UPDATE: Pneumonia Outbreak in Wuhan, China with answers about patients in Thailand and Japan

Daniel R. Lucey, MD, MPH, FIDSA

1/17/2020

Wuhan City in the Hubei Province of the People's Republic of China is on the Yangtze River and is the most populous city in central China. A major transportation hub, it is where a cluster of pneumonia-like illnesses that have since been identified as a novel coronavirus began in December, with the first patient reported on Dec. 12. That virus has since been diagnosed in two patients who had traveled outside of the country, to Thailand and Japan, although neither patient is reported to have visited the Wuhan City seafood market that linked the other cases. Dr. Daniel Lucey, who has responded to, and monitored information on outbreaks since 2001, updates information on the outbreak here. Dr. Lucey presented a Jan. 14 webinar at the United Nations on the outbreak, a congressional staff office briefing Jan. 16, and co-authored a Jan. 14 article on the outbreak with Dr. Annie Sparrow in Foreign Policy. The following update is the latest in a series of answers from Dr. Lucey to questions raised by the outbreak.

How many patients and how many deaths have been reported in Wuhan?

A total of 41 patients were reported between Dec. 8 2019 and Jan 2, 2020 with two deaths and five patients still severely ill, with the possibility that fatality could rise. As of Jan. 16, (translate button available) the number of patients discharged from care had reached 12.

What are risk factors for severe disease?

On Jan. 15, Wuhan Health officials posted on their outbreak webpage: “Of the 41 cases diagnosed, most were male, and the number of middle-aged and elderly people was higher. In the early stage of the case, fever and cough are the main symptoms, which can be manifested as persistent mild disease in the early stage. Older patients with underlying disease are more likely to progress to severe disease.” The two deaths were in men who had underlying chronic diseases, 61- and 69-years-old.

Is there one laboratory-confirmed case in Thailand and another in Japan?

Yes. A Chinese tourist from Wuhan developed fever there Jan. 5, but flew with a group to Bangkok Jan. 8 where she was identified on fever screening and hospitalized. She is recovering. She had not been to the market in Wuhan where most of the 41 patients had been, but she been to other markets in Wuhan.

What is known about the patient in Japan announced Jan. 15?

A 30 year-old man living near southern Tokyo (Kanagawa Prefecture) went to Wuhan where he developed a fever Jan. 3 and then flew back to Japan on Jan 6, with, apparently no fever at the airport. Hospitalized Jan. 10, he recovered, and was discharged Jan 15. Like the patient in Bangkok who had travelled n Wuhan, he also had not been to the Market that has been linked to the outbreak. He had, however, ”potential close contact with unspecified pneumonia patients in China,” according to the Japan Ministry of Health Jan 15 announcement. (Translate button available)

Has there been any suggestion of person-to-person transmission?

Yes, but evidence is limited currently and no proof of sustained transmission. One of the 41 patients who had not been to the Wuhan seafood market is married to a worker at the market. Thus, her infection is probably person-to-person. The patient in Japan could be person-to-person.

Has any infected animal from that one Wuhan Market been found infected?

Not yet. But taking the ONE HEALTH approach, China did find environmental samples from the one market that are positive for the novel virus. Yes. Today’s Jan. 16 South China Morning Post states: “Since Wednesday, passengers at Tianhe International Airport in Wuhan – the airport for the central Chinese city where the outbreak began – have been required to pass through electronic temperature sensors at each of its exits. Any that are found to have a body temperature of more than 38 degrees Celsius (100 degrees Fahrenheit) are then required to undergo a manual check and if the high temperature is confirmed, spend a period of time in a quarantine facility.”

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