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WHO Acknowledges Limited Human To Human Transmission of 2019-nCoV

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WHO says new China virus could spread, it's warning all hospitals

GENEVA (Reuters) - There has been “limited” human-to-human transmission of a new coronavirus that has struck in China, mainly small clusters in families, but there is potential for wider spread, the World Health Organization (WHO) said on Tuesday.

A Chinese woman has been quarantined in Thailand with a mystery strain, authorities said on Monday, the first time it has been detected outside China. In all, 41 cases of pneumonia - a symptom of the disease - have been reported in the central Chinese city of Wuhan, mainly through exposure at a seafood market.

Dr. Maria Van Kerkhove, acting head of WHO’s emerging diseases unit, told a Geneva news briefing that the agency had given guidance to hospitals worldwide about infection control in case of spread, including by a “super-spreading” event in a health care setting. “This is something on our radar, it is possible, we need to prepare ourselves,” she said.

Reporting by Stephanie Nebehay; editing by John Stonestreet

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Wuhan virus spreading between people: WHO

 
2020-01-14 HKT 19:27
 
There has been “limited” human-to-human transmission of a new coronavirus that has struck the mainland city of Wuhan, mainly small clusters in families, but there is potential for wider spreading, the World Health Organisation (WHO) said on Tuesday.

A Chinese woman has been quarantined in Thailand with a mystery strain, authorities said on Monday, the first time it has been detected outside China.

In all, 41 cases of the virus – which is similar to Sars which killed 299 in Hong Kong in 2003 – have been reported in Wuhan, mainly through exposure at a seafood market. One person there has died.

Dr. Maria Van Kerkhove, acting head of the WHO’s emerging diseases unit, told a Geneva news briefing that the agency had given guidance to hospitals worldwide about infection control in case of spread, including by a “super-spreading” event in a health care setting.

“This is something on our radar, it is possible, we need to prepare ourselves,” she said.

Hong Kong health officials have put dozens of people in isolation in hospital since New Year's Eve over fears they have caught the virus following trips to Wuhan, with three new suspected cases just on Tuesday.

But the SAR authorities haven't announced any confirmed cases and although Taiwan, Singapore and South Korea have all reported suspected cases, no province on the mainland, other than Hubei, has reported any patients feared to have the virus. (Refinitiv, RTHK)
 
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14 January 2020

Alessandra Vellucci, Director of the United Nations Information Service in Geneva, chaired the briefing, which was attended by the spokespersons for the United Nations Conference on Trade and Development, the World Health Organization, the World Food Programme, the Office of the High Commissioner for Human Rights, the International Organization for Migration, the United Nations High Commissioner for Refugees and the International Labour Organization.

Novel coronvirus in China

Tarik Jašarevic for the World Health Organization (WHO), said that on 31 December 2019, the Government of China had reported a cluster of cases of pneumonia of unknown cause in Wuhan, Hubei Province. On 9 January Chinese authorities had made a preliminary determination of a new coronavirus, identified in a hospitalized person with pneumonia in Wuhan. Two days later, Chinese authorities had issued additional information, updating case numbers to 41, reporting one death. They had also shared the complete genomic sequence with WHO and with the public. On 13 January, the health authorities of Thailand had announced the identification of the novel coronvirus in a person traveling from Wuhan.

WHO was still in the earliest stages of understanding this new virus, where it came from, and how it affected people.

Preliminary investigations conducted by national authorities had found no clear evidence of human to human transmission and there were no infections reported among health care workers. However, the mode(s) of transmission had not yet been determined and human to human transmission was always a concern when patients had respiratory symptoms, and this required further investigation. The genetic sequencing, shared by China on 11 January, enabled more countries to rapidly diagnose patients. This had helped Thailand identify the infected person.

So far, 41 suspected cases had tested positive in China for the new coronavirus. Of the 41 cases, seven have been discharged, six were severe, and one person has died. The other patients were reported in stable condition. The reported dates of symptom onset ranged between 8 December 2019-2 January 2020. No new cases had been reported by China since 3 January 2020. Common symptoms had included fever, breathing difficulties and pneumonia.

