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2019-nCoV 61F Patient Visited Other Markets In Wuhan


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Tourist from Wuhan (61F) did not visit Seafood Market with 2019-nCoV, but visited other wet markets prior to trip to Bangkok:

according to inquiries, this patient did not go to the market that the Chinese authorities ordered to close. But going to other markets... อ่านต่อที่ : https://www.dailynews.co.th/politics/751794

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'Diary' encourages patients with coronary infections. Revealing more Chinese patients
"Diary" encourage Patients with a new strain of corona. Explanation of the cause of not leaving home because still detecting the genetic material While S. Bamrat Accepting 3 additional Chinese patients. Preliminary examination has not been found.
Tuesday 14 January 2020 at 14.03 hrs.

On 14 January at Bamrasnaradura Institute, Mr. Anutin Charnverakul, Deputy Prime Minister and The Minister of Public Health visited and inspected Chinese patients infected with the new strain of corona virus. Incoming treatment At the Bharat Institute on January 8, ago At the same time, there was also talk and encouragement with relatives of this Chinese patient. Including encouraging patients and asking to be patient.

The relatives thanked the Thai government for providing good care and providing accommodation before they were admitted to the Bamras Institute. There is still concern because patients have chronic illnesses, such as high blood pressure and carry drugs. Almost come to an end, but at the moment, the Bamras Institute After having examined and provided blood pressure medication, the patients were relieved. 

After that, the relatives had conversations through the intercom with the patients in the separation room, encouraging the patients to heal. Don't worry. Since the Thai authorities now take good care However, the patients responded that they wanted to go home and were worried about their accompanying children, as they were young and therefore worried that they could not eat much. May cause illness.

Mr Anutin said that from the visit, this Chinese patient has been reported to have no fever. Depending on eating a little and having a little stress because having to live in a separation room alone, not going anywhere However, according to inquiries, this patient did not go to the market that the Chinese authorities ordered to close. But going to other markets Initially, the patient has no fever and is considered to be healed. But still have to wait for the lab test results again 

For the Chinese patients admitted at Bamras Institute, now 3 more are just normal flu. But stressed because he was in the separation room Some people would like to eat fried chicken. We try to provide to help him reduce stress. At the moment, it is under further examination. If there is no virus that we are monitoring, we will go back home. If wanting to continue traveling without any problems 

Reiterate the public, do not be alarmed During this period, if you can't avoid going to Wuhan, please don't go. In Thailand, it may be necessary to avoid areas with a lot of people. Anyone who sneezing, having a runny nose can take care of themselves as normal. And in the nature of humans, when infected, the body will build immunity to protect the body, there will be drugs or vaccines to prevent this disease or may have to wait. The important thing is if you have a fever There is a risk, please come and see a doctor as soon as possible to treat everything, everything that Thailand does. Is to follow the procedures of the World Health Organization. Please be comfortable.

Dr. Suwanchai Wattanayingcharoenchai, MD. Director-General of the Department of Disease Control Said that Chinese patients currently receiving treatment at Bamrasnaradura Institute have improved their symptoms without fever, but due to the presence of the coronal virus genetic material in the specimen, it is still unable to release home. Yes, because we currently have restrictions on the data of the new strain of corona virus, so we cannot release the risk of infecting people in public areas. We must take the preventive measures of the highest disease equal to the MERS infection. However, it is expected that patients may be able to leave the separation room today. 

Dr. Suwannachai continues, “The genetic material, if compared, is the same as humans after life. Can still detect DNA Therefore, even if the corona infection is the same Even if the infection is dead, we can still detect the genetic material. However, at this time we have collected samples. Infection because to find important information relevant '

Dr. Aphichat Wachiraphan, Director of Bamras Institute Said that at this time the institute Also received 3 Chinese people to be taken care of in the separation room to monitor the coronary infection. Because found to have fever The first is a 6-year-old child who came to look after at the Bamras Institute on January 12, while the other 2 are 5-year-old children and an elderly aged 75 years come to take care on 13 Jan ago, specimens have been collected for laboratory tests at the Department of Medical Sciences and Emerging Disease Health Science Center. Faculty of Medicine Chulalongkorn University Expected to know the test results soon.... อ่านต่อที่ : https://www.dailynews.co.th/politics/751794

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Health minister visits Chinese tourist with coronavirus

Recovering patient anxious to go home but caution essential, says chief of Infectious Diseases Institute where three others under observation

7 mins ago
 1 minute read
82397785_4045764858783172_63942903590184
 Photo Credit: Public Health Ministry

A 61-year-old Chinese woman who has become the first person to receive treatment in Thailand for the coronavirus newly identified in Wuhan in her homeland had a visit this week from Deputy Prime Minister Anutin Charnvirakul.

Anutin, who is also Minister of Public Health, on Tuesday paid the morale-boosting visit at Nonthaburi’s Bamrasnaradura Infectious Diseases Institute (BIDI), where three other tourists from Wuhan are being monitored for signs of the disease.

The woman, whose name has not been released, is said to be recovering and was previously due to be moved out of the institute on Monday (January 13). But Department of Disease Control (DDC) director-general Dr Suwannachai Wattanayingcharoenchai said she was asked to remain in quarantine after traces of coronavirus DNA were found in lab samples.

