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WHO EMRO Weekly Epidemiological Monitor: Volume 13, Issue no 4; 26 January 2020

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Current major event

Emergence of novel Coronavirus (2019-nCoV) in China

On 31 December 2019, WHO was informed about the detection of a cluster of pneumonia of unknown etiology in Wuhan City, Hubei Province of China. A novel coronavirus (2019-nCoV) was identified as the causative virus on 7 January 2020.

Editorial note

Coronaviruses (CoV) are a large family of viruses that circulate in animals and few of them are known to affect humans causing mild to moderate lower-respiratory tract illnesses. However, if the virus is novel, more severe outcomes are expected. Before current events there were only two incidences where highly pathogenic coronaviruses had emerged: SARS-CoV in 2002 and MERSCoV in 2012. 2019-nCoV was identified by Chinese authorities on 7 January 2020. Investigations were triggered by the detection of a cluster of 27 pneumonia cases of unknown etiology in Wuhan City, Hubei Province of China on 31 December 2019. The source of infection is still unknown and under investigation. Some cases have reported a common exposure: a local seafood and animal market in Wuhan City. The market was closed on 1 January 2020 for environmental sanitation and disinfection. The Chinese authorities continue to perform intensive surveillance, take preventive measures and conduct further epidemiological investigations (see timeline of events).

As of 24 January 2020, a total of 846 confirmed cases have been reported of 2019-nCoV globally. Of them, 830 cases were reported from China including 375 cases confirmed from Hubei Province. Of the 830 cases, 177 have been reported as severely ill and 25 deaths have been reported. 16 healthcare workers were affected as well within China.

Since then, the virus has spread to three other administrative regions (5 cases) and six other countries (11 cases) (see table). Almost all reported 2019-nCoV cases outside China had a travel history to Wuhan. No confirmed cases of the new coronavirus have been reported in the WHO Eastern Mediterranean Region to date.

Epidemiological information available from China has confirmed human-to-human transmission, however, more epidemiological data is needed to understand the full extent of human-to-human transmission. Further investigations are ongoing to characterize transmission modes, reproduction interval and clinical spectrum resulting from infections to inform and refine strategies to prevent, control and stop the spread of 2019-nCoV.

Current evidence suggests transmission may be occurring through droplets, contact and fomites. WHO is recommending standard precautionary measures to prevent infection spread include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs, as well as avoiding close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.

On 22 and 23 January, WHO DirectorGeneral convened an Emergency Committee under the IHR (2005). The committee has not declared the event as a PHEIC. WHO assessed the risk of this event to be very high in China, high at the regional level and moderate at the global level. WHO encourages all countries to continue enhancing preparedness and prevention activities. WHO advises against the application of any travel or trade restrictions based on the information available. If travellers develop respiratory illness before, during or after travel, they should seek medical attention and share travel history with their health care provider.

WHO has developed technical guidance, most of which was based on MERS experience in EMRO. The guidance is available on https://www.who.int/health-topics/ coronavirus. It is being continuously reviewed as new information becomes available.