Wuhan Coronavirus Outbreak PHEIC Decision Delayed

The World Health Organization (WHO) International Health Regulations Emergency Committee and WHO director-general Tedros Adhanom Ghebreyesus, PhD, will reconvene tomorrow, January 23rd, to determine if the Wuhan Coronavirus outbreak is a Public Health Emergency of International Concern (PHEIC).

The panel of 16 experts met at the United Nations’ Geneva Headquarters on January 22nd to discuss the outbreak. In a press conference, committee members indicated that the panel was split on whether or not to declare and PHEIC and will reconvene tomorrow to discuss the situation further.

Didier Houssin, MD, chairperson of the International Health Regulations Emergency Committee, stated that the split among the 16 committee members was "50/50, even."

"The decision about whether or not to declare a public health emergency of international concern is one I take extremely seriously, and one I am only prepared to make with appropriate consideration of all the evidence," Tedros said in the press release.

The January 22nd meeting came just 1 day after the US Centers for Disease Control and Prevention (CDC) announced the first Wuhan coronavirus case in the United States.

As of January 21st, China’s National Health Commission has confirmed 440 cases of pneumonia associated with the new coronavirus. The outbreak was originally tied to a seafood market in Wuhan, but new infections are no longer confined to the city.

Reports indicate that the city of Wuhan will be placed on public transport lockdown in order to reduce the spread of the virus.

Public #transportation such as bus, subway, ferry and long-distance bus in Wuhan will be temporarily closed since 10am Thursday. All flights and trains departed from #Wuhan will be temporarily cancelled to reduce risk of spread of the new virus, local govt says. #coronavirus pic.twitter.com/gtzIlFszaf

— China Daily (@ChinaDaily) January 22, 2020

"It’s stunning and concerning as it will likely cause a rush to get out before the new year and has questionable human rights implications," Saskia v. Popescu, PhD, a Contagion® contributor and infection preventionist said on the transportation lockdown. "It also has questionable efficacy in truly slowing transmission."

WHO has also confirmed cases in Japan, Thailand, and South Korea.

China notified the WHO of a pneumonia outbreak of then-unknown etiology on December 31, 2019. On January 9, 2020 WHO released a statement explaining that Chinese scientists had discovered a new coronavirus responsible for the outbreak.

The US Department of Homeland Security’s Customs and Border Protection (CBP) and CDC announced airport screenings for travelers from Wuhan at 3 major US airports on January 17, 2020.

The first US case patient, arriving at Seattle-Tacoma airport, did not arrive in an airport being screened. The patient was not symptomatic at the time, and the flight was not a direct flight from Wuhan.

Additionally, the patient did not go to any implicated animal markets in Wuhan, nor did he report close contact with any ill individuals.

The patient had apparently researched the virus online, and upon developing symptoms reached out to his health care provider on January 19, 2020.

The Wuhan coronavirus was confirmed in the US patient on January 20, 2020. Public health officials from Washington indicated that the patient was hospitalized out of precaution but overall is in good condition.

Clinicians should gather travel history information in any suspected patients. Surveillance case definitions from WHO are available here.

The WHO case definitions include standards for patients with severe acute respiratory infection as well as acute respiratory illness.

A suspect case applies to patients with severe acute respiratory infection when there is no other etiology to explain clinical presentation of symptoms and travel to or residence in Wuhan. The definition also applies to patients who are not a health care worker in an environment where patients with severe acute respiratory infections of unknown etiology are being cared for.

A suspect case also applies to patients with any acute respiratory illness and close contact with a confirmed or probable case of Wuhan coronavirus, working in an animal market, or working in a health care facility with reports of the virus in the 14 days prior to onset of symptoms.

Probable cases are defined as suspect cases where Wuhan coronavirus testing is inconclusive or testing was positive on a pan-coronavirus assay. Confirmed cases are defined by laboratory confirmation of Wuhan coronavirus infection.

For the most recent cases in the novel coronavirus outbreak, visit the Contagion® Outbreak Monitor.