is expected to reach the Canary Islands on May 10.

The vessel is set to dock near Tenerife, where residents have voiced concerns that its arrival could pose a potential health risk.

The Spanish government, in coordination with the World Health Organization (WHO), has agreed to allow passengers to disembark in the Canary Islands this weekend. The ship had travelled from Cape Verde, where three people were evacuated earlier due to illness.

According to the WHO, none of the passengers currently on board are showing symptoms of hantavirus.

Spain Issues Quarantine Measures

Despite the absence of symptoms among current passengers, Spain’s Health Ministry has announced strict quarantine protocols.

“All people considered contacts — those who remained on the ship between April 1 and May 10, or were in contact with a confirmed case — must undergo mandatory quarantine at the Central Hospital of the Gómez Ulla Defense in Madrid,” the ministry said.

Passengers will remain in individual rooms with no visitors allowed.

“During this period, they will undergo a PCR test upon arrival and another seven days later,” the ministry added.

Authorities will also carry out active surveillance, including twice-daily temperature checks to identify symptoms early.

If a laboratory test is positive by the National Microbiology Center, the patient will become a confirmed case and will be admitted to a High Level Isolation and Treatment Unit (UATAN) until clinical recovery.

WHO, CDC, ECDC Teams Monitoring Arrivals

According to media reports, more than 90 people from 23 nationalities remain aboard the Dutch-flagged MV Hondius. This includes: 38 Filipinos, 23 Britons, 17 Americans, 2 Indians and 14 Spaniards.

The 14 Spanish passengers will be transferred to Gómez Ulla Hospital in Madrid, where they will undergo a 45-day quarantine. Crew members from other countries will be repatriated to their respective nations.

WHO said it has developed and shared technical guidance documents in support of countries affected by the event, including covering management of the event on the ship, investigation of cases, disembarkation and management of returning passengers and crew members.

In its latest briefing, the UN health body said emergency response teams, including experts from the Netherlands and the European Centre for Disease Prevention and Control (ECDC), are coordinating efforts to manage the situation and assess all passengers and crew upon arrival.

A WHO official is currently on board alongside two Dutch healthcare workers and an ECDC expert.

WHO Technical Officer Anais Legand said health teams will review the exposure history of every passenger and crew member to determine who may face a higher risk of infection.

Passengers will also be screened for symptoms such as fever, fatigue, or signs of illness.

The US Centers for Disease Control and Prevention (CDC) said it plans to evacuate American passengers aboard the ship on a US government medical repatriation flight to Omaha, Nebraska.

Confirmed Andes Virus Cases

The WHO confirmed that six cases have tested positive for Andes virus, which can spread from person to person, through PCR testing.

The ship had 147 passengers and crew members on board when the outbreak was first reported on May 2, while another 34 people had already left the vessel.

Also read: Hantavirus: Israel Confirms 1st Case as UK, Spain Probe Suspected Infections; Should You Be Worried?

Four patients remain hospitalized in South Africa, the Netherlands, and Switzerland. A suspected case transferred to Germany later tested negative.

Contact Tracing Underway

Health authorities said contact tracing efforts will focus on identifying and assessing everyone who may have been exposed on board, particularly those who had close contact with confirmed or suspected cases.

Officials are evaluating several factors, including the incubation period, infectious stage of the virus, and overall risk profiles.

“You want to understand whether this person might be more likely to be sick,” Legand explained. Currently, there is no treatment or vaccine available for hantavirus.

What Is Hantavirus?

Read More: WHO Says 6-Week Hantavirus Incubation Raises Concern, But No Epidemic Risk

Hantavirus is primarily transmitted through contact with infected rodents or exposure to their urine, droppings, and saliva, though rare cases of person-to-person transmission have also been reported.

While hantavirus carries a mortality rate of up to 40 percent, the WHO stated that the overall global risk remains low.

According to the CDC, symptoms can appear one to eight weeks after exposure, initially presenting fatigue, fever, and muscle aches. As the disease progresses, it can cause coughing, shortness of breath, and chest tightness as fluid accumulates in the lungs.

A deadly case of hantavirus has been confirmed in Israel, while health authorities in the UK and Spain are investigating suspected infections in three individuals, raising fresh concerns over the spread of the rare rat-borne disease.