763 close contacts, including health workers, had been tracked until now and were being monitored for signs of illness; no related cases had been found. The follow-up of close contacts was still in progress. Investigations had found that some of the cases were workers, handlers or frequent visitors at a seafood market in Wuhan where live animals were sold, the Huanan seafood market.

WHO had been in regular and direct contact with Chinese and Thai authorities since the reporting of these cases. Both China and Thailand had shared information with WHO under the IHR. WHO was also informing other countries about the situation and providing support as requested.

WHO was working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modelling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission.

WHO was working closely with countries to help them prepare for the rapid detection and response to cases or clusters. Even before an outbreak stroke, WHO offered technical advice and capacity strengthening as needed, including laboratory support.

There were no immediate plans to call an Emergency Committee. However, the committee could be convened on short notice if needed.

Maria D. Van Kerkhove, Head ai of Emerging Diseases and Zoonoses Unit at the World Health Organization (WHO), said the disease will range from mild symptoms to very severe disease and death. The global community had a lot of experience with past coronaviruses. Based on experience, these viruses had the possibility to be transmitted from animals to humans. There was a possibility that transmission could be amplified, including in health care facilities. There was also a possibility of superspreading events – that was on WHO’s radar. It was important to identify the pathogen and the source of the outbreak; there were several ongoing investigations in that regard. It was important to determine which diseases the coronvirus caused, and if there had been human to human transmission. Information was needed to limit exposure and better understand the extent of infection.

Responding to questions from journalists, Mr. Jašarevic said that, for now, no travel or trade restrictions had been imposed in relation to this virus. Ms. Van Kerkhove added that WHO was developing diagnostic tests and guidelines to ensure a quick identification of infections. Currently, treatment of infected individuals was based on their specific symptoms.

https://www.unog.ch/unog/website/news_media.nsf/(httpNewsByYear_en)/F218C2070663E4F1C12584EB0050DE5E?OpenDocument

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Questions and answers on pneumonia outbreak of new coronavirus infection


(January 14, 2020)

Issuing authority: Wuhan City health committee | Published: 2020-01-15 00:10:06 | Hits:  2133  | Font Size:  Da Zhong Small
1. Recently, a tourist from Wuhan was diagnosed with a new coronavirus-infected pneumonia patient in Thailand. Please introduce the situation.

On January 13, 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?

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. 41 example. 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?

Existing survey results show that clear human-to-human evidence 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?

Among the 41 cases currently diagnosed , one was found to be clustered in the family. The husband and wife developed the disease first, and the husband first developed the disease. 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?

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. 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?

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?

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 are collected and tested in the market. At present, the test results found that some samples were positive for 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.

http://wjw.wuhan.gov.cn/front/web/showDetail/2020011509040

 
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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:

https://www.who.int/csr/don/14-january-2020-novel-coronavirus-thailand-ex-china/en/

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World on alert for potential spread of new SARS-like virus found in China

By Jon Cohen, Dennis Normile

Had the nightmare returned? That’s the question many were asking in the first 10 days of this year, after a new form of pneumonia emerged in Wuhan, a megacity in central China. The outbreak revived memories of severe acute respiratory syndrome (SARS), the disease that emerged in China in 2002 and sickened 8098 people in 37 countries before it was quashed in the summer of 2003. Like SARS, the Wuhan pneumonia cases were linked to a market selling myriad species of live animals, and they appear to be caused by a new member of the coronavirus family closely related to the SARS virus. And once again, China appeared to be less than forthcoming with information.

Today, global health experts are breathing a little easier. As Science went to press, only one of 42 people known to be infected had died: a 61-year-old man already suffering from abdominal tumors and chronic liver disease. (SARS had a 9.6% mortality rate.) No evidence suggests the virus easily passes between humans, which can turn a local problem into a global crisis. And Chinese researchers have now shared the sequence of six genomes of the as-yet-unnamed virus with the world.

 Scientists in other countries have used the data. The World Health Organization (WHO) plans to soon publish a diagnostic test for the new virus that was developed by Christian Drosten, a virologist at Charité University Hospital in Berlin, and other researchers based on the sequences released by China. It detects fragments from three different genes in the novel coronavirus that are also present in the SARS virus. “We wanted to use SARS as a basis because every public health laboratory has SARS RNA as a positive control so they can get started immediately," says Drosten, noting that SARS itself has not been detected in humans in 15 years. Ralph Baric, a coronavirus researcher at the University of North Carolina, Chapel Hill, is already trying to synthesize live virus from the data so that he can study it in animals and help develop a simple-to-use antibody test.