Anutin said she would be going home “soon”, once protocols for preventing transnational epidemics had been met. At least two labs – one at the Department of Medical Sciences and the other at Chulalongkorn University’s Faculty of Medicine – are testing the samples further.

Anutin said the woman eats little and is under stress, having been alone in quarantine since last Wednesday. He told her he understood her frustration but urged her to try and remain calm.

82459272_4045763628783295_63129801469995
Photo Credit: Public Health Ministry

The minister presented a gift basket to her relatives, who in turn thanked officials for taking care of them.

The patient, speaking through an intercom, said she wanted to go home and was worried about the young relatives travelling with her.

Dr Suwannachai explained that health authorities have to proceed cautiously since so little is known about the coronavirus or its ability to spread. The same precautionary measures are being applied as with Middle East respiratory syndrome (MERS), first identified in 2012.

He said the woman would likely be moved from the Airborne Infection Isolation Room later Tuesday.

BIDI director Dr Apichat Wachirapan said three other Chinese travellers were also in the isolation room – a six-year-old admitted on Sunday and a five-year-old and a 75-year-old admitted on Monday.

Although they appear to have the common flu, he said, samples from all three are being lab-tested as a precaution.

Anyone returning to Thailand from the Wuhan area in central Hubei province and experiencing fever, sore throat, coughing, a runny nose or difficulty breathing is urged to seek medical attention or call the DDC hotline, 1422.

https://www.thailandtoday.co/health-minister-visits-chinese-tourist-with-coronavirus/

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The cluster of the novel coronavirus was initially reported on Dec. 31. Since then, most cases were found to involve workers at or frequent visitors to Wuhan's Huanan Seafood Wholesale Market, which has been temporarily closed while environmental disinfection is carried out.

 

http://www.chinadaily.com.cn/a/202001/14/WS5e1d554fa310128217270cc6.html

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The woman, 61, who was confirmed by Thai authorities to have the new virus, had not visited the now-closed mainland seafood market associated with the outbreak, the Post learned on Tuesday.

The discovery raised fears that the woman, the first confirmed case outside China, could have caught the virus in Wuhan at other markets, which she was understood to have visited.

https://www.scmp.com/news/hong-kong/health-environment/article/3046030/wuhan-pneumonia-chinese-tourist-thai-case-did-not

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Wuhan pneumonia: Chinese tourist in Thai case did not visit outbreak-linked market, while scientists say virus not likely to prove as deadly as Sars

  • Woman, 61, could have caught the virus in Wuhan at other markets, as her infection has no relation to Huanan Seafood Wholesale Market
  • Chinese researchers released the genome sequence of the coronavirus over the weekend and one researcher said it was ‘not particularly close to Sars’
SCMP
 
Elizabeth Cheung,Jitsiree Thongnoi,Stephen Chen in Beijing,Zhuang Pinghui in Beijing

 

 
 
The Huanan Wholesale Seafood Market has been closed since January 1. Photo: AFPThe Huanan Wholesale Seafood Market has been closed since January 1. Photo: AFP
The Huanan Wholesale Seafood Market has been closed since January 1. Photo: AFP
 

The new virus behind recent pneumonia cases in Wuhan is unlikely to cause a widespread, deadly epidemic like Sars, scientists say, as revelations that a Chinese tourist in Thailand had not visited the market linked to the outbreak raised fears of a potential spread of the disease.

The woman, 61, who was confirmed by Thai authorities to have the new virus, had not visited the now-closed mainland seafood market associated with the outbreak, the Post learned on Tuesday.

The discovery raised fears that the woman, the first confirmed case outside China, could have caught the virus in Wuhan at other markets, which she was understood to have visited.

That came as Reuters quoted the World Health Organisation as saying there had been “limited” human-to-human transmission of the new coronavirus, but WHO spokesman Tarik Jasarevic told the Post in an email reply that “there has been no evidence” of such an occurrence.

 
 

Hong Kong’s Chief Executive Carrie Lam Cheng Yuet-ngor said an expert meeting would be held on Wednesday to discuss the latest development of the disease, upon the return of a team of local health officials who visited Wuhan to gain first-hand knowledge.

The virus has struck at least 41 people in Wuhan. Photo: Jun Mai
The virus has struck at least 41 people in Wuhan. Photo: Jun Mai

When asked why details of the two-day visit were not disclosed to the public, Lam said: “The trip, organised by the county's National Health Commission, invited not only delegates from Hong Kong, but also from Macau and Taiwan to understand how the mainland authorities have been handling the disease. It has not been kept secret.”

The tourist, who travelled to Bangkok from the city in Hubei province, was found to have a fever on arrival at Suvarnabhumi Airport on January 8 and was hospitalised that day. She was   to have been infected with the new coronavirus strain, which has struck at least 41 people in Wuhan and killed one.
 

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Dr Sopon Eamsiritavorn, from the Thai Ministry of Public Health’s Department of Disease Control, told the Post it appeared the woman’s infection was not related to the Huanan Seafood Wholesale Market, which Chinese authorities had linked to the Wuhan outbreak and had been closed since January 1.

