The health commission in Wuhan, a transit and business hub, says there
is no clear evidence so far that the unidentified disease can be
transmitted between humans, and no health-care workers have been
infected. Cases of fever have been reported in Hong Kong and Taiwan by
travelers who recently visited Wuhan, although there is no confirmation
that the illnesses are linked.
Since mid-December, 59 people have been diagnosed with viral pneumonia
of “unknown cause” — including seven who are critically ill, according
to Wuhan’s health commission.
The officials said an additional 163 people who have come into close
contact with the infected have been placed under close observation. No
deaths have been reported.
Several of the patients worked at Wuhan’s South China Seafood City, said
the authorities, who shut down the market on Jan. 1 to carry out daily
disinfections. The 1,000-stall bazaar sold not only seafood but marmots,
spotted deer and venomous snakes, according to state media reports that
described the market as “filthy and messy.”
Videos from Wuhan showed the market barricaded in recent days and guarded by police wearing surgical masks.
The emergence of a new illness out of China has carried echoes of the severe acute respiratory syndrome (SARS) epidemic,
which infected more than 8,000 people, killed 774 and sparked mass
panic as it spread across more than two dozen countries over eight
months after starting in China in November 2002.
SARS is thought to be an animal virus from an as-yet-uncertain animal
reservoir, perhaps bats, that spread to other animals, such as civet cats,
and first infected humans in China’s Guangdong province, according to
the World Health Organization. The tropical civet is sold and eaten as a
delicacy in southern China. The SARS epidemic delivered a political
shock to the Communist Party, which was widely condemned for mismanaging
the outbreak, covering up cases and smothering news reports.
Wuhan’s health commission, which has so far given relatively regular
news updates, said the new pneumonia cases were not caused by SARS. It
has also ruled out influenza, bird flu, adenoviruses and Middle East
respiratory syndrome (MERS), and said nucleic acid analysis was underway
to identify the pathogen.
“There are now two key questions: What is the cause of the disease? Is
it a brand new virus?” said Leo Poon, a Hong Kong University
epidemiologist who was among the first to decode the SARS coronavirus.
“Next: Is it transmissible between humans? We cannot yet rule out the
possibility entirely.”
Because Wuhan authorities began quarantining and disinfecting the market
on New Year’s Day, the number of new cases should taper off in the
coming weeks, Poon said.
“But if there are additional cases, that may suggest human-to-human
transmission” that would greatly complicate the situation, he added.
The WHO said it is monitoring the situation in China. The U.S. Centers for Disease Control and Prevention issued a low-level travel notice on Monday, reminding travelers to practice “usual precautions” inside the country.
On Tuesday, the CDC said it has established an incident management
structure to “optimize domestic and international coordination in the
event additional public health actions are required,” according to a
notice the agency sent to state health officers and public health
emergency preparedness directors.
There are no known U.S. cases or any cases in any countries outside
China, the CDC said. “But outbreaks of unknown respiratory disease are
always of concern, particularly when there are possible zoonotic origins
to the outbreak,” the CDC statement said. Later this week, the CDC
plans to issue a health alert notice to clinicians with a summary of the
current situation and guidance, the statement said.
Public health experts say it is reassuring that, so far, no health-care
workers have fallen sick. When the SARS outbreak began, the major alarm bells were
illness in doctors and nurses and the spread of disease from person to
person, said Tom Inglesby, director of the Center for Health Security of
the Johns Hopkins Bloomberg School of Public Health.
But while Chinese officials have ruled out several causes of the
illnesses, they have not provided detailed information about what tests
were performed, when they were done and at what point in the patients’
illnesses. Nor have Chinese officials provided a timeline of patient
illnesses, information that is typically made public quickly in disease
outbreaks.
“We’ve heard they ruled out SARS and MERS and other coronaviruses. There
seem to be a lot of reports that this is a novel pathogen, but we
haven’t seen the evidence,” said Jennifer Nuzzo, an epidemiologist and
senior scholar at the same center.
In the absence of additional information from Wuhan officials, other
countries have announced additional measures, such as quarantine and fever screening at airports.
If there is predictable and daily communication from Chinese health
leaders in charge of the response about what is known and what is
unknown about the outbreak, that “would tamp down some of the anxiety”
about the disease and the response, Nuzzo said.
If the Wuhan pneumonia were found to be contagious, it could pose a
major public health challenge coming just before the Lunar New Year
holiday, when more than 400 million Chinese are expected to travel —
including 7 million who vacation overseas.
In Beijing, the capital city’s health officials this week called for
“public health readiness” to respond to emergencies during the holiday
period between Jan. 24 — 30.
So far in Hong Kong, 30 people who have visited Wuhan in recent weeks
have been hospitalized with fever, and pharmacies in the city quickly
sold out of face masks, local media reported.
The city’s chief executive, Carrie Lam, told reporters on Tuesday that
authorities have rolled out new measures that would require Hong Kong’s
doctors to report suspected cases and give city officials legal powers
to quarantine suspected patients.
All travelers by high-speed rail from Wuhan will have their body temperature tested before entering Hong Kong, Lam said.
The Taiwanese government said eight people traveling from Wuhan have
exhibited fever, and it was offering to send epidemiologists to Wuhan to
help investigate.
Xu Jianguo, a former top Chinese public health official, struck an
assuring note and said the government’s disease control capabilities
today are much stronger than they were in the early 2000s.
“More than a decade has passed,” he said. “It’s impossible for something like SARS to happen again.”
Sun reported from Washington. Liu Yang contributed to this report.