Still, many questions remain. Researchers have not identified the animal species at the marketplace that harbored the virus. When it emerged and the true number of people infected remain a mystery. Meanwhile, a case in Thailand, reported on 13 January—in a tourist who flew from Wuhan to Bangkok—led WHO Director-General Tedros Adhanom Ghebreyesus to consult experts on outbreak responses. The patient had not visited the Wuhan market at the center of the outbreak but had been to other animal markets, WHO reported on 14 January.

The first known patient developed symptoms—which can include difficulty breathing and fever—on 8 December 2019. Officials closed the seafood market on New Year’s Day, and no new patients have been identified in Wuhan since 3 January. The virus was not found in 763 close contacts of those infected, or in health care workers, who often fall ill during outbreaks of viruses that can transmit between humans. “It is a limited outbreak,” says Xu Jianguo, who runs an infectious disease laboratory at the Chinese Center for Disease Control and Prevention and heads an evaluation committee that’s advising the Chinese government. “If no new patients appear in the next week, it might be over.”

WHO said in a 12 January statement that it was “reassured of the quality of the ongoing investigations and the response measures implemented in Wuhan, and the commitment to share information regularly.”

But others criticized the way early information came out. News that researchers had discovered a novel coronavirus came in an 8 January story in The Wall Street Journal; Xu confirmed the finding on a state-run TV station several hours later. “It’s not a good situation when The Wall Street Journal [reports] a SARS-like coronavirus before the Chinese government announces it,” Baric says. On 10 January, Jeremy Farrar, an infectious disease specialist who heads the London-based Wellcome Trust, tweeted his worry about rumors that the Chinese government did not share “critical public health information” because Chinese researchers wanted to ensure publication of their findings in high-profile journals first.

Less than 12 hours later, however, evolutionary biologist Edward Holmes of the University of Sydney published an “initial” sequence of the new coronavirus on virological.org, on behalf of a consortium led by Zhang Yong-Zhen of Fudan University in Shanghai. The next day, three groups working under China’s National Health Commission posted another five sequences of the virus, gathered from different patients, on GISAID, a database primarily used for sharing data on influenza viruses.

The six sequences differ little from each other, which evolutionary biologist Andrew Rambaut of the University of Edinburgh says is “consistent with a point source”—meaning they likely came from the same batch of infected animals at the Huanan Seafood Wholesale Market, which also sells birds, snakes, and rabbit meat. (No coronaviruses have ever been found in fish.) But the fact that cases surfaced over the course of 1 month suggests the source was more than one group of animals at one location, Farrar says: “It makes me worry that whatever the exposure was to, it went on for quite a long time.” Virologist Guan Yi of Hong Kong University agrees that the Wuhan outbreak was caused by multiple jumps from animal to human hosts “separately and independently.”

Whatever species spread the virus at the market may have picked it up from some natural reservoir. Many coronaviruses occur naturally in bats, and the new virus is closest to four bat viruses that have surface proteins capable of infecting human cells. Still, Rambaut cautions there may well be another natural host. “It’s quite similar to a bat virus in parts of its genome, but not so much in other parts,” he says.

Farrar notes that most confirmed cases to date were mild, which means that even before health officials recognized the outbreak, the virus may have infected many other people who never sought medical care. That makes it premature to conclude the pathogen doesn’t spread from human to human, he says. Nurses and doctors, too, may have been infected without anyone noticing, he adds: “With a coronavirus, I’d be very surprised if there wasn’t some limited human-to-human transmission.” So far, cases have been confirmed by detecting nucleic acid from the virus, which disappears after patients recover. Now that the virus has been isolated, researchers can also develop antibody tests that pick up signs of past infection.

Limited as the outbreak appears to date, Farrar and others still worry that travel of hundreds of millions of people for the Lunar New Year celebration on 25 January could spread the virus from Wuhan, a major transportation hub, to other cities. “With people, food and animals move,” says Farrar, who suspects that this outbreak “is not going away anytime soon.”

With reporting by Kai Kupferschmidt.

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