 

“It seems there’s no relation with the market,” he said, when asked whether the patient had visited the outbreak site.

A source familiar with the details of the case said the woman did not visit the market.

 

“But she did visit other markets before going to Thailand,” the source said.

Detailed investigations into the case were in progress.

Hong Kong’s Centre for Health Protection said on Tuesday that it had been closely monitoring the case in Thailand.

Professor David Hui Shu-cheong, a respiratory medicine expert from Chinese University, had previously said that if the woman had not been to the seafood market, it would suggest that the virus had spread to other parts of Wuhan.

Details on investigations in Thailand could be found by following reports from officials there, Jasarevic said.

Between December 31 and Tuesday, Hong Kong had reported 71 suspected cases, with 60 of them cleared and discharged.

Meanwhile, scientists who have studied the genome of the virus behind the recent outbreak believe it is unlikely to cause a widespread, deadly epidemic like Sars. The unnamed virus has been identified as a new strain of coronavirus, the same family of viruses as severe acute respiratory syndrome.

Chinese scientists released the virus’s genome sequence to the public on Saturday, and researchers who analysed the sequence said it was a distant relative of Sars and therefore unlikely to be as deadly.

“The description given by the Chinese scientists is accurate. This virus is not SARS-CoV and not particularly close by many standards. Based on previous research … the virus is likely attenuated in terms of disease,” said Vineet Menachery, an assistant professor with the University of Texas Medical Branch’s department of microbiology and immunology in Galveston.

Menachery analysed the genome sequence and found it had only about 73 per cent similarity to Sars.

“In certain patients, older people or people with comorbidities, the virus may cause more damage, but is not nearly problematic as the epidemic SARS-CoV strain,” he added.

The market at the centre of the outbreak has now been closed. Photo: AFP
The market at the centre of the outbreak has now been closed. Photo: AFP

Ralph Baric, a coronavirus researcher at the University of North Carolina, Chapel Hill, came up with a similar conclusion after his team tried to replicate the virus in their laboratory based on the genetic code provided by Chinese scientists.

Of the four known Sars-related bat viruses capable of infecting humans, this one was the most distant from Sars itself, Baric told Science.

Baric also praised the speed of the response to the virus. “One of the things that’s sad is that the public doesn’t realise how incredibly competent the public health and the basic science community are at going from a newly discovered virus to a tremendous amount of capacity to trace and try to control its spread,” he told the journal.

Xu Jianguo, head of an evaluation committee advising the Chinese government on the emerging virus, also told Science in an interview published on Friday that no new patients had appeared since January 5. “It’s good news. People fear something like Sars in 2003, but this is a different case. The outbreak is limited,” he said.

There had been worries about the transparency of the Chinese government's handling of the outbreak but now that concern had largely been dismissed, according to the Science report.

Dr Hu Ming, deputy director of the department of epidemiology and health statistics at Central South University in Changsha, said she had been following the situation in Wuhan closely and had not found any signs of a cover-up after the health authorities first announced the outbreak on December 31.

“There was lots of work to do. Sequencing, for instance, would take time. The data must be verified carefully before release. I believe they are following strict, professional procedures,” she said.

“We have learned a painful lesson from Sars.”

Scientists say the virus is a distant relation of Sars. Photo: AFP
Scientists say the virus is a distant relation of Sars. Photo: AFP

Feng Zijian, deputy director of the Chinese Centre for Disease Control and Prevention, told China Central Television on Tuesday that the genome sequence of the coronavirus had showed it was “neither Sars nor Mers” (Middle East respiratory syndrome) and the difference in their genome sequences was “very big”.

Sars infected more than 8,000 people, killing over 700 globally after originating in China in 2003.

In a Sunday statement, the WHO said the outbreak was probably associated with one seafood market in Wuhan, which had since been closed.

It also said it was “reassured of the quality of the ongoing investigations and the response measures implemented in Wuhan, and the commitment to share information regularly”.

The new virus was isolated, analysed and its genetic information released to the world 10 days after the confirmed outbreak. In 2003, it took more than three months to do the same with Sars.

https://www.scmp.com/news/hong-kong/health-environment/article/3046030/wuhan-pneumonia-chinese-tourist-thai-case-did-not

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Published Date: 2020-01-14 21:22:35
Subject: PRO/AH/EDR> Novel coronavirus (04): China (HU), Thailand ex China, WHO
Archive Number: 20200114.6889527

NOVEL CORONAVIRUS (04): CHINA (HUBEI), THAILAND ex CHINA, WHO
*************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Thailand ex China, no contact with implicated Seafood Market
[2] Thailand ex China (Wuhan) - WHO DON 14 Jan 2020
[3] Wuhan Public Health Commission update 14 Jan 2020
[4] Potential for International air travel spread

******
[1] Thailand ex China, no contact with implicated Seafood Market
Date: 14 Jan 2020
Source: South China Morning Post [edited]
https://www.scmp.com/news/hong-kong/health-environment/article/3046030/wuhan-pneumonia-chinese-tourist-thai-case-did-not


The new virus behind recent pneumonia cases in Wuhan is unlikely to cause a widespread, deadly epidemic like SARS [Severe acute respiratory syndrome], scientists say, as revelations that a Chinese tourist in Thailand had not visited the market linked to the outbreak raised fears of a potential spread of the disease.

