Image courtesy of Matthew and Heather via Flickr Creative Commons
In mid to late December, several employees of the Huanan Seafood Market in Wuhan, China fell ill with pneumonia-like illness [1]. The WHO China Country Office was notified of the cases on December 31, 2019 and as of January 7, 2020 there were 59 confirmed cases of the illness with no known etiology. Many of the cases have been reported to have had contact with the market. Of the 59 cases, there have been no deaths and seven individuals are in critical condition as of Sunday, January 5 [2]. The patients are currently receiving treatment in isolation and there are no confirmed cases outside of the area, however there are some expected cases in Hong Kong [2]. According to the World Health Organization, infected individuals presented with fever and several had difficulty breathing and evidence of invasive lesions of both lungs [3].
At this point, there is no evidence of person-to-person or healthcare worker infections. The ability for the pathogen to be transmitted will be one if not the most important factor in predicting the spread and burden of the disease overtime. The seafood market associated with the majority of the cases was closed on January 1, and sanitation process has begun [1]. If the pathogen was contracted primarily from the infected meat at the market and unable to be transmitted from person-to-person, the closure of the market should effectively eliminate new cases.
At the beginning of the outbreak, information about the cases was limited to citizens as well as to the public health and infectious disease community. Wang Linfa, an infectious disease expert at the Duke-NUS Medical School in Singapore expressed frustration about the limited availability of information. The initial ambiguity created some panic among the public. Rumors were spread on a popular Chinese social media site about the virulence and transmission of the disease. Authorities managed the situation by blocking the hashtag #WuhanSARS and since then have been quicker to relay pertinent information to the public and medical community [4].
On January 5, local authorities ruled out SARS which wreaked havoc in China in 2002-2003 epidemic killing over 700 people [5]. They also ruled out MERS, bird flu, and adenovirus [4]. As compared to the SARS outbreak which had a case fatality of 10%, this unknown pathogen has yet to kill any of the infected individuals which may be indicative of much less severe disease [2]. According to a microbiologist at the University of Hong Kong, Yuen Kwok-yung, “It is highly unlikely that this will lead to a major 2003-like epidemic…though we cannot be complacent” [2].
Learning from the SARS outbreak, the public health and medical community are taking extraordinary precautions against the unknown pneumonia. In Wuhan, close contacts of the cases are under surveillance, hospital visitation hours have been shortened, the market is being sanitized, and investigation of the pathogen etiology is taking place. China as well as some surrounding countries have implemented airport and high speed rail screening of travelers’ temperatures and have mandated the notification of the disease to appropriate authorities if suspected by a medical professional [1]. Chinese authorities are aiming to have the outbreak contained before millions visit China for the Lunar New Year celebrations on January 25 [1]. The WHO will continue to work vigilantly with China’s national authorities, the Wuhan Health Commission, and local hospitals to ensure timely and effective containment and treatment of the pathogen.
Update 01/09/2020: Lead scientists have shared that preliminary test results show that the mystery illness may be caused by a new coronavirus [6].
Update 01/21/2020: Case counts have exceeded 300 infections, including 6 deaths. WHO and Chinese authorities confirmed human-to-human transmission between close contacts. As the Chinese New Year approaches, airports around the globe are preparing for the potential spread of the virus [7].
Update 01/21/2020: First case of viral pneumonia identified in the United States after a traveler arrived in Washington state after being in the region around Wuhan [8].
Sources:
- https://www.cnn.com/2020/01/06/health/china-pneumonia-intl-hnk/index.html
- https://time.com/5759289/wuhan-pneumonia-outbreak-disease/
- https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/
- https://www.nytimes.com/2020/01/06/world/asia/china-SARS-pneumonialike.html
- https://www.bbc.com/news/world-asia-china-50984025
- https://www.bbc.com/news/world-asia-china-51047576
- https://www.reuters.com/article/us-china-health-pneumonia-deaths/china-mystery-virus-claims-sixth-victim-as-holiday-travel-stokes-risk-idUSKBN1ZJ2D2
- https://www.nytimes.com/2020/01/21/health/cdc-coronavirus.html
