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About the new cases of pneumonia of new coronavirus infection in Wuhan (January 18, 2020) Issuing authority: Wuhan City health committee | Published: 2020-01-19 00:43:40 | Hits: 4666 | Font Size: Da Zhong Small On January 17, 2020, national and provincial experts screened some cases of unexplained pneumonia that were screened by community health service centers in the city, and found and treated in various hospitals, based on their clinical manifestations, epidemiological history, and optimization. The positive results of the novel coronavirus nucleic acid detected by the subsequent detection kit were comprehensively judged, and 17 cases of pneumonia cases with new coronavirus infection were newly identified. Of the 17 patients, 12 were males and 5 were females; 9 were under 60 years of age, 8 were 60 years of age and older, the youngest was 30 years old and the oldest was 79 years old; the onset date was before January 13, 2020; first symptoms Fever, cough, or fever with cough; 3 cases were severe, and the rest were stable. Except for 2 cases of severe illness, which was temporarily unsuitable for transfer, the remaining 15 cases had been transferred to Wuhan Jinyintan Hospital for centralized treatment. The epidemiological investigation of 17 new cases is in-depth, and close contacts are also being tracked. In the next step, the city will continue to expand the search scope, identify suspected cases, and conduct sampling tests. http://wjw.wuhan.gov.cn/front/web/showDetail/2020011909075

[Forbidden News] Wuhan Pneumonia Frequently Occurs Abroad Only in China? [New Tang Dynasty Beijing time, January 18, 2020] Since the outbreak of new coronavirus pneumonia in Wuhan City, Hubei Province, China, at the end of December last year , there have been confirmed cases in Japan and Thailand , and suspected cases have also appeared in Hong Kong, Vietnam and other places, but However, there are no other provinces or cities in mainland China that have caused the epidemic situation, which has raised people's doubts. On January 16, the Wuhan Municipal Health and Health Committee issued an update, confirming that a patient infected with " new coronavirus pneumonia" died on the 15th. This is the second death of Wuhan pneumonia, after a patient died on the 9th. There are five more severe cases. In Wuhan, China, pneumonia of unknown cause occurred at the end of December last year. Authorities have not made the information public until it was revealed by the outside world. The number of reported infections gradually increased from 27 to 59. But since January 11, the number of infected people has remained at 41. The report said that 12 of them were discharged, 5 were severe, and the remaining patients were in stable condition and all received isolation treatment. On the same day, the Ministry of Health, Labour and Welfare held an emergency press conference and confirmed that the first case of Wuhan's new type of pneumonia was confirmed in Japan. It was a Chinese man living in Kanagawa Prefecture, Japan. He had been to Wuhan not long ago. The second case of Wuhan pneumonia was also found in Thailand. It was a Chinese woman who flew from Wuhan to Bangkok on the 13th. In addition, Vietnam's Thanh Niên reported that two Chinese people were suspected of having such pneumonia when they arrived in Da Nang, Vietnam on the 14th, and are currently being isolated and cared for. As for Hong Kong, which has close contacts with mainland China, as of the 15th, there were 71 suspected cases of Wuhan pneumonia, of which 11 were still in hospital. Taiwan, Vietnam, Macau, Singapore and other places have also appeared suspected cases of new coronavirus pneumonia. However, as the virus continued to spread overseas, no new cases were reported in China's domestic provinces or even in the six provinces close to Hubei. Does the virus stop only in mainland China? People strongly questioned whether the health authorities of the Communist Party of China concealed the epidemic. Some netizens said: ｢Coronal cases have gone abroad, and there are no other provinces in China except Wuhan. They also hold their hands under pressure and deceive themselves.｣ Some netizens ironically said that this is 这 a new type of patriotic pneumonia virus, which only goes abroad Province, it is also a politically patriotic virus. Tan Wei, a doctor living in New Zealand: The public opinion and the public also think that the Chinese Communist Party has concealed them. For historical reasons, during SARS, people in government departments concealed this. Because It has a ridiculous rule, that is, if you have SARS in this place, you have to punish that official. 官员 Dr Tan Wei believes that there are also political factors. Tan Wei: The CCP has a saying that stability is overriding everything. It does not want these things to cause a phenomenon of social instability. For it, stabilizing its rule is more important than the lives of ordinary people. ｣ Hu Naiwen, a traditional Chinese medicine physician of the Tongdetang National Medicine Co., Ltd. in Shanghai, Taiwan, said that the public still remembers that the Chinese Communist Party covered the outbreak and rapid spread of SARS in China during 2002 and 2003, which caused many deaths. They worry that old things will repeat themselves. Hu Naiwen, a doctor of traditional Chinese medicine in Tongdetang National Medicine Co., Ltd. in Shanghai, Taiwan: A previous experience was that the SARS epidemic occurred at the end of 2002. But in 2003, the news really came out around February. So many people I did n’t know about it for a while. So it spread to Hong Kong, Singapore, and Taiwan. Some people in Canada died from SARS. ｣ It is understood that on the 15th, the US State Department has issued an update on health alerts for travel to Wuhan, requiring citizens who feel unwell after going to Wuhan to seek medical treatment as soon as possible. Hong Kong, Macao, Taiwan, South Korea, Japan, and Southeast Asia have also strengthened border quarantine measures to take temperature checks on passengers from Wuhan. Now, the World Health Organization (WHO) has officially named the virus "Wuhan Pneumonia" as "2019 New Coronavirus" and said that the virus has a "limited human-to-human" situation. At the end of January, the new year's Eve in China, thousands of workers and students from other places will return home to spend the New Year or travel abroad for vacations. Whether the virus will spread and cause worries. Interview / Edited by Chen Han / Posted by Li Ming / Zhong Yuan https://www.ntdtv.com/b5/2020/01/17/a102755104.html

4 new cases of pneumonia freeze in Wuhan Beijing Time: 2020-01-18 06:56 [NTD Beijing, January 18, 2020] Wuhan pneumonia epidemic has been delayed. On the 18th local time, Wuhan officially announced that 4 new cases were added. New York, Los Angeles and San Francisco airports will begin screening Chinese tourists from Wuhan, including taking temperature measurements. In the early morning of the 18th, the Wuhan Health Commission reported that there were 4 new cases of pneumonia infected by the new coronavirus in the city . Prior to this, officially reported cases in Wuhan have remained in 41 cases from January 11 to 16. In the same period, the number of suspected cases in Hong Kong has increased from 67 to 81, and most of them have been to or from Wuhan. Yokogawa: " There are several epidemiological characteristics of pneumonia in Wuhan this time . First, when new cases or suspected cases are still being found in other countries and regions, there are no new cases in Wuhan There are very few new cases or new cases. Second, there are more suspected cases in Hong Kong than in Wuhan, and Hong Kong did not have the "super communicator" like SARS in 2003 . In this case, the number of cases in Wuhan should far exceed that in Hong Kong. " As of the 17th, in addition to mainland China, seven countries and regions around the world have reported confirmed or suspected cases of Wuhan pneumonia. Including 2 confirmed cases in Thailand and 1 confirmed case in Japan; and 2 suspected cases in Vietnam, 1 suspected in Singapore, 4 suspected in Taiwan, and 2 suspected cases in Macau. Yokogawa: "In addition to mainland China, Wuhan, no cases of pneumonia this report seems only to spread jumping outside, which is not in line with the characteristics of the spread of the epidemic can only be used in this case CCP is blocked epidemic to do Explanation. It is even more worrying that it is possible that this disease has not been tested, isolated and reported nationwide in accordance with the standards for acute infectious diseases. This is exactly what happened during SARS , and it is also One of the reasons for the large-scale spread of SARS. " Among them, although the Japanese diagnosed patients have been to Wuhan, they have not been to the source of the epidemic, "South China Seafood Market". In addition, there are a couple of cases in mainland China. Her husband works in the South China Seafood Market, but his wife denies that he has been to the market. Transmission possibility. Yokogawa: "If the virus has two mutations at the same time, one is highly human-to-human transmission, and the other is highly toxic with severe symptoms and high mortality. The simultaneous occurrence of two is very terrible. This is the case of SARS. Now that the situation is known, including overseas cases, it seems that the severity and mortality of symptoms are lower than SARS, but he does not mean that human-to-human transmission can be ruled out. There are already many signs that humans are likely to have occurred successor." German virology expert Christian Drosten believes that the new coronavirus and the 2003 SARS virus are "the same virus, but different in form." The SARS outbreak has killed at least 800 people worldwide. It is worth noting whether the epidemic will continue to spread with the arrival of the Chinese New Year peak. NTD reporter Lin Lan reports from New York https://www.ntdtv.com/b5/2020/01/17/a102755131.html