The woman, 61, who was confirmed by Thai authorities to have the new virus, had not visited the now-closed mainland seafood market associated with the outbreak, the Post learned on Tuesday [14 Jan 2020].

The discovery raised fears that the woman, the 1st confirmed case outside China, could have caught the virus in Wuhan at other markets, which she was understood to have visited. That came as Reuters quoted the World Health Organisation as saying there had been "limited" human-to-human transmission of the new coronavirus, but WHO spokesman Tarik Jasarevic told the Post in an email reply that "there has been no evidence" of such an occurrence.

Hong Kong's Chief Executive Carrie Lam Cheng Yuet-ngor said an expert meeting would be held on Wednesday [15 Jan 2020] to discuss the latest development of the disease, upon the return of a team of local health officials who visited Wuhan to gain 1st-hand knowledge.

When asked why details of the 2-day visit were not disclosed to the public, Lam said: "The trip, organised by the county's National Health Commission, invited not only delegates from Hong Kong, but also from Macau and Taiwan to understand how the mainland authorities have been handling the disease. It has not been kept secret."

The tourist, who travelled to Bangkok from the city in Hubei province, was found to have a fever on arrival at Suvarnabhumi Airport on [8 Jan 2020] and was hospitalised that day. She was confirmed on Sunday [12 Jan 2020] to have been infected with the new coronavirus strain, which has struck at least 41 people in Wuhan and killed one.

Dr Sopon Eamsiritavorn, from the Thai Ministry of Public Health's Department of Disease Control, told the Post it appeared the woman's infection was not related to the Huanan Seafood Wholesale Market, which Chinese authorities had linked to the Wuhan outbreak and had been closed since [1 Jan 2020]. "It seems there's no relation with the market," he said, when asked whether the patient had visited the outbreak site. A source familiar with the details of the case said the woman did not visit the market. "But she did visit other markets before going to Thailand," the source said.

Detailed investigations into the case were in progress.

Hong Kong's Centre for Health Protection said on Tuesday [14 Jan 2020] that it had been closely monitoring the case in Thailand.

Professor David Hui Shu-cheong, a respiratory medicine expert from Chinese University, had previously said that if the woman had not been to the seafood market, it would suggest that the virus had spread to other parts of Wuhan.

Details on investigations in Thailand could be found by following reports from officials there, Jasarevic said.

Between [31 Dec 2019] and Tuesday [14 Jan 2020], Hong Kong had reported 71 suspected cases, with 60 of them cleared and discharged.

Meanwhile, scientists who have studied the genome of the virus behind the recent outbreak believe it is unlikely to cause a widespread, deadly epidemic like SARS. The unnamed virus has been identified as a new strain of coronavirus, the same family of viruses as severe acute respiratory syndrome [SARS].

Chinese scientists released the virus's genome sequence to the public on Saturday [11 Jan 2020], and researchers who analysed the sequence said it was a distant relative of SARS and, therefore, unlikely to be as deadly.

"The description given by the Chinese scientists is accurate. This virus is not SARS-CoV and not particularly close by many standards. Based on previous research ... the virus is likely attenuated in terms of disease," said Vineet Menachery, an assistant professor with the University of Texas Medical Branch's department of microbiology and immunology in Galveston. Menachery analysed the genome sequence and found it had only about 73 per cent similarity to SARS. "In certain patients, older people or people with comorbidities, the virus may cause more damage but is not nearly as problematic as the epidemic SARS-CoV strain," he added.

Ralph Baric, a coronavirus researcher at the University of North Carolina, Chapel Hill, came up with a similar conclusion after his team tried to replicate the virus in their laboratory based on the genetic code provided by Chinese scientists.

Of the 4 known SARS-related bat viruses capable of infecting humans, this one was the most distant from SARS itself, Baric told Science.

Baric also praised the speed of the response to the virus. "One of the things that's sad is that the public doesn't realise how incredibly competent the public health and the basic science community are at going from a newly discovered virus to a tremendous amount of capacity to trace and try to control its spread," he told the journal.

Xu Jianguo, head of an evaluation committee advising the Chinese government on the emerging virus, also told Science in an interview published on Friday [10 Jan 2020] that no new patients had appeared since [5 Jan 2020]. "It's good news. People fear something like SARS in 2003, but this is a different case. The outbreak is limited," he said.

There had been worries about the transparency of the Chinese government's handling of the outbreak, but now that concern had largely been dismissed, according to the Science report. Dr Hu Ming, deputy director of the department of epidemiology and health statistics at Central South University in Changsha, said she had been following the situation in Wuhan closely and had not found any signs of a cover-up after the health authorities 1st announced the outbreak on [31 Dec 2020]. "There was lots of work to do. Sequencing, for instance, would take time. The data must be verified carefully before release. I believe they are following strict, professional procedures," she said. "We have learned a painful lesson from SARS."

