Outbreak of novel Coronavirus (2019-nCoV): Update

Background Information:

A novel Coronavirus (temporarily named ‘2019-nCoV’) is responsible for the outbreak of a pneumonia like illness that started in Wuhan, China, and has now spread to several countries.

Key Messages:

As of 23rd January 2020, a total of 557 cases of 2019-nCoV had been confirmed in China.

So far, the main clinical signs and symptoms reported in this outbreak include

fever,
difficulty in breathing, and
chest radiographs showing bilateral lung infiltrates.

As of 24 January 2020, human-to-human transmission has been confirmed largely in Wuhan city, but also some other places in China and internationally.

Not enough is known about the epidemiology of 2019-nCoV to draw definitive conclusions about

the full clinical features of disease,
the intensity of the human-to-human transmission, and
the original source of the outbreak.

That said, the World Health Organization (WHO) assumes a preliminary R0 estimate of 1.4-2.5 (this means that in a totally susceptible population, one case will infect 1.4 to 2.5 people). [The R0 (‘R naught’), or basic reproductive number, of a contagious disease is the number of cases that a case of the disease generates over the course of its infectious period in a susceptible population. The higher this number, the more dangerous the disease, the more lethal the outcome.]

The International Health Regulations (IHR) Emergency Committee convened on 23 January 2020, and made the following suggestions:

To WHO

support ongoing efforts through a WHO international multidisciplinary mission, including national experts.
provide all necessary technical and operational support to respond to this outbreak
the current requirements for declaring a Public Health Emergency of International Concern (PHEIC) are restrictive and binary- to consider development of an intermediate level of alert for evolving outbreaks

To China

Provide more information on cross-government risk management measures, including crisis management systems at national, provincial, and city levels, and other domestic measures.
Enhance rational public health measures for containment and mitigation of the current outbreak.
Enhance surveillance and active case finding across China, particularly during the Chinese New Year celebration.
Collaborate with WHO and partners to conduct investigations to understand the epidemiology and the evolution of this outbreak
Continue to share full data on all cases with WHO, including genome sequences, and details of any health care worker infections or clusters.
Conduct exit screening at international airports and ports in the affected provinces, with the aims early detection of symptomatic travelers for further evaluation and treatment, while minimizing interference with international traffic.
Encourage screening at domestic airports, railway stations, and long-distance bus stations as necessary.

To other countries

Further international exportation of cases may appear in any country.

All countries should be prepared

for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and
to share full data with WHO.

All countries should place particular emphasis on

reducing human infection,
prevention of secondary transmission and international spread and
contributing to the international response though multi-sectoral communication and collaboration and
active participation in increasing knowledge on the virus and the disease, as well as advancing research.

Countries should follow travel advice from WHO: