The World Health Organisation warns of 'possible evidence' of the novel coronavirus outbreak in China spreading, writes MedicalBrief. UK scientists say that official totals of 321 people infected with the deadly and little-understood new virus could be out by a factor of 35.
In major developments surrounding the novel coronavirus (2019-nCoV) outbreak centred in China, the World Health Organisation (WHO) said it sees possible evidence of sustained transmission – meaning the virus is spreading beyond just clusters of patients. In addition, China has reported another spike in cases – to more than 300 – plus two more deaths, with more newly affected provinces, while Taiwan reported its first 2019-nCoV case in a traveller from Wuhan.
Ahead of an emergency committee to assess if the 2019-nCoV developments warrant a public health emergency of international concern, the WHO said in a Tweet from its Western Pacific regional office that it's now clear that human-to-human transmission is occurring. It said the virus has infected 15 healthcare workers in Wuhan and noted that some of newly reported cases suggest that sustained transmission may be occurring. "But more information and analysis are needed on this new virus to understand the full extent of human-to-human transmission and other important details."
Healthcare worker infections are a closely watched marker for not only virus transmissibility, but also "super spreader" events that can amplify outbreaks, a feature seen in SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus) events.
A Chinese medical community tracking the developments in real time put the country's current total at 321 cases. Wuhan's health commission said that the 60 latest case-patients range in age from 15 to 88 and that the latest illness onset was 18 January – 20 of the patients are seriously ill. The report was translated and posted by FluTrackers, an infectious disease news message board.
The two deaths, which push the outbreak fatality count to six, were reported in a 66-year-old man and a 48-year-old woman, both of whom had underlying health conditions.
Taiwan's first imported case involves a woman in her 50s who worked in Wuhan. The Taiwan Centres for Disease Control (Taiwan CDC) didn't specify her exposure but said she got sick in Wuhan. The agency added that officials are monitoring 46 contacts.
Also, the WHO has posted more information on South Korea's imported case-patient, a 35-year-old Chinese woman from Wuhan who got sick in that city on Jan 18 and was diagnosed there with a cold before flying to South Korea the next day. Her fever was detected when she arrived at the Seoul airport, and tests yesterday on her samples were positive for 2019-nCoV. She said she hadn't visited any markets, did not have contact with any wild animals, and did not have contact with any known 2019-nCoV patients.
Scientists had warned earlier that official totals from Chinese authorities of how many people have been infected with a deadly and little-understood new virus could be out by a factor of 35. Business Insider reports that according to public health officials in Wuhan, 45 people have been infected with 2019-nCov. Two of the patients have died.
However, the report said, according to an analysis from Imperial College London, the number of people to be infected as of 12 January (per the study) is likely more in the region of 1,723 – a figure around 35 times greater than the 45 cases confirmed in a lab. Their analysis relies on statistical projection to figure out how widely the virus has spread from its point of origin at a seafood market in Wuhan.
The report said it hinges on the fact that three cases have been detected abroad: two in Thailand and one in Japan. Given that only around 3,400 of Wuhan's 19m residents take international flights each day, the experts said that in order for three infected people to have made it abroad, the total number must be in the thousands.
Here is the academics' conclusion: "It is likely that the Wuhan outbreak of a novel coronavirus has caused substantially more cases of moderate or severe respiratory illness than currently reported.
"The estimates presented here suggest surveillance should be expanded to include all hospitalised cases of pneumonia or severe respiratory disease in the Wuhan area and other well-connected Chinese cities."
Summary
Background: On the 31st December 2019, the World Health Organization (WHO) China Country Office was informed of cases of pneumonia of unknown aetiology in Wuhan City, Hubei Province, China [1]. A novel Coronavirus (2019-nCoV) related to the Middle Eastern Respiratory Syndrome virus and the Severe Acute Respiratory Syndrome virus has since been implicated [2].: As of 16th January 2020, 41 cases (including two deaths [3]) have been confirmed in Wuhan City with three confirmed cases in travellers detected in Thailand (2 cases) and Japan (1 case) [4–7]. Most cases have been epidemiologically linked to exposure at a seafood market in Wuhan which has been closed since 1 January 2020 in efforts to contain the outbreak. Although both travellers have a history of travel to Wuhan City, they did not visit the seafood market implicated in the other cases [2].: Using the number of cases detected outside China, it is possible (see Methods) to infer the number of clinically comparable cases within Wuhan City that may have occurred thus far.
Summary: We estimate that a total of 1,723 cases of 2019-nCoV in Wuhan City (95% CI: 427 – 4,471) had onset of symptoms by 12th January 2020 (the last reported onset date of any case).
Artificial intelligence may be able to help, says Dr Daniel Streicker, a life sciences researcher at Glasgow University. “AI can collect data on human movement from things like airline records, traffic information…you can even imagine information collected through Google.”
According to a report in The Daily Telegraph, creating such AI that can accurately predict the spread of disease has become a priority for researchers around the world.
US authorities have, meanwhile, begun screening travellers arriving in the country from Wuhan, reports STAT News. Passengers arriving from Wuhan in San Francisco and Los Angeles and at New York’s John F Kennedy International Airport will be checked for symptoms of the infection, which include cough, sore throat, and fever.
The report says the US Centres for Disease Control and Prevention is deploying 100 extra staff members to the three airports to help with the screening of 2019-nCoV.
While the overall risk to people in the US is low, “we know it’s crucial to be proactive and prepared,” Dr Nancy Messonnier, the director of CDC’s National Centre for Immunisation and Respiratory Diseases, said. Messonnier added that this was still the early days of the outbreak and that the CDC’s policies could change as more is learned about the virus.
The report says the US joins several other countries, primarily in Southeast Asia, that have been screening passengers from Wuhan for signs of the virus. Global health authorities are on particular alert because of the millions of people expected to travel around the upcoming Lunar New Year holidays.
[link url="http://www.cidrap.umn.edu/news-perspective/2020/01/who-eyes-possible-sustained-ncov-spread-china"]University of Minnesota Centre for Infectious Disease Research and Policy (CIDRAP) material[/link]
[link url="https://twitter.com/WHOWPRO/status/1219478547644813312"]WHO WPRO tweet thread[/link]
[link url="https://www.who.int/csr/don/21-january-2020-novel-coronavirus-republic-of-korea-ex-china/en/"]WHO statement[/link]
[link url="https://reliefweb.int/report/china/epidemiological-update-novel-coronavirus-2019-ncov-20-january-2020"]Reliefweb update[/link]
[link url="https://www.businessinsider.co.za/new-china-virus-likely-infected-1723-not-45-scientists-2020-1"]Full Business Insider report[/link]
[link url="http://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/news–wuhan-coronavirus/"]Imperial College London analysis[/link]
[link url="https://www.telegraph.co.uk/technology/2020/01/21/ai-could-combat-spread-chinas-deadly-coronavirus/"]Full report in The Daily Telegraph[/link]
[link url="https://www.statnews.com/2020/01/17/u-s-to-begin-health-screenings-at-three-airports-for-cases-of-novel-chinese-virus/"]Full STAT News report[/link]