Feng Zijian, deputy director of the Chinese Centre for Disease Control and Prevention, told China Central Television on Tuesday [14 Jan 2020] that the genome sequence of the coronavirus had showed it was "neither SARS nor MERS" (Middle East respiratory syndrome) and the difference in their genome sequences was "very big.."

SARS infected more than 8000 people, killing over 700 globally after originating in China in 2003.

In a Sunday [12 Jan 2020] statement, the WHO said the outbreak was probably associated with 1 seafood market in Wuhan, which had since been closed. It also said it was "reassured of the quality of the ongoing investigations and the response measures implemented in Wuhan, and the commitment to share information regularly."

The new virus was isolated, analysed and its genetic information released to the world 10 days after the confirmed outbreak. In 2003, it took more than 3 months to do the same with SARS.

[Bylines: Elizabeth Cheung, Jitsiree Thongnoi, Stephen Chen in Beijing, Zhuang Pinghui in Beijing]

--
Communicated by:
ProMED-mail Rapporteur Kunihiko

[For more discussion on these findings, see comment following section [2]. - Mod.MPP]

******
[2] Thailand ex China (Wuhan) - WHO DON 14 Jan 2020
Date: 14 Jan 2020
Source: WHO Emergencies preparedness, response, Disease outbreak news [edited]
https://www.who.int/csr/don/14-january-2020-novel-coronavirus-thailand-ex-china/en/


On [13 Jan 2020], the Thailand's Ministry of Public Health (MoPH) reported the 1st 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 Jan 2020], she developed fever with chills, sore throat and headache. On [8 Jan 2020], she took a direct flight to Thailand from Wuhan City together with 5 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 Jan 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 Jan 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 Jan 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 Jan 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 Jan 2020], Thai health authorities have taken the following measures:

- 8 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 1 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 1st exported case of novel coronavirus from Wuhan city, China. Since the initial report of cases in Wuhan city on [31 Dec 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 Jan 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 Jan 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 https://www.who.int/health-topics/coronavirus
- WHO travel advice for international travel and trade in relation to the outbreak of pneumonia caused by a new coronavirus in China https://www.who.int/ith/2020-0901_outbreak_of_Pneumonia_caused_by_a_new_coronavirus_in_C/en/
- Thailand Ministry of Public Health situation update on novel coronavirus (in Thai) https://ddc.moph.go.th/viralpneumonia/
- Wuhan Municipal Health Commission's briefing on the pneumonia epidemic situation, (in Chinese) http://wjw.wuhan.gov.cn/front/web/list2nd/no/710

--
Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[There are many interesting points and findings related to this imported case of the Wuhan novel CoV (I'll use Wuhan nCoV for the time being) into Thailand.

- 1st, an individual infected with the Wuhan nCoV, travelled outside of Wuhan and was detected on arrival at the Suvarnabhumi Airport in Bangkok via fever screening. Thoughts: the virus is travelling with the multitude of people who are travelling from Wuhan (see section [4] below).

- 2nd, the date of onset of illness was 5 Jan 2020, Thoughts: The most recent date of onset in the original cluster of 41 individuals was 2 Jan 2020, so there may be continued transmission.

- 3rd, the patient did not visit the Huanan South China Seafood Market but did visit a "local fresh market" on a regular basis prior to illness onset. Thoughts: Transmission was not associated with exposure in the Huanan South China Seafood Market. Possible other sources could involve exposure to host/intermediary host (as yet undefined/unidentified) at another fresh market (presume fresh market means wet market), or possible exposure to an individual who was infected with the Wuhan nCoV, with limited person-to-person transmission. In either event, it is clear that this virus is not isolated to the Huanan South China Seafood Market in Wuhan City. Heightened concerns come with the upcoming Chinese New Year celebrations, with major population movement, and major food preparations, which may include major exposures to wet markets in Wuhan as well as elsewhere in China. Hence the need for rapid identification of the host and possible intermediary hosts.

- 4th, clinical presentation was fever, sore throat, headache. Thoughts: a mild upper respiratory infection presentation not always presenting to the health sector for etiology of testing, and if seen in an urgent care center in the USA, would most likely be tested for Group A streptococcal infection and not investigated further.

- 5th, sequencing of the virus confirmed it was the Wuhan nCoV. Thoughts: There isn't further information to know whether it was identical to the isolates from the Huanan South China Seafood Market or whether there were differences suggesting a separate introduction (from host to humans)

As for comparisons with SARS, it is too early to draw conclusions with 20/20 hindsight on this virus and the clinical and epidemiological presentations. An alarmist point of view could mention that the presumed index case of SARS-CoV infection worked with contact with the implicated civet cats and had date of onset of illness on 22 Nov 2002. The 1st information about the outbreak in Guangdong with "scores of cases including medical personnel dying" was on 10 Feb 2003, and retrospective timeline demonstrated a slow start to the outbreak with the "explosion" happening in January 2003, approximately 6-8 weeks after the index case illness, and 3-4 weeks before news of the outbreak leaked outside of China. Hence, we've potentially identified the index case here with date of onset on 8 Dec 2019, and we are now 4.5 weeks following this index case, potentially not enough time for genetic changes that might produce a more virulent clinical picture in some individuals and might arm the virus with human-to-human transmission capabilities.