Internet transmission of Wuhan fever patients full of patients unprotected doctor couple infected (Photos) Chinese netizens in the online community filmed the scene of a hospital staff in Wuhan wearing protective clothing to work. (Twitter screenshot) Beijing Time: 2020-01-18 06:49 [NTD Beijing, January 18, 2020] After a netizen broke the news that the patients at Wuhan Tongji Hospital were full, a group of photos came out from the online community in Mainland China recently, showing that doctors at a hospital in Wuhan are wearing tight The patient's protective clothing is wrapped in a consultation. Other netizens broke the news that a couple of attending physicians were suspected of being infected with the new coronavirus and had been rescued for several days. All the above information has been banned and cleared, indicating that the CCP has exercised strict control over the news about the 2019-nCoV epidemic . After the outbreak of a new coronavirus pneumonia outbreak in Wuhan, China, the public is very concerned about whether this virus, which is 80% similar to SARSE, has spread. A netizen named "Xiehe Xiaoyi DO Xiansen" posted a few photos on a Chinese social networking platform Weibo that appeared to be taken in a hospital in Wuhan. The picture shows that the medical staff working in the fever clinic in the hospital are wearing protective clothing and tightly wrapped themselves from head to toe. Some of the patients visiting the hospital did not even wear masks, which obviously lacked awareness of the risk of infectious diseases. . The netizen also posted a post saying that he insisted for a few more days, "I will return to Dahuang Mountain, which has good environment next week." Chinese netizens exposed photos of medical staff in a hospital in Wuhan wearing protective clothing to diagnose and treat patients. (Weibo screenshot) Chinese netizens with user name "Wind in the Smoke" reprinted these photos and disclosed in the post that they have a friend who is a staff member of Tongji Hospital. Now the doctors who send out hotspots in the hospital are "fully armed", and they all attend The doctor has been rescued for several days, and the doctor's wife has been admitted to Jinyintan Hospital. It is understood that Jinyintan Hospital is a hospital that focuses on treating patients infected with the new coronavirus in Wuhan. Netizens "Mid-Class Youth" also reposted this group of pictures, and posted that the Wuhan Hospital was full and there had been cases of infected medical staff. In order to control the data of new cases, most patients are not diagnosed. Ordinary people persuade them to go home to "care", and patients with special relationship will be quarantined. It is speculated that perhaps because of too many patients, the hospital can no longer afford it, and doctors can only be protected as much as possible, and ordinary fever patients are left to die on their own. In addition, Chinese netizens reposted the aforementioned photos and other netizens' posts on Twitter when the wind rose again, showing that netizens broke the news that the actual situation is much more serious than the report, and that his hospital has several medical staff "medical" ", But a notice was issued inside the hospital, asking medical staff to" don't talk nonsense, "so everyone was afraid to say it. All the pictures and texts reprinted by the above original post and other netizens have all been deleted and blocked by the Chinese Communist Party webmaster. However, according to the screenshots forwarded by Chinese netizens to Twitter, the contents of these pictures and texts are on the Internet with Wuhan netizen "Mr. Shu" The breaking news in the community is highly consistent. On Thursday (16th —) "Mr. Shusss" broke the news on Weibo that his father had a fever on the 9th and was examined and treated in Wuhan Xinhua Hospital for 3 days. He was transferred to Wuhan because his condition did not improve. Tongji Hospital. It was found that the Tongji Hospital was overcrowded and that many patients were lying on the floor in the corridor. The netizen's father was asked to go home and quarantine because he had no bed after 2 days of treatment at Tongji Hospital. As a result, his father's condition deteriorated and he could not breathe after going home. After many setbacks, he was admitted to Jinyintan Hospital. What's more serious is that Mr. Shu himself and his mother have also had fever for three days. CT showed bilateral lung infections, but Jinyintan Hospital can no longer treat them. At present, all the contents of the "Mr. Shu" Weibo account have also been emptied, showing that the Chinese Communist Party's network management agency has severely blocked news about the 2019-nCoV epidemic . The outside world has noticed that the current confirmed cases of 2019-nCoV infected people in China are from Wuhan, Hubei, and there are no related epidemic reports in other cities in Hubei Province and other provinces except Hubei. Wang Yuedan, deputy director of the Department of Immunology at Peking University who has worked on SARS, told the BBC that the main reason for this situation is likely that the virus was not tested in other parts of China. "Whether you go to Hong Kong or abroad, there will be quarantine requirements for exit, especially if you are from Wuhan," Wang Yuedan said. "However, no request has been received from hospitals or other places in China. Concerned about fever patients from Wuhan, the common cold will not detect the coronavirus." (Reporter Tang Di comprehensive report / responsible editor: Ming Xuan) https://www.ntdtv.com/b5/2020/01/17/a102755031.html

[Wuhan Explosive Disease] Netizens broke the news that the hospital was full of fever patients, and Weibo was quickly emptied. 21 hours ago Netizens revealed the situation of Wuhan Hospital on Weibo, which was blocked immediately. (the Internet) AAA The outbreak of a new coronavirus in Wuhan, Hubei, has caused two deaths, but the authorities have not specifically announced the situation. Even Hong Kong experts went north to investigate and the media follow-up was once detained by the police for questioning. A netizen in the Mainland recounted the specific situation of his father's pneumonia infection and a test at the hospital. The hospital was full of fever patients, there were not enough beds, and because of too many patients, he was forced to lie on the floor of the corridor. He was then asked to go home for isolation. After netizens revealed the situation of the hospital, Weibo was blocked and emptied. Related news: [Wuhan Explosive Disease] Japan's first patient confirmed in Vietnam The netizen was called "Mr. Tree sss", and he posted on Weibo about his father's infection with coronavirus pneumonia. His father showed discomfort on the 9th of this month, and he has always had a low fever. He went to the Xinhua Hospital in Wuhan to seek medical treatment. After computer scans and blood tests, in addition to finding shadows in the lungs, he knew he was infected with the virus. After three days of treatment, the condition of the netizen's father did not improve, so he was transferred to Wuhan Tongji Hospital. Wuhan Tongji Hospital has a special fever clinic. "Mr. Shusss" indicates that the hospital is full of fever patients, and there are too many people lying on the floor of the corridor. The doctor examined the father of the netizen and gave him two consecutive days of injections. The doctor said that he had no bed and could not go through the admission procedure. He even asked the netizen to take his father home for isolation. Related news: [Wuhan Explosive Disease] Japan's first patient confirmed in Vietnam Netizens said that after his father returned home, he began to pant, couldn't breathe, and continued to have a fever. The situation became more and more serious, so he took his father back to his hometown. The doctor in his hometown suggested that he be transferred to the hospital and returned to Wuhan Gold and Silver, which specializes in the treatment of the new coronavirus. Tan Hospital. "Mr. Tree sss" also said that he and his mother also began to feel unwell. He began to have fever since the 13th. The doctor did the same checkup as his father. The situation did not improve. Netizens said that they felt very helpless. Jinyintan Hospital said it was not set up. At the clinic, he didn't know where to go for treatment. He believed that to tell the truth, he even said, "I am responsible for the above remarks." Many netizens have read the message of "Mr. Tree sss". Some people think it is true, but others have questioned him as "rumor making": "Too many people are lying on the floor of the corridor? Are they fake?" Ask the patient to come to the hospital and don't run around! "" Take a video (video) to confirm! " However, the Weibo of "Mr. Shusss" was suddenly blocked and the content was emptied. Other netizens were worried that he had disappeared from the authorities: "Mr. Shusss has even disappeared with Weibo!" I hope the bloggers are safe! " Sina Weibo https://hk.appledaily.com/local/20200117/7AI4Y35QCTXLW7RPQBMXMVJPDI/

No epidemic in other parts of China? Experts explode: authorities do not require testing Countries around China have strengthened quarantine. The picture shows a passenger at an international airport in Japan reminding passengers from Wuhan to report if they have a cough and fever. (STR / JIJI PRESS / AFP via Getty Images) Beijing Time: 2020-01-18 12:44 [NTD Beijing, January 17, 2020] Wuhan's "new coronavirus" epidemic has spread to a number of countries around China, and within China, no other cases have been reported. It is seriously suspected that the CCP concealed the epidemic again. A professor from Peking University told foreign media that the authorities did not require other regions to take relevant quarantine measures at all. In recent days, suspected Wuhan "new coronavirus" infection cases have been found in many countries around China, many of which have been diagnosed. However, in China, all reported confirmed cases come from Wuhan, and the number of patients in Wuhan has not increased for a week. Wang Yuedan, deputy director of the Department of Immunology at Peking University who has worked on SARS research, told the BBC that the main reason for the absence of outbreak reports in other parts of China is likely that the Chinese authorities did not require the virus to be tested. Wang Yuedan said, "Whether you go to Hong Kong or abroad, there will be quarantine requirements when you leave the country , especially if you are from Wuhan. However, no matter whether it is a hospital or other places in China, you have not received a request to pay attention to fever patients from Wuhan. No coronavirus will be detected. " The Peking University professor only described what the general medical staff could see. However, the outside world suspects that the truth behind the scenes may not be because the Chinese Communist Party has rigorously ordered all regions to conceal the epidemic situation and repeat the mistakes of the 2003 SARS outbreak. A few days ago, there was a heat spread in Shenzhen's medical care industry. An Indian lady with "severe pneumonia" symptoms appeared in Nanshan People's Hospital. However, the hospital immediately stated that the patient "has been ruled out of SARS and the new coronavirus", but acknowledged that "the pathogen is unknown" and that the patient was not in danger of life. In Wuhan, after authorities were forced to acknowledge the outbreak at the end of last month, the number of reported infections continued to rise, from 27 to 59. But since last Saturday, the number of infected people has been fixed at 41 people. The official media also announced that no new cases were found after January 3. However, according to local residents in Wuhan, some hospitals are crowded with "unknown pneumonia" patients, and local medical resources are seriously inadequate. Except for individual patients who were sent to Jinyintan Hospital, many patients were required to "home and isolate" themselves. Moreover, in order not to increase the number of cases of "new coronavirus" infections, hospitals are required to generally not confirm the diagnosis of patients. At the end of December, the medical and health care industry in Wuhan first reported multiple SARS cases in the South China Seafood Market. Officials were forced to acknowledge the epidemic, but insisted it was "unknown pneumonia" and denied SARS. A few days later, the disease was officially announced as coming from a "new coronavirus". But Hong Kong experts point out that the so-called "new coronavirus" has nearly 80% of the same genes as SARS virus. German experts even more bluntly stated that this is "a SARS virus". One of the main reasons for the SARS outbreak in 2003 was the CCP ’s efforts to conceal the epidemic, which has caused insufficient attention around the world. After the suspected SARS outbreak in Wuhan, many neighboring countries and Hong Kong and Taiwan areas learned lessons and quickly adopted quarantine measures. However, because there are no outbreak reports in other parts of China, the quarantine objects in these countries or regions can only be targeted at people from Wuhan, China. (Reporting by reporter Zhong Gusheng / responsible editor: Ming Xuan) https://www.ntdtv.com/gb/2020/01/17/a102754951.html

