CDC Issues Level 1 (Watch) Travel Notice For Unidentified Pneumonia - Wuhan, China

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The CDC has weighed in on the growing cluster of unidentified pneumonia cases in Wuhan, China on their Travelers' Health Website, with the following Watch Level 1 advisory. 

A watch level 1 is the lowest tier advisory. The next highest is Alert Level 2 (Yellow), followed by Warning Level 3 (Red).

Previously, media reports indicated that the `seafood market' which has been linked to the outbreak also sold poultry, pork, and rabbit -  but today's notice expands that list, stating: In addition to seafood, the market sells chickens, bats, marmots, and other wild animals. 

The 2003 SARS epidemic has been linked to `wild flavor' ("yewei" or 野味) restaurants that provided exotic animal dishes, including civet cats, snake soup, pangolin, and fried bats.  Animals were often  kept alive in cages in kitchens, and butchered and cooked to order. 

It is believed this may have facilitated the jump of the SARS coronavirus from an animal host to humans. 

While the sale of many of these exotic animals was made illegal following the epidemic, old habits die hard, and enforcement has been lax (see Despite Crackdown, `Wild Flavor’ Trade Continues In China).

Nearly two months ago, in African Swine Fever's (ASF) Other Impacts; Pharmaceuticals, Bushmeat, and Food Insecurity), we looked at concerns that the  pork shortage caused by African Swine Fever might induce more people to dine on `bushmeat', which has the potential of spreading zoonotic diseases. 

Today's CDC announcement follows yesterday's WHO statement, and the recent ordered enhanced surveillance of travelers coming from that region by Taiwan, Hong Kong, and Macao public health officials.

Pneumonia of Unknown Cause in China

Watch - Level 1, Practice Usual Precautions

Key Points

There is a cluster of cases of pneumonia in Wuhan, China. The cause is not yet known, nor is the mode of transmission.

The cluster is centered at the Wuhan South China Seafood City (also called the South China Seafood Wholesale Market and the Hua Nan Seafood Market). The market has been closed since January 1, 2020, for cleaning and disinfection.

Travelers to Wuhan, China, should avoid living or dead animals, animal markets, and contact with sick people.

The situation is evolving. This notice will be updated as more information becomes available.

What is the current situation?

There is a cluster of cases of pneumonia in Wuhan, China. As of January 5, 2020, local, provincial, and national health commissions in China have reported a total of 59 cases with no deaths. The cluster is centered at the Wuhan South China Seafood City (also called the South China Seafood Wholesale Market and the Hua Nan Seafood Market).

In addition to seafood, the market sells chickens, bats, marmots, and other wild animals. The market has been closed since January 1, 2020, for cleaning and disinfection.

Health authorities in China are monitoring more than 150 close contacts for illness. To date, there have been no reports of spread from person to person or to health care workers.

Symptoms include fever and difficulty breathing. Though the cause of this cluster is unknown, there is concern that it is a virus. Local authorities have reported negative laboratory results for seasonal influenza, avian influenza, adenovirus, and two specific coronaviruses known to cause respiratory illness (severe acute respiratory syndrome [SARS] and Middle East respiratory syndrome [MERS]).
What can travelers do to protect themselves?

Travelers to Wuhan should

• Avoid animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat).

• Avoid contact with sick people.

• Wash hands often with soap and water.

If you traveled to Wuhan and feel sick, you should

• Stay home. Except for seeking medical care, avoid contact with others.

• Don’t travel while sick.

• Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell the doctor about your recent travel and your symptoms.

• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.

• Clinician Information

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.

Although the etiology and transmission dynamics have yet to be determined, CDC recommends a cautious approach to symptomatic patients with a history of travel to Wuhan. Ask such patients to don a surgical mask as soon as they are identified. 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.

For additional infection control guidance see: https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html.

This notice was originally posted January 6, 2020.