China Investigates Pneumonia Tied to New Coronavirus

On December 31, 2019, the World Health Organization (WHO) China Country Office was alerted to a pneumonia outbreak of then-unknown etiology which has made headlines in the following days. It has since been identified as a new coronavirus. The outbreak of pneumonia has been concentrated in Wuhan city, the capital city of Hubei province. Hubei province is located in central China.

According to a WHO statement on the matter, several patients were vendors or dealers in the Huanan Seafood market. On January 1, 2020 the market was closed for sanitation and disinfection.

On January 9, WHO released another statement confirming reports that Chinese authorities had made the preliminary determination of a novel coronavirus in a person hospitalized for pneumonia.

"Further investigations are also required to determine the source, modes of transmission, extent of infection and countermeasures implemented. WHO continues to monitor the situation closely and, together with its partners, is ready to provide technical support to China to investigate and respond to this outbreak," WHO officials wrote.

The US Centers for Disease Control and Prevention (CDC) also issued a statement on the matter, writing that as of January 5, 2020, national authorities in China had reported 59 cases. No deaths have been reported at this time.

While the CDC is monitoring the situation, they have refrained from raising alarm, instead recommending usual precautions for travelers in outbreak areas. The CDC’s advice for travelers to central China includes avoiding animal markets, avoiding contact with sick people, and frequent hand washing.

The CDC also detailed the clinical presentation of case-patients.

“As of this posting, case-patients in the cluster reportedly have had fever, difficulty breathing, and bilateral lung infiltrates on chest radiograph. For patients with similar respiratory symptoms who recently traveled to Wuhan, consider pneumonia related to the cluster and notify infection control personnel and your local health department immediately."

The CDC recommends clinicians equip case-patients with a surgical mask, and advises use of contact precautions.

“Conduct their evaluation in a private room with the door closed. Personnel entering the room to evaluate the patient should use contact precautions and wear an N95 disposable facepiece respirator. For patients admitted for inpatient care, implement contact and airborne isolation precautions, in addition to standard precautions, until further information becomes available.”

Before the discovery of the new coronavirus, the Hong Kong Centre for Health Protection released a letter to local clinicians on the matter detailing a variety of pathogens which had been ruled out.

“The causative pathogen is still being investigated by the Mainland [Chinese] health authorities. Respiratory pathogens including influenza viruses, avian influenza viruses, adenovirus, Severe Acute Respiratory Syndrome coronavirus and Middle East Respiratory Syndrome coronavirus have been ruled out. It is highly likely that this condition is caused by a novel pathogen,” officials told doctors.

The outbreak has led to concern throughout the region. On January 4, 2020, for example, officials from the Singapore Ministry of Health reported the possibility that a 3 year-old Chinese national with pneumonia and travel history to Wuhan was associated with the outbreak.

However, on January 5, 2020 Singaporean officials released an update, confirming that the case is not linked to the pneumonia cluster in Wuhan. Instead, the patient’s illness was caused by respiratory syncytial virus.

While some media outlets have made comparisons to the 2003 epidemic of Severe Acute Respiratory Syndrome (SARS) it is not yet clear how severe this outbreak will be. In what could be seen as implicit reference to the widely scrutinized state response to the SARS outbreak, WHO noted China's more substantial public health infrastructure in their statement on January 9.

"Preliminary identification of a novel virus in a short period of time is a notable achievement and demonstrates China’s increased capacity to manage new outbreaks."

Contagion® will continue to follow the situation and provide updates as more information becomes available.