Video From a Hospital in Wuhan https://www.weibo.com/tv/v/IpWhHniLq?fid=1034:4461822418550792

Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with 2019 Novel Coronavirus (2019-nCoV) January 17, 2020 To date, we do not fully understand the pathogenic potential and transmission dynamics of 2019 Novel Coronavirus (2019-nCoV). Until more information becomes available, precautions should be taken in collecting and handling specimens that may contain 2019-nCoV. Timely communication between clinical and laboratory staff is essential to minimize the risk incurred in handling specimens from patients with possible 2019-nCoV infection. Such specimens should be labeled accordingly, and the laboratory should be alerted to ensure proper specimen handling. General and specific biosafety guidelines for handling 2019-nCoV specimens are provided below. For additional detailed instructions please refer to the following: Biosafety in Microbiological and Biomedical Laboratories (BMBL) – Fifth Edition Laboratory Biosafety Manual – Third Editionexternal icon General Guidelines (for working with potentially infectious materials) Laboratory workers should wear appropriate personal protective equipment (PPE) which includes disposable gloves, laboratory coat/gown and eye protection when handling potentially infectious specimens. Any procedure with the potential to generate fine-particulate aerosols (e.g., vortexing or sonication of specimens in an open tube) should be performed in a Class II Biological Safety Cabinet (BSC). Appropriate physical containment devices (e.g., centrifuge safety buckets; sealed rotors) should be used for centrifugation. Ideally, rotors and buckets should be loaded and unloaded in a BSC. Perform any procedures outside a BSC in a manner that minimizes the risk of exposure to an inadvertent sample release. After specimens are processed, decontaminate work surfaces and equipment with appropriate disinfectants. Use any EPA-registered hospital disinfectant. Follow manufacturer’s recommendations for use-dilution (i.e., concentration), contact time, and care in handling. All disposable waste should be autoclaved. Specific Guidelines Virus isolation in cell culture and initial characterization of viral agents recovered in cultures of 2019-nCoV specimens are NOT recommended at this time. The following activities may be performed in BSL-2 facilities using standard BSL-2 work practices: Pathologic examination and processing of formalin-fixed or otherwise inactivated tissues Molecular analysis of extracted nucleic acid preparations Electron microscopic studies with glutaraldehyde-fixed grids Routine examination of bacterial and mycotic cultures Routine staining and microscopic analysis of fixed smears Final packaging of specimens for transport to diagnostic laboratories for additional testing. Specimens should already be in a sealed, decontaminated primary container. Inactivated specimens (e.g., specimens in nucleic acid extraction buffer) The following activities involving manipulation of potentially infected specimens should be performed as above and in a Class II BSC: Aliquoting and/or diluting specimens Inoculating bacterial or mycological culture media Performing diagnostic tests that do not involve propagation of viral agents in vitro or in vivo Nucleic acid extraction procedures involving potentially infected specimens Preparation and chemical- or heat-fixing of smears for microscopic analysis Clinical Laboratory Testing Clinical laboratories performing routine hematology, urinalysis, and clinical chemistry studies, and microbiology laboratories performing diagnostic tests on serum, blood, or urine specimens should follow standard laboratory practices, including Standard Precautions, when handling potential 2019-nCoV specimens. For additional information, see Biosafety in Microbiological and Biomedical Laboratories (BMBL) – Fifth Edition (page 225). Packing, Shipping and Transport Packaging, shipping, and transport of specimens from suspect cases or PUI’s of 2019-nCoV infection must follow the current edition of the International Air Transport Association (IATA) Dangerous Goods Regulationsexternal icon. Follow shipping regulations for UN 3373 Biological Substance, Category B when sending potential 2019-nCoV specimens. Resources Packaging Checklist, see Category B Saf-T-Pakpdf icon Packing Instructions 650 for UN 3373external icon Click on “Infectious substances” and there is an option to download the packing instructions. Labels for UN 3373 When using cold pack pdf icon – Include the name and telephone number of the person who will be available during normal business hours who knows the content of the shipment (can be someone at CDC). Place the label on one side of the box and cover the label completely with clear tape (do not tape just the edges of the label). When using dry ice pdf icon – Include the name and telephone number of the person who will be available during normal business hours who knows the content of the shipment (can be someone at CDC). Place the label on one side of the box and cover the label completely with clear tape (do not tape just the edges of the label). Schematic for packaging, UN 3373 Category Bpdf icon Top of Page Page last reviewed: January 17, 2020 https://www.cdc.gov/coronavirus/2019-nCoV/lab-biosafety-guidelines.html

Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Patients Under Investigation (PUIs) for 2019 Novel Coronavirus (2019-nCoV) January 17, 2020 Health care providers should contact their local/state health department immediately to notify them of patients with fever and lower respiratory illness who traveled to Wuhan, China within 14 days of symptom onset. Local and state public health staff will determine if the patient meets the criteria for a patient under investigation (PUI) for 2019 Novel Coronavirus (2019-nCoV). The current the Centers for Disease Control and Prevention (CDC)s definition for a PUI is available. Clinical specimens should be collected from PUIs for routine testing of respiratory pathogens at either clinical or public health labs. Note that clinical laboratories should NOT attempt viral isolation from specimens collected from 2019-nCoV PUIs. At this time, diagnostic testing for 2019-nCoV can be conducted only at CDC. State and local health departments who have identified a PUI should immediately notify CDC’s Emergency Operations Center (EOC) at 770-488-7100 to report the PUI and determine whether testing for 2019-NCoV at CDC is indicated. The EOC will assist local/state health departments to collect, store, and ship specimens appropriately to CDC, including during afterhours or on weekends/holidays. Testing for other respiratory pathogens by the provider should be done as part of the initial evaluation and should not delay specimen shipping to CDC. If a PUI tests positive for another respiratory pathogen, after clinical evaluation and consultation with public health authorities, they may no longer be considered a PUI. Specimen Type and Priority To increase the likelihood of detecting infection, CDC recommends: Collection of three specimen types, lower respiratory, upper respiratory and serum specimens for testing is recommended. If possible, additional specimen types (e.g., stool, urine) should be collected and should be stored initially until decision is made by CDC whether additional specimen sources should be tested. Specimens should be collected as soon as possible once a PUI is identified regardless of symptom onset. Maintain proper infection control when collecting specimens. General Guidelines Store specimens at 2-8°C and ship overnight to CDC on ice pack. Label each specimen container with the patient’s ID number (e.g., medical record number), unique specimen ID (e.g., laboratory requisition number), specimen type (e.g., serum) and the date the sample was collected. Complete a CDC Form 50.34 for each specimen submitted. In the upper left box of the form, 1) for test requested select “Respiratory virus molecular detection (non-influenza) CDC-10401” and 2) for At CDC, bring to the attention of enter “Stephen Lindstrom: 2019-nCoV PUI”. I. Respiratory Specimens A. Lower respiratory tract Bronchoalveolar lavage, tracheal aspirate Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container. Refrigerate specimen at 2-8°C and ship overnight to CDC on ice pack. Sputum Have the patient rinse the mouth with water and then expectorate deep cough sputum directly into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container. Refrigerate specimen at 2-8°C and ship overnight to CDC on ice pack. B. Upper respiratory tract Nasopharyngeal swab AND oropharyngeal swab (NP/OP swab) Use only synthetic fiber swabs with plastic shafts. Do not use calcium alginate swabs or swabs with wooden shafts, as they may contain substances that inactivate some viruses and inhibit PCR testing. Place swabs immediately into sterile tubes containing 2-3 ml of viral transport media. NP and OP specimens can be combined in the same vial. Refrigerate specimen at 2-8°C and ship overnight to CDC on ice pack. Nasopharyngeal swab: Insert a swab into the nostril parallel to the palate. Leave the swab in place for a few seconds to absorb secretions. Swab both nasopharyngeal areas with the same swab.Oropharyngeal swab (e.g., throat swab): Swab the posterior pharynx, avoiding the tongue. Nasopharyngeal wash/aspirate or nasal aspirate Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container. Refrigerate specimen at 2-8°C and ship overnight to CDC on ice pack. II. Serum Minimum volume required: Children and adults: Collect 1 tube (5-10 mL) of whole blood in a serum separator tube. Infant: A minimum of 1 mL of whole blood is needed for testing pediatric patients. If possible, collect 1 mL in a serum separator tube. Serum separator tubes should be stored upright for at least 30 minutes, and then centrifuged at 1000–1300 relative centrifugal force (RCF) for 10 minutes before removing the serum and placing it in a separate sterile tube for shipping (such as a cryovial). Refrigerate the serum specimen at 2-8°C and ship overnight to CDC on ice-pack. III. Shipping Specimens PUI’s must be packaged, shipped, and transported according to the current edition of the International Air Transport Association (IATA) Dangerous Goods Regulationsexternal icon. Store specimens at 2-8°C and ship overnight to CDC on ice pack. If a specimen is frozen at -70°C ship overnight to CDC on dry ice. Additional useful and detailed information on packing, shipping, and transporting specimens can be found at Interim Laboratory Biosafety Guidelines for Handling and Processing Specimens Associated with 2019 Novel Coronavirus (2019-nCoV). For additional information, consultation, or the CDC shipping address, contact the CDC Emergency Operations Center (EOC) at 770-488-7100. Page last reviewed: January 17, 2020 https://www.cdc.gov/coronavirus/2019-nCoV/guidelines-clinical-specimens.html

Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus Although the transmission dynamics have yet to be determined, CDC currently recommends a cautious approach to patients under investigation for 2019 Novel Coronavirus Such patients should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed, ideally an airborne infection isolation room if available. Healthcare personnel entering the room should use standard precautions, contact precautions, airborne precautions, and use eye protection (e.g., goggles or a face shield). Immediately notify your healthcare facility’s infection control personnel and local health department. Additional Infection Control Practices Resources Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings Page last reviewed: January 15, 2020 https://www.cdc.gov/coronavirus/2019-nCoV/infection-control.html

Interim Guidance for Healthcare Professionals Limited information is available to characterize the spectrum of clinical illness associated with 2019-nCoV. No vaccine or specific treatment for 2019-nCoV infection is available; care is supportive. The CDC clinical criteria for a 2019-nCoV patient under investigation (PUI) have been developed based on what is known about MERS-CoV and SARS-CoV and are subject to change as additional information becomes available. Health care providers should obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness. CDC guidance for evaluating and reporting a PUI for MERS-CoV remains unchanged. Criteria to Guide Evaluation of Patients Under Investigation (PUI) for 2019-nCoV Patients in the United States who meet the following criteria should be evaluated as a PUI in association with the outbreak of 2019-nCoV in Wuhan City, China. phone iconContact your local or state health departmentexternal icon Healthcare providers should immediately notify their local or state health department in the event of a PUI for 2019-nCoV. Clinical features and epidemiologic risk Clinical Features & Epidemiologic Risk Fever1 and symptoms of lower respiratory illness (e.g., cough, difficulty breathing) and In the last 14 days before symptom onset, a history of travel from Wuhan City, China. – or – In the last 14 days before symptom onset, close contact2 with a person who is under investigation for 2019-nCoV while that person was ill. Fever1 or symptoms of lower respiratory illness (e.g., cough, difficulty breathing) and In the last 14 days, close contact2 with an ill laboratory-confirmed 2019-nCoV patient. The criteria are intended to serve as guidance for evaluation. Patients should be evaluated and discussed with public health departments on a case-by-case basis if their clinical presentation or exposure history is equivocal (e.g., uncertain travel or exposure). Recommendations for Reporting, Testing, and Specimen Collection Updated January 17, 2020 Healthcare providers should immediately notify both infection control personnel at their healthcare facility and their local or state health department in the event of a PUI for 2019-nCoV. State health departments that have identified a PUI should immediately contact CDC’s Emergency Operations Center (EOC) at 770-488-7100 and complete a 2019-nCoV PUI case investigation form available below. Download PDF file pdf icon[PDF – 211 KB] Download Microsoft Word file word icon[DOC – 90 KB] CDC’s EOC will assist local/state health departments to collect, store, and ship specimens appropriately to CDC, including during afterhours or on weekends/holidays. At this time, diagnostic testing for 2019-nCoV can be conducted only at CDC. Testing for other respiratory pathogens should not delay specimen shipping to CDC. If a PUI tests positive for another respiratory pathogen, after clinical evaluation and consultation with public health authorities, they may no longer be considered a PUI. This may evolve as more information becomes available on possible 2019-nCoV co-infections. For biosafety reasons, it is not recommended to perform virus isolation in cell culture or initial characterization of viral agents recovered in cultures of specimens from a PUI for 2019-nCoV. To increase the likelihood of detecting 2019-nCoV infection, CDC recommends collecting and testing multiple clinical specimens from different sites, including all three specimen types—lower respiratory, upper respiratory, and serum specimens. Additional specimen types (e.g., stool, urine) may be collected and stored. Specimens should be collected as soon as possible once a PUI is identified regardless of time of symptom onset. Additional guidance for collection, handling, and testing of clinical specimens is available. Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019-nCoV Interim Health Care Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings CDC’s Health Alert Network Update: Outbreak of Pneumonia Associated with Novel Coronavirus 2019 (nCoV-2019) in Wuhan, China. Footnotes 1Fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain fever-lowering medications. Clinical judgment should be used to guide testing of patients in such situations. 2Close contact is defined as— a) being within approximately 6 feet (2 meters), or within the room or care area, of a novel coronavirus case for a prolonged period of time while not wearing recommended personal protective equipment or PPE (e.g., gowns, gloves, NIOSH-certified disposable N95 respirator, eye protection); close contact can include caring for, living with, visiting, or sharing a health care waiting area or room with a novel coronavirus case.– or – b) having direct contact with infectious secretions of a novel coronavirus case (e.g., being coughed on) while not wearing recommended personal protective equipment. See CDC’s Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus Data to inform the definition of close contact are limited. Considerations when assessing close contact include the duration of exposure (e.g., longer exposure time likely increases exposure risk) and the clinical symptoms of the person with novel coronavirus (e.g., coughing likely increases exposure risk as does exposure to a severely ill patient). Special consideration should be given to those exposed in health care settings. Additional Resources: Directory of Local Health Departmentsexternal icon World Health Organization (WHO) Coronavirusexternal icon WHO guidance on clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspectedexternal icon Page last reviewed: January 17, 2020 https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html

