Thursday, January 09, 2020

WHO (WPRO) Statement On Cluster Of Pneumonia Cases In Wuhan, China


The World Health Organization published an update overnight (EST time) regarding the ongoing investigation into the Wuhan City pneumonia cluster (see CDC HAN Advisory).  While much remains to be learned, over the past 24 hours it has been tentatively confirmed to be due to a novel coronavirus, and we should learn much more in the days and weeks ahead.

First the WHO statement, then I'll return with a  postscript.

WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China
9 January 2020

Chinese authorities have made a preliminary determination of a novel (or new) coronavirus, identified in a hospitalized person with pneumonia in Wuhan. Chinese investigators conducted gene sequencing of the virus, using an isolate from one positive patient sample. Preliminary identification of a novel virus in a short period of time is a notable achievement and demonstrates China’s increased capacity to manage new outbreaks.
Initial information about the cases of pneumonia in Wuhan provided by Chinese authorities last week – including the occupation, location and symptom profile of the people affected – pointed to a coronavirus (CoV) as a possible pathogen causing this cluster. Chinese authorities subsequently reported that laboratory tests ruled out SARS-CoV, MERS-CoV, influenza, avian influenza, adenovirus and other common respiratory pathogens.
Coronaviruses are a large family of viruses with some causing less-severe disease, such as the common cold, and others more severe disease such as MERS and SARS. Some transmit easily from person to person, while others do not. According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people.
Globally, novel coronaviruses emerge periodically in different areas, including SARS in 2002 and MERS in 2012. Several known coronaviruses are circulating in animals that have not yet infected humans.
As surveillance improves more coronaviruses are likely to be identified.
China has strong public health capacities and resources to respond and manage respiratory disease outbreaks. In addition to treating the patients in care and isolating new cases as they may be identified, public health officials remain focused on continued contact tracing, conducting environmental assessments at the seafood market, and investigations to identify the pathogen causing the outbreak.
In the coming weeks, more comprehensive information is required to understand the current status and epidemiology of the outbreak, and the clinical picture. Further investigations are also required to determine the source, modes of transmission, extent of infection and countermeasures implemented. WHO continues to monitor the situation closely and, together with its partners, is ready to provide technical support to China to investigate and respond to this outbreak.
The preliminary determination of a novel virus will assist authorities in other countries to conduct disease detection and response. Over the past week, people with symptoms of pneumonia and reported travel history to Wuhan have been identified at international airports.
WHO does not recommend any specific measures for travellers. WHO advises against the application of any travel or trade restrictions on China based on the information currently available.

Media Contacts

Paige Snider
External Relations and Communication
World Health Organization
Telephone: +86 10 6532 7190 Extension. 81262

We are still only 9 days into the unfolding story of this unidentified pneumonia outbreak in Wuhan, China - one that has caused major concern across Hong Kong, Taiwan, and Macao - and one that has sparked a great deal of speculation on the internet.
While some of the details have been slow in coming, such as patient demographics (age, gender, location, comorbidities, etc.) and epidemiological data on contacts and exposures -  considering we appear to be confronted with a novel emerging virus - China has demonstrated remarkable progress in identifying the type of virus in a very short period of time. 
The number of cases, and the ability of this viral illness to transmit remains ill-defined, and while frustrating, this is something we see with every infectious disease outbreak; regardless of where in the world it occurs.

Although we often have official `case counts', it is well understood that these numbers likely under-represent the total number of cases.

Credit CDC

Right now, when the `known' numbers are small, and our understanding of this pathogen is quite limited, small jumps in case counts are often viewed with alarm. And all too often, when fresh information isn't quick enough in coming, the internet tends to fill that particular void with whatever it can.
Good reasons why we need to be cautious in accepting, and interpreting, the latest viral news report.  Since even `official' numbers are suspect, Caveat Lector should rule the day.
I couldn't even begin to guess where we'll be with this story a month from now. It could already be a footnote in outbreak history - and we'll have moved on to the next big thing - or it could be consuming every news cycle.
While I recognize the potential of this outbreak, neither outcome would surprise me at this point.  
But whether China's PUE (Pneumonia of Unknown Etiology) sparks the next global health crisis, or we see a resurgence of avian flu this spring, or some other emerging infectious disease begins to race around the globe, we need to be prepared for the fact that it will happen again.   
If not this year, then next year, or sometime over the next decade. 
It will probably come upon us quickly, and with little warning.  And anything we haven't done by that time to prepare, will cost us dearly.  So, while PUE may - or may not - be the next big threat, as we  barrel headlong into a new and uncertain decade, it behooves us to take pandemic planning, and preparedness, seriously.

Some recent pandemic preparedness blogs include:

HCWs Willingness To Work During A Pandemic

The Inaugural Global Health Security Index

ECDC: Health Emergency Preparedness for Imported Cases of High-Consequence Infectious Diseases
Center for Health Security Report On Preparedness for A High-impact Respiratory Pathogen

#NatlPrep: Personal Pandemic Preparedness

WHO/World Bank GPMB Pandemic Report : `A World At Risk'