Tuesday, December 31, 2019

China: 27 Cases of `Atypical Viral Pneumonia' Reported In Wuhan, Hubei

Wuhan - Credit Wikipedia


While it may turn out to be something relatively innocuous , the dedicated newshounds at FluTrackers began posting numerous reports out of China a little before midnight (EST) on an outbreak of an - as yet - unidentified viral pneumonia in Wuhan; the capital and largest city (pop. 11 million) in Hubei Province.
SARS - not unexpectedly - is being widely mentioned in both Chinese and international media reports as a possible cause, but recent media reports indicate that local officials are downplaying that notion. 
This report from RTHK.HK.

Internal media quotes Wuhan CDC staff saying viral pneumonia case is not related to SARS
2019-12-31 HKT 14:00
Viral pneumonia broke out in Wuhan, 7 of which were critically ill. Most of the cases came from merchants in Wuhan South China Seafood City. Experts from the National Health Commission arrived in Wuhan for testing and verification. Southern Metropolis Daily quoted a staff member of the Wuhan Centers for Disease Control and Prevention as saying that it had nothing to do with SARS.
Staff also said that receiving reports of related pneumonia cases is relatively common and many pathogens may cause it. Some patients have a relatively long course of disease, and there is a process of testing, which is being fully investigated. It should be announced in the past two days. According to the information circulating on the Internet, the staff said that there are many types of pneumonia, and the country will monitor it every year, saying " Don't worry at all, you can say responsibly that it has nothing to do with SARS. "
People's Daily quoted news reports that since this month, Wuhan has confirmed 27 cases of viral pneumonia, all of which are viral pneumonia or lung infections, and the authorities are conducting tests, isolation treatment and disinfection. Many people in Wuhan Hospital believe that the current cause is not clear, and it cannot be concluded that it is the SARS virus rumored online. Other severe pneumonia is more likely. Even SARS virus has a mature prevention and treatment system, and the public need not panic.
The Wuhan Municipal Health and Medical Commission's Medical Affairs and Medical Administration Department issued an urgent notice, requiring some medical institutions to make statistics and report treatment in a timely manner.

Another report, this time from Zaobao.com, provides additional `official' reassurance, citing `no significant human-to-human transmission'.  Reports suggest that the bulk of the cases so far are among merchants in Wuhan South China Seafood City, which could indicate either H-2-H transmission or a shared environmental exposure.

Wuhan Bulletin: Preliminary analysis shows no significant human-to-human transmission of viral pneumonia
Posted / December 31, 2019 2:27 PM
Update / December 31, 2019 2:45 PM
The Wuhan Municipal Health and Health Committee issued a notification on the pneumonia epidemic. The preliminary analysis of the cases was viral pneumonia. All cases have been isolated for treatment, no obvious human-to-human transmission has been found, and no medical staff infection has been found.
According to the "Beijing News" report, Wuhan Health and Health Commission has released news that 27 cases have been found, seven of which are in serious condition, and the remaining cases are stable and controllable. Two patients are expected to be discharged in the near future.
The clinical manifestations of the cases were mainly fever, a few patients had difficulty breathing, and chest radiographs showed bilateral lung infiltrative lesions.
Since we don't have a timeline indicating how long this outbreak has been going on, a lack of infected medical staff may, or may not, be significant.  `Bad news', particularly when it involves disease outbreaks, often takes time to filter out of China, and is almost always presented in the best `light'.
One of the Chinese phrases we in flublogia keep an eye out for is `非典型肺炎'  - aka Atypical Pneumonia - and it is currently lighting up Twitter and Chinese language media sources.  
Even if - as the RTHK report above suggests - that SARS is not a reasonable suspect, there are a number of other novel coronavirus contenders we are keeping an eye on in China (see PNAS: SARS-like WIV1-CoV Poised For Human Emergence).

Long time readers will recall that back in 2012 there was a brief media flap over what was initially feared to be a return of SARS in China - also in Hebei Province -  but it was quickly identified as Ad55 (see China Denies Internet Rumor Of SARS Outbreak and China: Hebei Outbreak Identified As Adenovirus 55).
A novel flu is also a possibility, although by now they ought to have at least narrowed it down to an influenza A virus. 
In February and March of 2013, however, several cases of `atypical pneumonia' were hospitalized in Anhui and Shanghai province, and it took several weeks before it was revealed that they were the first victims of a newly emerged avian H7N9 virus (see  China: Two Deaths From H7N9 Avian Flu).

Whatever this turns to be (and the possibilities are myriad at this point), it comes just weeks before the start of Chunyun, or the Spring Festival travel season - which begins about 15 days before the Lunar New Year (Jan 25th).

Lasting about 40 days, Chunyun marks the largest annual human migration in the world. Hundreds of millions of people - primarily in China, but also across much of Asia - will travel home (mostly via crowded rail and bus) for a traditional family gathering. 
Monitored closely every year due to its potential for spreading infectious diseases, thus far - very much like the Hajj - this period of intense travel has yet to spark a major epidemic. 
As of 0345 hrs EST, Hong Kong's CHP, Taiwan's CDC, and  Macao's government portal have not reported on these cases.  FluTrackers and I will continue to monitor Chinese language and English language reports, and we'll update this situation when more become known.

Stay tuned.