Interim Guidance for Preventing 2019 Novel Coronavirus (2019-nCoV) from Spreading to Others in Homes and Communities This interim guidance is based on what is currently known about 2019 novel coronavirus (2019-nCoV) and transmission of other viral respiratory infections. CDC will update this interim guidance as needed and as additional information becomes available. Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with MERS and SARS. The potential for human-to-human transmission of 2019-nCoV is unknown. The following interim guidance may help prevent this virus from spreading among people in homes and in communities. This interim guidance is for: people confirmed to have 2019-nCoV infection, who do not need to be hospitalized and who can receive care at home people being evaluated by a healthcare provider for 2019-nCoV infection, who do not need to be hospitalized and who can receive care at home caregivers and household members of a person confirmed to have, or being evaluated for, 2019-nCoV infection other people who have had close contact with a person confirmed to have, or being evaluated for, 2019-nCoV infection Prevention Steps for People who may have 2019-nCoV Infection If you are feeling sick and are confirmed to have, or being evaluated for, 2019-nCoV infection you should follow the prevention steps below until a healthcare provider or local or state health department says you can return to your normal activities. Stay home except to get medical care You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas, and do not use public transportation or taxis. Separate yourself from other people in your home As much as possible, you should stay in a different room from other people in your home. Also, you should use a separate bathroom, if available. Call ahead before visiting your doctor Before your medical appointment, call the healthcare provider and tell them that you have, or are being evaluated for, 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Wear a facemask You should wear a facemask when you are in the same room with other people and when you visit a healthcare provider. If you cannot wear a facemask, the people who live with you should wear one while they are in the same room with you. Cover your coughs and sneezes Cover your mouth and nose with a tissue when you cough or sneeze, or you can cough or sneeze into your sleeve. Throw used tissues in a lined trash can, and immediately wash your hands with soap and water for at least 20 seconds. Wash your hands Wash your hands often and thoroughly with soap and water for at least 20 seconds. You can use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands. Avoid sharing household items You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with other people in your home. After using these items, you should wash them thoroughly with soap and water. Monitor your symptoms Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before going to your medical appointment, call the healthcare provider and tell them that you have, or are being evaluated for, 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask your healthcare provider to call the local or state health department. Top of Page Prevention Steps for Caregivers and Household Members If you live with, or provide care at home for, a person confirmed to have, or being evaluated for, 2019-nCoV infection, you should: Make sure that you understand and can help the person follow the healthcare provider’s instructions for medication and care. You should help the person with basic needs in the home and provide support for getting groceries, prescriptions, and other personal needs. Have only people in the home who are essential for providing care for the person. Other household members should stay in another home or place of residence. If this is not possible, they should stay in another room, or be separated from the person as much as possible. Use a separate bathroom, if available. Restrict visitors who do not have an essential need to be in the home. Keep elderly people and those who have compromised immune systems or chronic health conditions away from the person. This includes people with chronic heart, lung or kidney conditions, and diabetes. Make sure that shared spaces in the home have good air flow, such as by an air conditioner or an opened window, weather permitting. Wash your hands often and thoroughly with soap and water for at least 20 seconds. You can use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands. Wear a disposable facemask, gown, and gloves when you touch or have contact with the person’s blood, body fluids and/or secretions, such as sweat, saliva, sputum, nasal mucus, vomit, urine, or diarrhea. Throw out disposable facemasks, gowns, and gloves after using them. Do not reuse. Wash your hands immediately after removing your facemask, gown, and gloves. Avoid sharing household items. You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with a person who is confirmed to have, or being evaluated for, 2019-nCoV infection. After the person uses these items, you should wash them thoroughly (see below “Wash laundry thoroughly”). Clean all “high-touch” surfaces, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, body fluids and/or secretions or excretions on them. Read label of cleaning products and follow recommendations provided on product labels. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves or aprons and making sure you have good ventilation during use of the product. Use a diluted bleach solution or a household disinfectant with a label that says “EPA-approved.” To make a bleach solution at home, add 1 tablespoon of bleach to 1 quart (4 cups) of water. For a larger supply, add ¼ cup of bleach to 1 gallon (16 cups) of water. Wash laundry thoroughly. Immediately remove and wash clothes or bedding that have blood, body fluids and/or secretions or excretions on them. Wear disposable gloves while handling soiled items. Wash your hands immediately after removing your gloves. Read and follow directions on labels of laundry or clothing items and detergent. In general, wash and dry with the warmest temperatures recommended on the clothing label. Place all used disposable gloves, gowns, facemasks, and other contaminated items in a lined container before disposing them with other household waste. Wash your hands immediately after handling these items. Monitor the person’s symptoms. If they are getting sicker, call his or her medical provider and tell them that the person has, or is being evaluated for, 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask the healthcare provider to call the local or state health department. Caregivers and household members who do not follow precautions when in close contact with a person who is confirmed to have, or being evaluated for, 2019-nCoV infection, are considered “close contacts” and should monitor their health. Follow the prevention steps for close contacts below. Discuss any additional questions with you state or local health department Prevention Steps for Close Contacts If you have had close contact with someone who is confirmed to have, or being evaluated for, 2019-nCoV infection, you should: Monitor your health starting from the day you first had close contact with the person and continue for 14 days after you last had close contact with the person. Watch for these signs and symptoms: Fever. Take your temperature twice a day. Coughing. Shortness of breath or difficulty breathing. Other early symptoms to watch for are chills, body aches, sore throat, headache, diarrhea, nausea/vomiting, and runny nose. If you develop any of these symptoms, follow the prevention steps for caregivers and household members described above, and call your healthcare provider as soon as possible. Before going to your medical appointment, call the healthcare provider and tell them about your close contact with someone who is confirmed to have, or being evaluated for, 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask your healthcare provider to call the local or state health department. If you do not have any symptoms, you can continue with your daily activities, such as going to work, school, or other public areas. Top of Page Page last reviewed: January 18, 2020 https://www.cdc.gov/coronavirus/2019-ncov/guidance-prevent-spread.html

Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus (2019-nCoV) This interim guidance is for staff at local and state health departments, infection prevention and control professionals, healthcare providers, and healthcare workers who are coordinating the home care and isolation1 of people who are confirmed to have, or being evaluated for 2019 novel coronavirus (2019-nCoV) infection (see Criteria to Guide Evaluation of Patients Under Investigation (PUI) for 2019-nCoV). This document does not apply to patients in healthcare settings. For interim healthcare infection prevention and control recommendations, see (insert link). Although the potential for human-to-human transmission of 2019-nCoV is unknown, this interim guidance is based on what is currently known about transmission of other viral respiratory infections. CDC will update this interim guidance as needed and as more information becomes available. People who are confirmed to have, or being evaluated for, 2019-nCoV infection and do not require hospitalization for medical reasons may be cared for in a residential setting after a healthcare professional determines that the setting is suitable. Providers should contact their state or local health department to discuss home care, home isolation, or other measures for close contacts and for patients under investigation (PUI) for 2019-nCoV, and to discuss criteria for discontinuing any such measures. See Interim Guidance for Health Professionals for more information. Assess the Suitability of the Residential Setting for Home Care In consultation with state or local health department staff, a healthcare professional should assess whether the residential setting is suitable and appropriate for home care; assess whether the patient is capable of adhering to precautions that will be recommended as part of home care or isolation (respiratory hygiene, hand hygiene, etc.); and notify their local or state health department that the residential setting has been determined to be suitable for home care and that hospital discharge is planned. Provide Guidance for Precautions to Implement during Home Care A healthcare professional should provide CDC’s interim guidance for Preventing 2019-nCoV from Spreading to Others in Homes and Communities to the person confirmed to have, or being evaluated for, 2019-nCoV infection, and to the caregiver and household members; and contact their state or local health department to discuss criteria for discontinuing any such measures. Page last reviewed: January 18, 2020 https://www.cdc.gov/coronavirus/2019-ncov/guidance-home-care.html

2019 Novel Coronavirus (2019-nCoV), Wuhan, China This is an emerging, rapidly evolving situation and CDC will provide updated information as it becomes available, in addition to updated guidance. On This Page Situation Summary Risk Assessment What to Expect CDC Response Other Available Resources Updated January 17, 2020 Situation Summary View larger image The Centers for Disease Control and Prevention (CDC) is closely monitoring an outbreak caused by a novel (new) coronavirus in Wuhan City, Hubei Province, China. Chinese authorities identified the new coronavirus, which has resulted in more than 40 confirmed human infections in China with two deaths reportedexternal icon. A number of countries are actively screening incoming travelers from Wuhan and exported cases have been confirmed in Thailandexternal icon and Japanexternal icon. Chinese health authorities posted the full genome of the so-called “2019 novel coronavirus” or “2019-nCoV” in GenBankexternal icon, the NIH genetic sequence database, and in the Global Initiative on Sharing All Influenza Data (GISAIDexternal icon) portal. Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with MERS and SARS. Many of the patients in the outbreak in Wuhan, China have reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread. Some patients in the outbreak reportedly have not had exposure to animal markets, suggesting that some limited person-to-person spread is occurring. There are ongoing investigations to learn more. This is a rapidly evolving situation and information will be updated as it becomes available. Risk Assessment Outbreaks of novel virus infections among people are always of public health concern. The risk from these outbreaks depends on characteristics of the virus, including whether and how well it spreads between people, the severity of resulting illness, and the medical or other measures available to control the impact of the virus (for example, vaccine or treatment medications). Chinese health authoritiesexternal icon have reported that many patients in China visited a large seafood and animal market. They additionally report that several hundred health care workers caring for outbreak patients are being monitored and no spread of this virus from patients to health care workers has been detected. They report no sustained spread of this virus in the community, but there are indications that some limited person-to-person spread may have occurred. Cases outside China have all occurred in travelers from Wuhan. There is much more to learn about how the 2019-nCoV virus spreads, severity of associated illness, and other features of the virus. Investigations are ongoing. Based on current information, however, the immediate health risk from 2019-nCoV to the general American public is deemed to be low at this time. Nevertheless, CDC is taking proactive preparedness precautions. What to Expect Access to the full genetic sequence of 2019-nCoV will help identify infections with this virus going forward. More cases may be identified in the coming days, including more in countries outside China, and possibly in the United States. Given what has occurred previously with MERS and SARS, it’s likely that some limited person-to-person spread will continue to occur. CDC Response CDC is closely monitoring this situation and is working with WHO. CDC has established an Incident Management Structure to optimize domestic and international coordination to this emerging public health threat. CDC has updated its interim travel health notice for this destination to provide information to people who may be traveling to Wuhan City and who may get sick. CDC laboratories currently have the capacity to detect 2019-nCoV by sequencing the virus and comparing the sequences against the genetic sequence that are publicly posted. CDC also is using the genetic sequence data provided by China to begin work on a test to detect this virus more easily. Currently, testing for this virus must take place at CDC. On January 17, CDC will begin entry screening of passengers on direct and connecting flights from Wuhan China to the three main ports of entry in the United States. On January 17, CDC issued an updated interim Health Alert Notice (HAN) Advisory to inform state and local health departments and health care providers about this outbreak. Other Available Resources The following resources are available with information on 2019-nCoV World Health Organization, Coronavirusexternal icon CDC Information on Coronaviruses CDC Travelers’ Health: Novel Coronavirus in China CDC Health Alert Network Advisory information for state and local health departments and health care providers https://www.cdc.gov/coronavirus/2019-nCoV/summary.html

Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV) in Wuhan, China Distributed via the CDC Health Alert Network January 17, 2020, 2030 ET (8:30 PM ET) CDCHAN-00426 Summary The Centers for Disease Control and Prevention (CDC) continues to closely monitor an outbreak of a 2019 novel coronavirus (2019-nCoV) in Wuhan City, Hubei Province, China that began in December 2019. CDC has established an Incident Management System to coordinate a domestic and international public health response. Coronaviruses are a large family of viruses. Some cause illness in people; numerous other coronaviruses circulate among animals, including camels, cats, and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) (https://www.cdc.gov/coronavirus/mers/index.html) and Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) (https://www.cdc.gov/sars/index.html). Chinese authorities report most patients in the Wuhan City outbreak have been epidemiologically linked to a large seafood and animal market, suggesting a possible zoonotic origin to the outbreak. Chinese authorities additionally report that they are monitoring several hundred healthcare workers who are caring for outbreak patients; no spread of this virus from patients to healthcare personnel has been reported to date. Chinese authorities are reporting no ongoing spread of this virus in the community, but they cannot rule out that some limited person-to-person spread may be occurring. China has reported that two of the patients have died, including one with pre-existing medical conditions. Chinese health officials publicly posted the genetic sequence of the 2019-nCoV on January 12, 2020. This will facilitate identification of infections with this virus and development of specific diagnostic tests. Thailand and Japan have confirmed additional cases of 2019-nCoV in travelers from Wuhan, China. It is possible that more cases will be identified in the coming days. This is an ongoing investigation and given previous experience with MERS-CoV and SARS-CoV, it is possible that person-person spread may occur. There is much more to learn about the transmissibility, severity, and other features associated with 2019-nCoV as the investigations in China, Thailand, and Japan continue. Additional information about this novel virus is needed to better inform population risk. This HAN Update provides a situational update and guidance to state and local health departments and healthcare providers that supersedes guidance in CDC’s HAN Advisory 424 distributed on January 8, 2020. This HAN Update adds guidance for evaluation of patients under investigation (PUI) for 2019-nCoV, prevention and infection control guidance, including the addition of an eye protection recommendation, and additional information on specimen collection. Background An outbreak of pneumonia of unknown etiology in Wuhan City was initially reported to WHO on December 31, 2019. Chinese health authorities have confirmed more than 40 infections with a novel coronavirus as the cause of the outbreak. Reportedly, most patients had epidemiological links to a large seafood and animal market. The market was closed on January 1, 2020. Currently, Chinese health authorities report no community spread of this virus, and no transmission among healthcare personnel caring for outbreak patients. No additional cases of infection with 2019-nCoV have been identified in China since January 3, 2020. On January 13, 2020 public health officials in Thailand confirmed detection of a human infection with 2019-nCoV in a traveler from Wuhan, China. This was the first confirmed case of 2019-nCoV documented outside China. On January 17, 2020 a second case was confirmed in Thailand, also in a returned traveler from Wuhan City. On January 15, 2020 health officials in Japan confirmed 2019-nCoV infection in a returned traveler from Wuhan City. These persons had onset dates after January 3, 2020. These cases did not report visiting the large seafood and animal market to which many cases in China have been linked. On January 11, 2020, CDC updated the level 1 travel health notice (“practice usual precautions”) for Wuhan City, Hubei Province, China with additional information (originally issued on January 6, 2020): https://wwwnc.cdc.gov/travel/notices/watch/novel-coronavirus-china. Recommendations for Healthcare Providers Limited information is available to characterize the spectrum of clinical illness associated with 2019-nCoV. No vaccine or specific treatment for 2019-nCoV infection is available; care is supportive. The CDC clinical criteria for a 2019-nCoV patient under investigation (PUI) have been developed based on what is known about MERS-CoV and SARS-CoV and are subject to change as additional information becomes available. Healthcare providers should obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness. CDC guidance for evaluating and reporting a PUI for MERS-CoV remains unchanged. Criteria to Guide Evaluation of Patients Under Investigation (PUI) for 2019-nCoV Patients in the United States who meet the following criteria should be evaluated as a PUI in association with the outbreak of 2019-nCoV in Wuhan City, China. The above criteria are also available at https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html. The criteria are intended to serve as guidance for evaluation. Patients should be evaluated and discussed with public health departments on a case-by-case basis if their clinical presentation or exposure history is equivocal (e.g., uncertain travel or exposure). Recommendations for Reporting, Testing, and Specimen Collection Healthcare providers should immediately notify both infection control personnel at their healthcare facility and their local or state health department in the event of a PUI for 2019-nCoV. State health departments that have identified a PUI should immediately contact CDC’s Emergency Operations Center (EOC) at 770-488-7100 and complete a 2019-nCoV PUI case investigation form available at https://www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdfpdf icon. CDC’s EOC will assist local/state health departments to collect, store, and ship specimens appropriately to CDC, including during afterhours or on weekends/holidays. At this time, diagnostic testing for 2019-nCoV can be conducted only at CDC. Testing for other respiratory pathogens should not delay specimen shipping to CDC. If a PUI tests positive for another respiratory pathogen, after clinical evaluation and consultation with public health authorities, they may no longer be considered a PUI. This may evolve as more information becomes available on possible 2019 nCoV co-infections. For biosafety reasons, it is not recommended to perform virus isolation in cell culture or initial characterization of viral agents recovered in cultures of specimens from a PUI for 2019-nCoV. To increase the likelihood of detecting 2019-nCoV infection, CDC recommends collecting and testing multiple clinical specimens from different sites, including all three specimen types—lower respiratory, upper respiratory, and serum specimens. Additional specimen types (e.g., stool, urine) may be collected and stored. Specimens should be collected as soon as possible once a PUI is identified regardless of time of symptom onset. Additional guidance for collection, handling, and testing of clinical specimens is available at https://www.cdc.gov/coronavirus/2019-nCoV/. Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019-nCoV Although the transmission dynamics have yet to be determined, CDC currently recommends a cautious approach to patients under investigation for 2019-nCoV (https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html). Such patients should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed, ideally an airborne infection isolation room if available. Healthcare personnel entering the room should use standard precautions, contact precautions, airborne precautions, and use eye protection (e.g., goggles or a face shield). Immediately notify your healthcare facility’s infection control personnel and local health department. Additional Infection Control Practices Resources Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html) Notes1Fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain fever-lowering medications. Clinical judgment should be used to guide testing of patients in such situations.2Close contact with a person who is under investigation for 2019-nCOV. Close contact is defined as— See CDC’s Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus (https://www.cdc.gov/coronavirus/2019-nCoV/infection-control.html). Data to inform the definition of close contact are limited. Considerations when assessing close contact include the duration of exposure (e.g., longer exposure time likely increases exposure risk) and the clinical symptoms of the person with novel coronavirus (e.g., coughing likely increases exposure risk as does exposure to a severely ill patient). Special consideration should be given to those exposed in healthcare settings. For More Information More information is available at at https://www.cdc.gov/coronavirus/2019-nCoV/index.html or by calling 800-CDC-INFO | (800-232-4636) | TTY: (888) 232-6348 The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations. DEPARTMENT OF HEALTH AND HUMAN SERVICES HAN Message Types Health Alert: Conveys the highest level of importance; warrants immediate action or attention. Health Advisory: Provides important information for a specific incident or situation; may not require immediate action. Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action. Info Service: Provides general information that is not necessarily considered to be of an emergent nature. ### This message was distributed to state and local health officers, state and local epidemiologists, state and local laboratory directors, public information officers, HAN coordinators, and clinician organizations. ### https://emergency.cdc.gov/han/han00426.asp

The CDC has released a HAN nationwide creating a case definition and updated guidance for clinicians and states.