The optimistic point of view recognizes the transparency and openness of China in terms of releasing information on the initial cluster of cases, the speed in which the virus was identified (less than 1 month vs. 4-5 months for SARS-CoV), and the international collaboration that is occurring at the very near start of this newly identified viral threat. With the given level of cooperation and collaboration, one hopes that any changes in virulence and transmissibility of the virus will be identified early and control measures will be implemented accordingly.

One key measure that needs to be in place sooner rather than later is the treatment and response of medical personnel to febrile respiratory illness presentations and the use of respiratory precautions at all points of contact in the medical setting.

One should be very cautious about predictions at this stage.

A map of Thailand showing provinces can be found at https://legacy.lib.utexas.edu/maps/middle_east_and_asia/thailand_admin-2013.jpg.

HealthMap/ProMED-mail maps:
China: http://healthmap.org/promed/p/5294
Thailand: http://healthmap.org/promed/p/151 - Mod.MPP]

******
[3] Wuhan Public Health Commission update 14 Jan 2020
Date: 14 Jan 2020
Source: Wuhan Public Health Commission [in Chinese, mach. trans. edited]
http://wjw.wuhan.gov.cn/front/web/showDetail/2020011509040


Tuesday, [14 Jan 2020], National People's Health Commission of Hubei Province, Wuhan Municipal People's Government

Questions and answers on pneumonia outbreak of new coronavirus infection ([14 Jan 2020])
Issuing authority: Wuhan City health committee

1. Recently, a tourist from Wuhan was diagnosed with a new coronavirus-infected pneumonia patient in Thailand. Please introduce the situation.

Response: On [13 Jan 2020], Thailand reported a case of pneumonia with a new coronavirus infection from Wuhan. The city attaches great importance to timely investigation. The patient is a citizen of our city and is now receiving treatment in Thailand with a stable condition. At the same time, the health department conducted medical observations on all close contacts of the patient found, and there is no abnormal performance at present.

2. At present, in order to detect pneumonia cases of new coronavirus infection as early as possible, what measures have been taken in our city?

Response: After the outbreak, the city quickly carried out screening of relevant cases in all medical institutions in the city. Up to now, the expert group has integrated the clinical manifestations, epidemiological history, and laboratory test results of patients to determine new cases of pneumonia caused by coronavirus. [There were 41 cases identified]. Recently, our city has further strengthened case monitoring and search. On the one hand, we continue to do a good job of monitoring for pneumonia of unknown cause, and on the other hand, we carry out case searches at various medical institutions at all levels in our city in order to detect cases early.

3. As of now, has there been any case of human-to-human transmission?

Response: Existing survey results show that clear evidence of human-to-human transmission has not been found, and the possibility of limited human-to-human transmission cannot be ruled out, but the risk of continued human-to-human transmission is low. Further research is currently underway combining clinical and epidemiological data.

4. Has a family clustering case been found?

Response: Among the 41 cases currently diagnosed, one was found to be clustered in the family. The husband and wife developed the disease, with the husband having developed the disease first. He was an employee of the South China Seafood Wholesale Market. His wife denied a history of South China Seafood Wholesale Market exposure.

5. What are close contacts? Why medical observation of close contacts for 14 days? If close contacts develop symptoms during the observation period, how can they be diagnosed and diagnosed?

Response: At present, the close contacts defined in this epidemic are those who live with patients, work and study in the same room, live in the same room, and who have not taken effective protective measures during the diagnosis and treatment of cases. In addition, laboratory testing personnel, other patients or accompanying staff in the ward, other contact situations determined by disease control professionals in the same transportation with the patient and close contact with the person.

With reference to the incubation period of diseases caused by other coronaviruses, information about this new coronavirus case, and current prevention and control practices, the medical observation period for close contacts is set to 14 days, and home medical observations are made for close contacts. During the observation period, once the close contacts are found to have abnormal clinical manifestations such as fever and cough, the close contacts will be sent to the designated medical institution for investigation, diagnosis and treatment in a timely manner.

6. What are the characteristics of the epidemic that have been found so far? What is the development trend of the epidemic?

Response: Of the 41 cases diagnosed, most were male, and the number of middle-aged and elderly people was higher. In the early stage of the case, fever and cough are the main symptoms, which can be manifested as persistent mild disease in the early stage. Older patients with underlying disease are more likely to progress to severe disease.

Preliminary results of existing etiology studies and epidemiological investigations show that most of the cases are related to the South China Seafood Wholesale Market exposure, a few cases deny a history of South China Seafood Wholesale Market exposure, and some cases have been exposed to similar cases. No community transmission has been identified.

7. After closing the South China Seafood Wholesale Market, are there any findings in the market? What measures have other markets taken?

Response: After the South China Seafood Wholesale Market was closed, the city strengthened its disposal of market environmental hygiene, carried out disinfection and sanitary disposal of the market, and carried out garbage cleaning and disinfection. In order to strengthen the traceability work, environmental specimens were collected and tested in the market. At present, the test results found that some samples were positive for the new coronavirus. At the same time, preliminary investigations have been conducted in other markets, and no clues related to the source of the infection have been found.

