Overview: Investigation of an outbreak of pneumonia cases originating in Wuhan, China identified a novel (new) coronavirus as the etiologic agent. The first cases reported had links to a seafood and live animal market in Wuhan, China, suggesting infection of humans from an animal source. Human-to-human transmission has now been reported.
Description: On 10 January 2020, Chinese health officials reported 41 cases of pneumonia due to a novel coronavirus, including seven patients with severe illness and one death. The initial cases associated with the outbreak were identified between 08 December 2019 and 02 January 2020. To date, over 448 total cases have been diagnosed: 441 cases and 9 deaths in China; 4 in Thailand, 1 in Japan, 1 in South Korea, and 1 in the United States. All cases diagnosed outside of China reported recent travel to Wuhan.
Symptoms have included fever, cough, and difficulty breathing. A laboratory in China identified a novel coronavirus (2019-nCoV) as the etiologic agent. The sequence of the virus has been released publicly. Clinical characteristics of infection, such as incubation period, have not yet been determined. As of this report, human-to-human transmission has been reported. Fifteen healthcare workers have been infected, but we do not know whether these are all from one or multiple facilities.
The first cases identified have been linked to the Wuhan South China Seafood City (also called the South China Seafood Wholesale Market and the Hua Nan Seafood Market), which sells chickens, cats, marmots, other wild animals, and seafood. This market has been closed since 01 January 2020 for cleaning and disinfection. Of note, one person diagnosed in Thailand did not report visiting this market, but did report visiting other live animal markets in Wuhan during her visit. Given that this outbreak has been linked to seafood and animal markets, it is likely that the virus originated in an animal and was initially transmitted from an animal to one or more humans.
Background: Coronaviruses are a large family of viruses. There are several known human coronaviruses that usually only cause mild respiratory disease, such as the common cold. However, at least twice previously, coronaviruses have emerged to infect people and cause severe disease: severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). The cases in this outbreak tested negative for both SARS and MERS.
Response: Health authorities in China are monitoring close contacts, including health care workers, for illness. Several territories in Asia and the United States are screening incoming travelers from Wuhan.
Recommendations for Member States:
- All Member States should enhance their surveillance for severe acute respiratory infections (SARI)1 and to carefully review any unusual patterns of SARI or pneumonia cases. Examples of enhanced surveillance include:
- Adding questions about travel and testing for coronaviruses to existing influenza surveillance systems;
- Notifying healthcare facilities to immediately inform local public health officials about persons who meet the case definition for SARI and recently traveled to Wuhan (or other affected countries).
- Member States that receive direct or connecting flights from Wuhan should consider screening incoming passengers for severe respiratory illness and a history of recent travel to Wuhan. Member States should be prepared to expand questions about recent travel to additional countries as the outbreak evolves.
- Notify WHO and Africa CDC immediately if suspected or confirmed cases of infection with novel coronavirus are identified. Africa CDC can be notified by emailing AfricaCDC@africa-union.org and StephanieS@africa-union.org.
- Prepare to collect specimens from patients suspected of having novel coronavirus infection. Interim guidance on specimen collection and handling is available from WHO at https://www.who.int/health-topics/coronavirus/laboratory-diagnostics-for-novel-coronavirus.
- Provide guidance to the general public about seeking immediate medical care and informing healthcare providers about recent travel in anyone who develops symptoms of severe respiratory illness and recently traveled to Wuhan or one of the affected areas.
Africa CDC actions:
- Africa CDC is working with laboratories in Member States to identify facilities that are able to receive and test specimens for novel coronavirus infection.
- Africa CDC will update national public health institutes in Member States on Thursday, 23 January 2020 at 12pm East Africa Time. Details for this teleconference will be sent separately.
- Africa CDC will continue to provide updated and relevant information to Member States as it becomes available.
Resources for more information:
- China CDC. Coronavirus overview. http://www.chinacdc.cn/yyrdgz/202001/t20200109_211159.html
- Shanghai Public Health Clinical Center & School of Public Health. 10 January 2020. Initial genome release of novel coronavirus. http://virological.org/t/initial-genome-release-of-novelcoronavirus/319
- US Centers for Disease Control and Prevention. 14 January 2020. Novel Coronavirus (2019-nCoV), Wuhan, China. https://www.cdc.gov/coronavirus/novel-coronavirus-2019.html
- WHO. Coronavirus overview. https://www.who.int/health-topics/coronavirus
- WHO. Laboratory protocols. https://www.who.int/health-topics/coronavirus/laboratorydiagnostics-for-novel-coronavirus
- Wuhan Municipal Health Commission. http://wjw.wuhan.gov.cn/
Endnotes
- WHO SARI case definition: anyone with an acute respiratory infection with history of fever (or measured fever of ≥ 38 C°) and cough with symptom onset within the last 10 days that requires hospitalization. https://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/