China reports second death from Wuhan coronavirus as Thailand confirms another case Man in Wuhan, 69, dies two weeks after being admitted to hospital with the new strain Thailand reports second infected patient as countries across Asia continue to find confirmed or suspected cases Zhuang Pinghui in Beijing andJitsiree Thongnoi Published: 12:40pm, 17 Jan, 2020 TOP PICKS This Week in Asia Rise of Chinese-only prostitution surprises the Philippines 13 Jan 2020 Economy China hails phase one trade deal, but waits eight hours before posting text 16 Jan 2020 This Week in Asia Wuhan coronavirus: Asia battens down for Lunar New Year rush 10 Jan 2020 This Week in Asia Tokyo university fires professor over ‘will not hire Chinese’ tweet 16 Jan 2020 News Tsai says Beijing must face reality that Taiwan is ‘independent country’ 15 Jan 2020 News Chinese customs seizes 23kg of frozen breast milk from passenger 17 Jan 2020 This Week in Asia India and the US over China: Maldives picks a side in Indian Ocean 17 Jan 2020 News China’s trade deal with US ‘rewriting globalisation’, Europeans complain 17 Jan 2020 News EU’s former ambassador to South Korea suspect in China spy probe 17 Jan 2020 Economy Are the ‘good times’ over for China’s under pressure middle class? 16 Jan 2020 990 Wuhan Medical Treatment Centre, where people with the virus have been treated. Photo: Simon Song A second person has died after contracting the coronavirus found in the central Chinese city of Wuhan, while Thailand has confirmed a second case of the virus. A 69-year-old man died on Wednesday, Wuhan Health Commission said late on Thursday. He had shown symptoms on December 21 before being admitted to Wuhan Medical Treatment Centre – where all suspected cases of the viral pneumonia have been treated – on January 4 after his condition worsened, the commission’s statement said. The man had a heart muscle infection and tuberculosis when he was admitted to hospital, it said. It follows the death last week of a 61-year-old man, who had tested positive for the coronavirus and also had abdominal tumours and chronic liver disease. Wuhan outbreak: Thailand confirms first case of virus outside China The Wuhan health authority said that the city had reported no new cases as of Wednesday and that 12 of the 41 patients confirmed to have been infected had recovered and been discharged from hospital. Five were being treated as severe cases. Of the 763 people identified as having had close contact with the 41 patients, 644 were no longer under medical observation, it said. China’s second confirmed death from the coronavirus came as Thailand’s health ministry said it had detected a second case of the strain. SUBSCRIBE LUNAR Get updates direct to your inbox SUBMIT By registering, you agree to our T&C and Privacy Policy The Thai ministry said on Friday morning that a 74-year-old Chinese woman had been confirmed as being infected – the second case found in Thailand in less than a week. China identifies new coronavirus behind Wuhan pneumonia outbreak The second patient landed in Thailand on Monday, five days after a 61-year-old woman arriving in Bangkok from Wuhan was confirmed as the first case of the coronavirus outside China. Both women were being treated at Bamrasnaradura Infectious Diseases Institute, but Dr Sukhum Kanchanapimai, permanent secretary of the Thai health ministry, said at a press conference on Friday that there was no relation between the two cases. Sukhum said that more than 13,000 travellers from Wuhan had been screened at four Thai airports in the previous fortnight. He said the 61-year-old Chinese woman no longer had a fever but a second assessment was needed before she could be discharged. Wuhan pneumonia: how search for source unfolded 15 Jan 2020 Other Asian countries have reported confirmed or suspected cases of the coronavirus this week. On Thursday, Japanese health authorities said a Chinese man in his 30s living in Kanagawa prefecture, south of Tokyo, had tested positive for the new strain after visiting Wuhan and having close contact with a patient. The man was discharged on Wednesday. The same day, Singapore’s health ministry reported its third suspected case, saying it had quarantined a 69-year-old man who had been diagnosed with pneumonia after visiting Wuhan. Two Chinese nationals from Wuhan had previously been placed in quarantine in the city but later tested negative for the coronavirus. As a precautionary measure, two Chinese tourists from Wuhan were quarantined by Vietnam’s Ministry of Health after showing fever symptoms when they landed at Da Nang airport on Tuesday. The strain found in Wuhan, named 2019-nCoV by the World Health Organisation (WHO), is the latest of the seven known human coronaviruses. Of the six that were previously known, four caused only minor respiratory symptoms similar to those of a cold. The other two are severe acute respiratory syndrome (Sars) , which killed more than 700 people worldwide in 2002-03 after originating in China, and Middle East respiratory syndrome (Mers), which has killed more than 850 around the world since 2012. China coronavirus: five members of two families among those infected 16 Jan 2020 The new strain has been found in samples taken from Huanan Seafood Wholesale Market in Wuhan, where many of the patients had been vendors, handlers or frequent visitors. Some of those testing positive for the virus have denied ever going to the market, raising fears of limited human-to-human transmission. While the Chinese health authorities continued to look for the source of the infection, the WHO said it was unsurprising that there had been cases outside China and further cases could be found in other countries. “We are still in the early stages of understanding this new virus, where it came from and how it affects people,” a spokesperson told the South China Morning Post. “There are still many unknowns, and the situation may continue to evolve.” The organisation has not recommended any restrictions on travel or trade. Meanwhile, authorities in Wuhan have stepped up efforts to contain the spread of the virus by setting up temperature detectors in its international airport and three major railway stations. Those confirmed to have a body temperature of 38 degrees Celsius (100 degrees Fahrenheit) or above would be taken into temporary quarantine, the local transport authority said. Sign up now for our 50% early bird offer from SCMP Research: China AI Report. The all new SCMP China AI Report gives you exclusive first-hand insights and analysis into the latest industry developments, and actionable and objective intelligence about China AI that you should be equipped with. https://www.scmp.com/news/china/society/article/3046501/china-reports-second-death-wuhan-coronavirus

About the situation of prevention and control of pneumonia caused by new coronavirus infection in our city (January 17, 2020) Issuing authority: Wuhan City health committee | Published: 2020-01-18 00:13:26 | Hits: 1704 | Font Size: Da Zhong Small I. About the new cases On January 16, 2020, experts from the provinces and municipalities newly identified 4 cases of pneumonia with a new type of coronavirus infection based on the clinical manifestations, epidemiological history of the patients, and the results detected by the diagnostic kit issued by the country. All 4 patients were male. They developed symptoms from January 5 to 8, 2020, and were admitted to the hospital from January 8 to 13 for treatment. After treatment, the symptoms improved and the condition is stable. They have been transferred to Wuhan Jinyintan Hospital for centralized treatment. . Epidemiological investigations of the four new cases are underway, and close contacts are also being tracked. Second, the main measures for the prevention and control of the recent epidemic Further do a good job in the management of pre-inspection and triage of medical institutions at all levels and early diagnosis, and early detection, isolation and early treatment. The sanitary killing of the South China Seafood Wholesale Market, other agricultural fairs in the city and the living environment of related hospitals, patients and close contacts will continue. Carry out a patriotic health campaign with the theme of “renovating the environment, cleaning homes, and welcoming the festival” to promote a healthy lifestyle. 3. Related situation of close contacts of confirmed cases abroad Seventeen Thai close contacts of the first confirmed patients were tracked, all of which were included in medical observations. One of them had symptoms of low fever and mild cough, and has been transferred to designated hospitals for treatment. Personnel information, tracking of close family contacts is under way; 4 cases of close family contacts have been tracked for patients with confirmed cases notified in Japan, all of which have been included in medical observation. http://wjw.wuhan.gov.cn/front/web/showDetail/2020011809065

On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan (MHLW) reported an imported case of laboratory-confirmed 2019-novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China. The case-patient is male, between the age of 30-39 years, living in Japan. View the full article

Fourteen new confirmed cases were reported from 8 to 14 January in the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo. View the full article

Laboratory diagnostics for novel coronavirus WHO laboratory testing for 2019 novel coronavirus (pdf) 587 KB Several assays that detect the novel coronaviruses detected in Wutan, China have been recently developed, or are under development. This page is intended as a resource for laboratories wishing to test for coronavirus using an assay that already has some degree of validation. The protocols or SOPs posted here may be followed to create assays using commercially prepared oligonucleotide primers, probes and controls and paired with appropriate enzymes for reverse transcription real-time PCR. In some cases, the group that posts the protocol may also be willing to send reagents or reagent mixes prepared in their laboratories, with or without associated fees. Assay descriptions posted to this page may detect only the Wuhan strain of coronavirus, and some may also detect other strains (e.g. SARS-CoV) that are genetically similar. Detailed information will be provided on each assay protocol that is posted here. It is strongly recommended to contact the protocol provider institution if you obtain weak positive control results or unusual lab findings. Available protocols in order received. More protocols will be posted when they become available. Diagnostic detection of Wuhan coronavirus 2019 by real-time RT-PCR – Charité, Berlin Germany (pdf) 1535 KB Disclaimer: The order on the list is by country of the hosting institution and does not imply any preference of WHO. Neither the names of vendors or manufacturers included in the protocols are preferred/endorsed by WHO. The protocols have not yet been validated through WHO process. Assumptions: This procedure assumes a basic familiarity with rRT-PCR assays. Safety Information: Specimen processing should be performed in accordance with pertaining national biological safety regulations. Protocol use limitations: Optional clinical specimens for testing has not yet been validated. https://www.who.int/health-topics/coronavirus/laboratory-diagnostics-for-novel-coronavirus

[Wuhan Pneumonia] The Hospital Authority stated that 2 critically ill patients needed external life support treatment January 15, 2020 02:52 Report Lai Weiwen, Chief Infection Control Director of the Hospital Authority, said that all 41 patients in Wuhan had mild to moderate pneumonia, and no symptoms were found but the virus was positive. Lai Weiwen pointed out that 7 to 8 of them were in serious condition, severe patients were aged 40 to 78, and had kidney and liver failure at the same time, and 2 patients needed external life support treatment. Severe patients worsened after more than 10 days. Some patients were found to be infected with other viruses at the same time, and some patients were found to have secondary infections. Local judgments indicate that long-term chronic diseases, elderly people, and obesity are high-risk factors. Lai Weiwen pointed out that a specific rapid test was developed locally, and viruses were found in throat secretion, sputum and blood. The overall number of white blood cells in patients with pneumonia is normal or low, and the lymphocytes are lower than normal. This phenomenon has occurred in other pneumonia. In addition, the lungs of local pneumonia patients will be filled with inflammatory secretions. Patients are treated locally with supportive care, including oxygen and intravenous injections. Early treatment with Tamiflu was used locally, but it was discontinued after it was found not to be flu. Local preaching has a certain degree of utility. No local ribavirin or protease was used. Lai Weiwen pointed out that the discharge conditions for pneumonia patients in Wuhan were more than 10 days of fever reduction, and two samples that were 48 hours apart were negative for the virus. As for the deceased patient who became ill last month and died on January 9th, he is a chronically ill patient because his family objected that no autopsy was performed. https://www.singtao.ca/4037242/2020-01-14/news-【武漢肺炎】醫管局指2名重症病患需體外生命支持治療/?variant=zh-hk