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Communicated by:
Mary Marshall
<[email protected]>

[The important information in this Q and A that has not been covered in other reports is the confirmation of one suspected human-to-human transmission from a husband to his wife, and confirmation that there were some confirmed cases with no known contact with the Huanan South China Seafood Wholesale Market or other known cases, further suggesting the Huanan South China Seafood Wholesale Market was not the only possible location for transmission of this newly identified Wuhan nCoV.

An excellent interactive map showing the locations of Seafood Markets in Wuhan city can be found at: https://www.google.com/maps/search/map+oF+Wuhan+City+showing+seafood+markets/@30.4943417,114.137178,11z/data=!3m1!4b1. It is impressive but not surprising to see the multitude of markets, presumably "wet markets" in the city, a city with a population over 11 million inhabitants. - Mod.MPP]

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[4] Potential for International air travel spread
Date: 14 Jan 2020
Source: Journal of Travel Medicine [excerpted, edited]
https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm/taaa008/5704418


Pneumonia of Unknown Etiology in Wuhan, China: Potential for International Spread Via Commercial Air Travel
Bogoch II, Watts A, Thomas-Bachli A, C Huber, Kraemer MUG, Khan K. Journal of Travel Medicine, taaa008, https://doi.org/10.1093/jtm/taaa008. Published: 14 Jan 2020


Highlight: "There is currently an outbreak of a pneumonia of unknown etiology in Wuhan, China. While there are still several unanswered questions, we evaluate the potential for international dissemination of this disease via commercial air travel should the outbreak continue.

We evaluated 2018 travel data generated from the International Air Transport Association (IATA) to quantify passenger volumes originating from the international airport in Wuhan, China, between January through March [2018], inclusive.

We also report Infectious Disease Vulnerability Index (IDVI) scores for countries receiving significant numbers of travellers from Wuhan. The IDVI score is a validated tool to estimate a country's capacity to prepare for and manage infectious disease threats. A score is based on metrics from seven domains; demographic, health care, public health, disease dynamics, political (domestic), political (international), and economic. Countries are scored between 0-1, with higher scores representing greater capacity to respond to outbreaks.

Table 1 [available at source links] outlines the top 20 destination cities with passengers arriving from Wuhan; Bangkok, Hong Kong, Tokyo, and Taipei received the largest volumes with 41 080, 23 707, 20 001, and 17 645 arrivals between January and March [2018], respectively. The IDVI for these leading destinations all exceed 0.65. Sydney and Victoria, Australia, and Dubai, UAE are the only 3 cities in the top 20 destinations that are outside of Asia. Bali, Indonesia has the lowest IDVI score (0.563) in the top 20 destination cities.

Fortunately, most countries receiving the largest volumes of passengers from Wuhan, China appear to have high IDVI scores, corresponding to relatively strong public health and healthcare capacity."

--
Communicated by:
ProMED-mail
<[email protected]>

[This article is a very interesting analysis of the easily identifiable high-risk locations for importation of cases from Wuhan. The table is enlightening both in terms of the amount of airplane traffic in a 3-month period between Wuhan city and other countries, as well as the apparent public health capacity of the Asian countries that will potentially be receiving cases if this outbreak continues and expands its geographic locations. - Mod.MPP]
See Also
Novel coronavirus (03): China (HU) animal reservoir suggested, RFI 20200114.6887480
Novel coronavirus (02): Thailand ex China (HU) WHO 20200113.6886644
Novel coronavirus (01): China (HU) WHO, phylogenetic tree 20200112.6885385
Undiagnosed pneumonia - China (HU) (10): genome available, Hong Kong surveill. 20200111.6883998
Undiagnosed pneumonia - China (HU) (09): novel coronavirus, more info, fatality 20200110.6883253
Undiagnosed pneumonia - China (HU) (08): novel coronavirus, WHO 20200110.6881082
Undiagnosed pneumonia - China (HU) (07): official confirmation of novel coronavirus 20200108.6878869
Undiagnosed pneumonia - China (06): (HU) Hong Kong surveillance, USA CDC alert 20200108.6876648
Undiagnosed pneumonia - China (05): (HU) novel coronavirus identified 20200108.6877694
Undiagnosed pneumonia - China (04): (HU) Hong Kong surveillance 20200106.6874277
Undiagnosed pneumonia - China (03): (HU) updates, SARS, MERS ruled out, WHO, RFI 20200105.6872267
Undiagnosed pneumonia - China (02): (HU) updates, other country responses, RFI 20200103.6869668
Undiagnosed pneumonia - China (01): (HU) wildlife sales, market closed, RFI 20200102.6866757
2019
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Undiagnosed pneumonia - China: (HU) RFI 20191230.6864153
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BANGKOK (AP) — A Chinese visitor to Thailand has been confirmed to be infected with a new strain of coronavirus that has been linked to a pneumonia outbreak in central China, health officials said Monday.

The U.N.’s World Health Organization said Thai officials have reported that a traveler from the Chinese city of Wuhan has been hospitalized in Thailand with the virus.

The outbreak of the virus has been traced to Wuhan, where it affected several dozen people who had been to a major meat and seafood market.