Hantavirus is primarily transmitted through contact with infected rodents or exposure to their urine, droppings, and saliva, though rare cases of person-to-person transmission have also been reported.

According to the World Health Organization (WHO), eight cases — including three deaths — have been confirmed so far. However, additional suspected and confirmed cases are continuing to emerge across countries.

Despite growing concern, the WHO, the US Centers for Disease Control and Prevention (CDC), and other health agencies have stated that the overall public health risk remains low.

Here’s a look at the countries reporting confirmed and suspected hantavirus cases.

Israel

The case in Israel, reported by the local newspaper Maariv, is believed to have been infected during a stay in Eastern Europe several months ago. It is reportedly not linked to the ongoing outbreak linked to the MV Hondius cruise ship in the Atlantic Ocean.

The patient underwent an antibody test after the symptoms appeared, which showed exposure to hantavirus, the report said. A PCR (polymerase chain reaction) test was then conducted to detect the virus’s genetic material, confirming the infection, it added.

The patient was said to be in stable condition, not in need of intensive care or strict isolation, and was being kept under medical observation.

Details about the patient and the medical center where the diagnosis was made could not yet be published, but have been reported to the country's Health Ministry.

UK

The UK Health Security Agency had confirmed two British cases connected to the outbreak on board the MV Hondius.

One remains in a stable condition in the Netherlands after being evacuated from the ship, the other remains in intensive care after being flown to South Africa last month.

A third case is also being suspected on the remote South Atlantic island of Tristan da Cunha, where the ship stopped in mid-April, the UK HSA said.

In addition, the agency said that two British nationals are self-isolating at home after potential exposure to hantavirus on the cruise ship. The pair had disembarked earlier in the voyage and currently shows no symptoms.

They were part of a group of 30 people from a dozen nations - including seven Britons - who disembarked from the ship at St Helena in the south Atlantic on 24 April, according to operator Oceanwide Expeditions. Four Britons who disembarked on St Helena remain there, BBC reported.

They do not have symptoms but are in contact with health officials. It is understood that medical staff will be sent to the islands to provide support.

Also read: Donald Trump Says Hantavirus Is 'Under Control'; Questions Grow Over CDC Research Cuts

Spain

A 32-year-old woman who shared an airplane with a MV Hondius cruise ship passenger who later died of hantavirus is now showing symptoms consistent with the disease, Secretary of State for Health Javier Padilla said while speaking to the media.

The woman ⁠has been taken to a hospital in Alicante, where she ⁠remains in isolation, he added. Her symptoms included coughing and "general malaise".

She is being transferred to a hospital in the city of Alicante where she will be tested ‌for ⁠the virus, with results expected 24 to 48 hours later, according to a statement on the regional health department's website.

Padilla said the woman, a resident of Alicante in the Valencia region, ⁠was sitting two rows behind the cruise ship passenger, but the contact between them "was brief" since the passenger had only been "on ⁠board for a short time" during the flight.

Netherlands

The World Health Organization confirmed that a KLM flight attendant, who was isolating in an Amsterdam hospital with mild symptoms after being in brief contact with a hantavirus patient, has tested negative for the virus.

Her case supports the WHO experts’ theory that the rat-borne disease can only be transmitted person-to-person through prolonged, close contact.

Singapore

Two Singaporean residents who were onboard the MV Hondius cruise ship have tested negative for the virus, the Communicable Diseases Agency (CDA) said today.

The 67-year-old and a 65-year-old had been tested and isolated in the city state. The CDA's National Public Health Laboratory conducted testing on multiple samples collected from the individuals and confirmed that hantavirus, including the Andes virus, was not detected, it said.

“The risk to the general public in Singapore is currently low,” the CDA said.

Hantavirus: The Common Symptoms And How To Reduce Your Risk

According to the CDC, symptoms can appear one to eight weeks after exposure, initially presenting fatigue, fever, and muscle aches. As the disease progresses, it can cause coughing, shortness of breath, and chest tightness as fluid accumulates in the lungs.

The CDC reports that about one-third of individuals who develop respiratory symptoms from the disease may not survive.

You can reduce your risk by eliminating and minimizing your contact with rodents in your home, workplace, or campsite. The best way is to seal holes and gaps in your home or garage and keep the rodents from entering your home. You can also place traps in and around your home to decrease rodent infestation. Clean up any easy-to-get food that could attract rodents.