[Wuhan Pneumonia] Wuhan South China Seafood Market Environmental Samples Detected Virus Couples and the Transmission of Humans or Objects Was Not Determined (16:26) Figure 2-1-The mainland authorities in the South China seafood market believed to be the source of pneumonia in Wuhan, environmental samples are against the new crown... (Profile picture) A pneumonia caused by a new coronavirus broke out in Wuhan. A government team from Hong Kong met with reporters this afternoon (15th) after a visit to Wuhan. Zhang Zhujun, director of the Department of Infectious Diseases of the Center for Health Protection, said that in the South China Seafood Market in Wuhan, which is suspected to be the source of the disease, environmental samples have been tested positive for the new coronavirus; a case of a couple infected by the mainland has not yet been identified. It is said that his wife became ill after he brought home items from the market and polluted the environment. She also pointed out that in addition to the couple's case, there was also a case of a three-person group in which the patients were a father and son and a son-in-law. Zhang Zhujun said that of the 41 patients in Wuhan, seven adults had visited the South China Seafood Market, which is believed to be the source of the disease. The remaining patients reported that they had not been there or were "too serious to ask", and most of the patients appeared on the market for sale. The area of aquatic seafood is not for those who sell game. She said that in addition to living together, the three patients in the three-person group also operated stores in the South China Seafood Market. The onset time was relatively short. It is believed that they may be more likely to be jointly exposed to the virus and less likely to be transmitted from person to person. However, she said that during the inspection, she did not ask in detail what the three patients were selling in the market. "The question was missed." Therefore, she was not sure. They could only infer that they were also selling aquatic products. A couple who was defined as a family group case, Zhang Zhujun initially only said that her husband developed the disease first, and his wife developed the disease "every few days". After questioning, she said that "there was no question to be clear". It is believed that the conversation between the mainland personnel occurred about 5 days apart. She also did not ask whether the condition of the wife, who was later affected, was more severe or milder than that of her husband. Zhang Zhujun pointed out that environmental samples from the South China seafood market, including the ground, table tops, and gloves, were positive for the new coronavirus, and the samples came from areas where aquatic products were sold. She said that although human-to-human cases of infected couples could not be ruled out at this stage, it is also possible that the husband brought home the virus-carrying items from the market, which polluted the home environment and infected his wife. https://news.mingpao.com/ins/港聞/article/20200115/s00001/1579076442327/【武漢肺炎】武漢華南海鮮市場環境樣本驗出病毒-夫婦發病未確定人傳人或物件傳播

[Wuhan Pneumonia] Health Protection Center: 70% of patients work in Wuhan seafood market. Society 16:27 2020/01/15 share it: PopularWei Junjie One King is released from prison 2020 luck Wuhan pneumonia delicious Tianwang Australian mountain fire fierce fire drama autumn and winter soup anti-cancer new direction child health ▲ The Hong Kong Government held a press conference to report on the Wuhan investigation. (Photo by Chen Guofeng) The pneumonia epidemic in Wuhan has continued. The government sent staff to Wuhan to inspect the local prevention and control and the situation of the epidemic. A press conference was held today (15th) to report the situation. 70% of patients work long hours in the South China Seafood Market in Wuhan. The relevant merchants mainly sell aquatic products, not game. However, it was revealed that in addition to aquatic products and birds, the market involved also includes bamboo rats, snakes, crickets, hedgehogs, etc. Game, but the quantity of game sold is unknown. Zhang Zhujun pointed out that the personnel of the health and health committee of the authorities detected viruses in the market environment, such as the location of the underground, countertops, and gloves, all of which were found near the aquatic stalls. She pointed out that the local staff did not collect only near the aquatic stalls, but the virus was only found in the aquatic stalls. As for the survival time of the virus, it is still to be studied. Because it is not an animal sample, the health committee failed to pinpoint the source of the virus. She also pointed out that Mainland experts have formulated rapid tests for new coronaviruses and have successively distributed them to provinces and cities across the country. Hong Kong has also obtained relevant nucleic acid reagents and is in the process of developing rapid tests for the viruses. When asked about a case in Thailand that had not been diagnosed in the South China Seafood Market but had been to other wet markets in Wuhan, Zhang Zhujun said that the authorities were still investigating the location of the market in question. The Government also said that the confirmed cases involved a couple, but the incidence of relatively late husband, wife, husband to have a chance of infection, and transmits wife, so I do not exclude person to person, please Air: [pneumonia] Government Wuhan: Wuhan pneumonia Does not rule out throat, sputum and blood in patients with limited human-to-human transmission Editor-in-chief: Chen Ziqian https://topick.hket.com/article/2542847/【武漢肺炎】衞生防護中心 ：7成患者於武漢海鮮市場工作　亦有售竹鼠刺蝟等野味

Novel Coronavirus – Thailand (ex-China) Disease outbreak news 14 January 2020 On 13 January 2020, the Thailand’s Ministry of Public Health (MoPH) reported the first imported case of lab-confirmed novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China. The case is a 61-year-old Chinese woman living in Wuhan City, Hubei Province, China. On 5 January 2020, she developed fever with chills, sore throat and headache. On 8 January 2020, she took a direct flight to Thailand from Wuhan City together with five family members in a tour group of 16 people. The traveler with febrile illness was detected on the same day by thermal surveillance at Suvarnabhumi Airport (BKK), Thailand, and was hospitalized the same day. After temperature check and initial assessment, she was transferred to the hospital for further investigations and treatment. The patient’s full exposure history is under investigation. She reported a history of visiting a local fresh market in Wuhan on regular basis prior to the onset of illness on 5 January 2020; however, she did not report visiting the Huanan South China Seafood Market from where most of the cases were detected. Samples tested positive for coronaviruses by reverse transcriptase-polymerase chain reaction (RT-PCR) on 12 January 2020. The genomic sequencing analysis performed by Emerging Infectious Diseases Health Science Center, the Thai Red Cross Society (EID-TRC) and the Thai National Institute of Health (Thai NIH), Department of Medical Sciences confirmed that the patient was infected with the novel coronavirus (2019-nCoV) which was isolated in Wuhan, China (for more information, please see the Disease Outbreak News published on 12 January 2020). As of this writing, the patient is in a stable condition and in hospital. Public health response The Ministry of Public Health Thailand implemented measures for screening travelers from Wuhan city on 3 January 2020 at Suvarnabhumi Airport, Don Mueang, Phuket and Chiang Mai airports, and activated enhanced surveillance at public and private hospitals. Since the identification of the case on 5 January 2019, Thai health authorities have taken the following measures: Eight febrile travelers were detected by a thermo-scan at Suvarnabhumi Airport. They have been isolated and tested, and none of them have been confirmed with 2019-nCov infection. A total of 182 contacts were identified and are being monitored. The contacts were fellow passengers as well as members of the same tour group. Only one contact developed respiratory symptoms and the PCR test of throat swab yields positive for Respiratory Syncytial Virus (RSV). Risk communication guidance has been shared with the public and a hotline has been established by the Department of Disease Control for people returning from the affected area in China with related symptoms. The Ministry of Public Health of Thailand has international-standard diagnosis and medical care, and is closely coordinating with WHO and related departments for the potential response measures. WHO risk assessment This is the first exported case of novel coronavirus from Wuhan city, China. Since the initial report of cases in Wuhan city on 31 December 2019, 41 cases have a preliminary diagnosis of 2019-nCoV infection, including 1 death in a person with severe underlying medical conditions (for more information, please see the Disease Outbreak News published on 12 January 2020). As the traveler did not report having visited the market linked to most of the other cases, it is vital that investigations continue to identify the source of infection. To date, China has not reported any cases of infection among healthcare workers or contacts of the cases. Based on the available information there is no clear evidence of human-to-human transmission. No additional cases have been detected since 3 January 2020 in China. Additional investigation is needed to ascertain the presence of human-to-human transmission, modes of transmission, common source of exposure and the presence of asymptomatic or mildly symptomatic cases that are undetected. It is critical to review all available information to fully understand the potential transmissibility among humans. WHO advice Health authorities should work with travel, transport and tourism sectors to provide travelers with information to reduce the general risk of acute respiratory infections via travel health clinics, travel agencies, conveyance operators and at points of entry. WHO has provided interim guidance for novel coronaviruses . WHO advises against the application of any travel or trade restrictions on Thailand based on the information currently available on this event. For more information on novel coronavirus, please see: Technical interim guidance for novel coronavirus, WHO WHO travel advice for international travel and trade in relation to the outbreak of pneumonia caused by a new coronavirus in China Thailand Ministry of Public Health situation update on novel coronavirus (in Thai) Wuhan Municipal Health Commission's briefing on the pneumonia epidemic situation, (in Chinese) https://www.who.int/csr/don/14-january-2020-novel-coronavirus-thailand-ex-china/en/