Thai Public Health Minister Anutin Charnvirakul said it appears to be the first confirmed case of the virus found outside China, the Bangkok Post newspaper and other Thai media reported.

 

He identified the infected tourist as a 61-year-old woman whose symptoms were detected on arrival at Bangkok’s Suvarnabhumi Airport last Wednesday. Her coronavirus was confirmed Sunday by a laboratory test, Anutin said.

She has been treated at an isolation ward at a state health facility outside of Bangkok, and no longer has any fever or respiratory symptoms, he said.

Eight other people with possible symptoms have also been held at the facility, he said, but none has been confirmed to have the virus.

A statement issued Monday by the Geneva-based World Health Organization said it is working with officials in Thailand and China following the report of the confirmed case outside China. The agency says its director-general is consulting with the agency’s emergency committee, which generally decides whether viral outbreaks merit an expanded response from health authorities.

“The possibility of cases being identified in other countries was not unexpected, and reinforces why WHO calls for ongoing active monitoring and preparedness in other countries,” the agency said. “WHO reiterates that it is essential that investigations continue in China to identify the source of this outbreak and any animal reservoirs or intermediate hosts.”

The virus is not believed to be spread by human-to-human contact.

Officials in Wuhan said over the weekend that a total of 41 people were suffering from pneumonia caused by the new coronavirus and a 61-year-old man had died — China’s first known death from the virus.

China says the cause of the Wuhan outbreak remains unknown but has sought to play down speculation that it could be a reappearance of the SARS epidemic, which killed hundreds in 2002 and 2003.

Coronaviruses are a large family of viruses, some of which cause the common cold. Others found in bats, camels and other animals have evolved to cause more severe illnesses.

Common symptoms include a runny nose, headache, cough and fever. Shortness of breath, chills and body aches are associated with more dangerous kinds of coronaviruses, according to the U.S. Centers for Disease Control and Prevention.

http://www.khaosodenglish.com/news/crimecourtscalamity/2020/01/14/officials-confirm-1st-case-of-coronavirus-from-chinas-wuhan/

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Meanwhile, a   from Wuhan is being treated at a hospital in Nonthaburi, to the north of Bangkok, after testing positive for the new strain on her arrival in Thailand.
The   (WHO) said in a tweet on Wednesday morning that the woman was a frequent visitor to a fresh market in Wuhan, though not specifically the one at the centre of the outbreak.

“The patient reported a history of visiting a local fresh market in Wuhan on a regular basis prior to the onset of illness; however, she did not report visiting the Huanan South China Seafood Market from where most of the novel #coronavirus (2019-nCoV) cases were detected,” it said, using the official name of the newly identified virus.

Professor David Hui Shu-cheong, an expert on respiratory medicine at the Chinese University of Hong Kong, said that on the basis of the woman’s statement, authorities in Wuhan should investigate the market she said she had visited and check any others that sold game meat.

Officials in Wuhan said earlier that several people who had been in close contact with the tourist had been put under medical observation, but none had shown any abnormal symptoms.

Despite the absence of clear evidence of human-to-human transmission and lack of infections reported among health care workers, the WHO called for further investigation into possible modes of transmission, because of the dangers of the potential human-to-human spread of respiratory illnesses.

“It can be difficult to determine if they are ill due to exposure to a common source of infection, or because one person passed the illness to the other,” it said in a statement.

“Existing investigation found no clear human-to-human evidence. The possibility of limited human-to-human transmission cannot be ruled out, but the risk of continued human-to-human transmission is low.”

Health experts have not ruled out the possibility of the virus spreading from person to person. Photo: Jun Mai
Health experts have not ruled out the possibility of the virus spreading from person to person. Photo: Jun Mai

Wuhan authorities have collected environment samples from the seafood market, which has been closed since January 1, and found some that tested positive for the coronavirus.

Preliminary investigations in other markets in the city had found no clues to the source of the outbreak, the health commission said.

Chuang said she was told that some of the samples – taken from table tops, the floor and vendors’ gloves, among other places – had tested positive for the coronavirus.

“I understand they have also collected samples from other areas of the market but so far only those collected from the seafood section tested positive.”

Asked if there was any evidence that the virus could have come from an animal, Chuang said: “I understand [local experts] may also have started trying to trace the source of the virus to animals.

“The experts are of the view that the chance of seafood being the source of the virus [found in the environmental samples] is not high. Thus, the direction would be tracing it to some other animal,” she said.

“The Huanan Seafood Wholesale Market mainly sells seafood and poultry. We were also given to understand that animals such as bamboo rats, snakes, badgers and hedgehogs were also available there.”

Most of the people diagnosed were middle-aged or elderly and male, the Wuhan health authority said. Six of the 41 were still being treated as severe cases, while seven had been cured and discharged.

More than 760 people who had been in close contact with those patients had been put under medical investigation, with 187 having been removed from quarantine by Tuesday after showing no symptoms for two weeks, the authorities said.

As a major transport hub with a population of 11 million people, the pneumonia outbreak in Wuhan has raised concerns the disease could spread to other cities during the 

 travel season, which is now under way.

https://www.scmp.com/news/china/society/article/3046173/china-says-human-transmission-not-ruled-out-wuhan-coronavirus

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