A deadly case of hantavirus has been confirmed in Israel, while health authorities in the UK and Spain are investigating suspected infections in three individuals, raising fresh concerns over the spread of the rare rat-borne disease.

The case reported from is unlikely to be linked with the ongoing outbreak linked to the MV Hondius cruise ship, currently sailing to the Canary lslands.

The UK is suspecting its third case from a remote South Atlantic island of Tristan da Cunha. Spain is suspecting its first case in a 32-year-old woman who shared an airplane with a MV Hondius cruise ship passenger who later died of hantavirus.

In a good news, suspected cases from Singapore and the Netherlands have reportedly turned negative.

The health officials across 12 countries have joined the WHO in contact tracing efforts. They are:

• Canada
• Denmark
• Germany
• The Netherlands
• New Zealand
• Saint Kitts and Nevis
• Singapore
• Sweden
• Switzerland
• Türkiye
• The United Kingdom
• The United States of America

US CDC Classifies Outbreak As 'Level 3' Emergency

The US Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Centers and has classified the hantavirus outbreak as "Level 3" emergency.

Level 3 is the lowest level of emergency activation and is typical for this stage, ABC News reported.

It also signifies that the risk of the rat-borne virus to the general public remains low. However, the public health agency is actively monitoring the situation.

As per the media report, activating the Emergency Operation Centers signals that an emergency team, consisting of epidemiologists, scientists, and physicians, may have been set up to assist with the response.

No Immediate Public Health Threat To India, says ICMR

After reports of two Indian nationals infected with hantavirus aboard MV Hondius cruise ship, Dr Naveen Kumar, director of the ICMR’s National Institute of Virology (NIV), said that there is "no immediate public health threat” to India.

Dr Kumar said the outbreak appears to be isolated, and that there is currently no evidence of community spread. He stressed that, unlike COVID-19, hantavirus does not spread easily between humans.

“The reported hantavirus cases appear to be isolated ones, and there is no immediate public health threat to India,” he was quoted as saying by news agency PTI.

According to the World Health Organization, the Indian passengers were among a small cluster of suspected infections identified aboard the ship, with health authorities monitoring contacts and taking precautionary measures.

Surveillance Capacity Adequate In India

Kumar said India has sufficient laboratory infrastructure to detect suspected hantavirus cases through the ICMR-NIV and the nationwide Viral Research and Diagnostic Laboratory Network.

“India has diagnostic capacity for hantavirus infection through the ICMR-National Institute of Virology and the nationwide Viral Research and Diagnostic Laboratory Network of 165 labs,” he said.

He said symptoms generally appear one to five weeks after exposure. It includes

fever,

• severe body ache,
• headache,
• fatigue,
• nausea,
• abdominal pain,
• dry cough.

2 Indians Among Crew On MV Hondius Cruise Ship

Two Indians are among 149 people aboard MV Hondius, the expedition cruise ship hit by a deadly hantavirus outbreak that has so far left three passengers dead and eight others infected, according to a BBC report.

The vessel, operated by Oceanwide Expeditions, began its journey from Ushuaia, Argentina, on April 1 and is currently travelling to Spain's Canary Islands on May 10.

According to the World Health Organization, eight people onboard the cruise ship MV Hondius have been infected with hantavirus. Of these, three have died, and five have been confirmed to have the virus. However, more people are likely to be infected, as the disease can take a long time to show symptoms.

The luxury cruise ship was carrying around 150 passengers and crew members from 28 countries.

The nationalities included 38 people from the Philippines, 31 from the United Kingdom, 23 from the United States, 16 from the Netherlands, 14 from Spain, nine from Germany, six from Canada and two crew members from India, BBC reported.

While it is yet not known whether they're infected or not, Dr Puneet Misra, Professor of Community Medicine, AIIMS Delhi, told ANI News Agency that it is likely that the two passengers "might have been exposed to the infection".

He added that "there is no pandemic or epidemic threat" with hantavirus. "The public should not worry. There is no need for panic..."

"Andes strain may be only hantavirus strain known to spread human-to-human, but requires prolonged close physical contact and is far less transmissible than COVID-19," Former WHO deputy director-general Soumya Swaminathan was quoted as saying to PTI.

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