Outbreak of “Mystery” Coronavirus Rapidly Evolving

A “novel virus”, originating in China, has captured the attention of infectious disease specialists around the world. Of particular concern to those who may have a compromised immune system, and the elderly, the CDC is issuing regular information updates. This particular virus has never been seen in humans before – hence the nickname, the “mystery virus”. The WHO has called an emergency meeting to discuss what is known – and next steps.

Screenings are being held for incoming flights to the US from certain high risk areas.

From the Centers for Disease Control (CDC):

The novel Coronavirus (2019-nCoV) is now passing from human to human, having evolved from contamination at an identified local fish market.

The CDC calls this “an emerging, rapidly evolving situation”, and they will provide updated information as it becomes available, in addition to updated guidance.

The Centers for Disease Control and Prevention (CDC) is closely monitoring an outbreak caused by a novel (new) coronavirus in Wuhan City, Hubei Province, China. Chinese authorities first identified the new coronavirus, which has resulted in about 200 confirmed human infections in China with three deaths reported. A number of countries, including the United States, are actively screening incoming travelers from Wuhan and exported cases have been confirmed in Thailand, Japan, and South Korea.

Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with MERS and SARS. Past MERS and SARS outbreaks have been complex, requiring comprehensive public health responses.

Many of the patients in the outbreak in Wuhan, China have reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread. However, a growing number of patients reportedly have not had exposure to animal markets, suggesting limited person-to-person spread is occurring.

There are ongoing investigations to learn more. This is a rapidly evolving situation.

Risk Assessment

Outbreaks of novel virus infections among people are always of public health concern. The risk from these outbreaks depends on characteristics of the virus, including whether and how well it spreads between people, the severity of resulting illness, and the medical or other measures available to control the impact of the virus (for example, vaccine or treatment medications).

There is much more to learn about how the 2019-nCoV virus spreads, severity of associated illness, and other features of the virus. Investigations are ongoing. Based on current information, however, the immediate health risk from 2019-nCoV to the general American public is deemed to be low at this time. Nevertheless, CDC is taking proactive preparedness precautions.

What to Expect

Access to the full genetic sequence of 2019-nCoV will help identify infections with this virus going forward. More cases may be identified in the coming days, including more in countries outside China, and possibly in the United States. Given what has occurred previously with MERS and SARS, it’s likely that some limited person-to-person spread will continue to occur.

CDC Response To Date

• CDC is closely monitoring this situation and is working with WHO.
• CDC established a 2019-nCoV Incident Management Structure on January 7, 2020.
• CDC has updated its interim travel health notice for this destination to provide information to people who may be traveling to Wuhan City and who may get sick.
• CDC began entry screening of passengers on direct and connecting flights from Wuhan China to the three main ports of entry in the United States on January 17, 2020.
• CDC issued an updated interim Health Alert Notice (HAN) Advisory to inform state and local health departments and health care providers about this outbreak on January 17, 2020.
• CDC has developed a Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test that can diagnose 2019-nCoV. Currently, testing for this virus must take place at CDC, but in the coming days and weeks, CDC will share these tests with domestic and international partners.

From the World Health Organization (WHO):

On 10 January, WHO published a range of interim guidance for all countries on how they can prepare for this virus, including how to monitor for sick people, test samples, treat patients, control infection in health centres, maintain the right supplies, and communicate with the public about this new virus.

Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. 

Based on currently available information, WHO does not recommend any restriction of travel or trade. Countries are encouraged to continue strengthening their preparedness for health emergencies in line with the International Health Regulations (2005).Standard recommendations to prevent infection spread include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.

Based on currently available information, WHO does not recommend any restriction of travel or trade. Countries are encouraged to continue strengthening their preparedness for health emergencies in line with the International Health Regulations (2005).