 |
| Credit Wikipedia |
#14,613
We have our first official update - published by the Wuhan Municipal Health Commission - on China's cluster of unidentified pneumonia cases since the outbreak was first announced on December 31st. Over the past 4 days, what little we've learned has been gleaned from neighboring (Hong Kong, Macao, Taiwan) Health authorities.
The number of hospitalized cases has increased (from 27) to 44, with 11 listed in critical condition. The report states that `. . . common respiratory diseases such as influenza, avian influenza, and adenovirus infection have been ruled out.'While 121 close contacts (a small number, given 44 primary cases) are being monitored, and they cite ` . . . no clear evidence of human-to-human transmission. . . ', no other epidemiological details are provided.
The report continues to refer to the affected region of Wuhan as a `seafood market', but local reporting has stated that other animal products, including poultry, pork, and wild game are offered for sale there as well.
All of which means, we are still dealing with a medical mystery.
First, the translated statement from the Wuhan Health Commission, then I'll return with a postscript.
As there appears to be a significant spread in the severity of symptoms (25% classified as severe, or critical), it is possible - perhaps even likely - that there are additional mild (or even subclinical) cases that have not been identified.
Whether this outbreak escalates into more than a regional problem, or simply becomes a quickly forgotten footnote in history, is anyone's guess. But if we manage to dodge a bullet this time, there will be plenty more opportunities for the next great public health crisis to emerge in the coming years.
Wuhan Municipal Health and Health Commission's report on unexplained viral pneumonia
Issuing authority: Wuhan City health committee | Published: 2020-01-03 17:00:42
Since December 2019 , our committee has carried out surveillance of respiratory diseases and related diseases, and found cases of viral pneumonia of unknown cause. The clinical manifestations of the cases are mainly fever, a few patients have difficulty breathing, and chest radiographs show bilateral lung infiltrative lesions.
As of 8:00 on January 3, 2020, a total of 44 patients with unexplained diagnosis of viral pneumonia were found, of which 11 were critically ill, and the vital signs of the remaining patients were generally stable.
At present, all cases are being treated in isolation at Wuhan medical institutions. 121 close contacts have been tracked and medical observations have been tracked. The follow-up of close contacts is still ongoing.
An epidemiological survey showed that some cases were operating households in Wuhan South China Seafood City. As of now, preliminary investigations have shown no clear evidence of human-to-human transmission and no medical staff infections. Pathogen identification (including nucleic acid detection and virus isolation and culture) and cause tracing are ongoing, and common respiratory diseases such as influenza, avian influenza, and adenovirus infection have been ruled out.
After the outbreak, the State and Provincial Health and Health Commission attached great importance to it and sent working groups and expert teams to Wuhan to guide the local epidemic response and disposal work. Wuhan Municipal Health and Health Commission has conducted relevant case searches and retrospective investigations in medical institutions throughout the city, and has completed the environmental sanitation disposal of South China Seafood City, and further hygiene investigations are ongoing.
January 3, 2020The good news in all of this is - while more cases have been detected - novel influenza A (avian or swine) appears to have been eliminated from consideration, along with other common respiratory viruses (adenovirus, SARS, etc.).
They are still calling it a `viral pneumonia', which suggests they've ruled out pneumonic plague, Legionella, and other bacterial infections as well.What this leaves us with is a viral infection of unknown etiology, one that is possibly newly emerging. While 44 (known) cases in just over a week from a single area of town might suggest human-to-human spread, this could also still be due to common environmental exposure, or perhaps even a vector borne illness (ticks, mosquitoes, etc.).
As there appears to be a significant spread in the severity of symptoms (25% classified as severe, or critical), it is possible - perhaps even likely - that there are additional mild (or even subclinical) cases that have not been identified.
And, since we don't know the pathogen, its incubation period, or how it is being acquired, it is still too soon to speculate on what threat it may pose.As we discussed at some length in The Third Epidemiological Transition (Revisited), we live in an age of emerging and re-emerging infectious diseases, many of zoonotic origin. MERS-CoV, SARS, Zika, HIV, SFTS, Nipah, Hendra, Marburg, Ebola, Lassa Fever . . . the list is long and growing.
Whether this outbreak escalates into more than a regional problem, or simply becomes a quickly forgotten footnote in history, is anyone's guess. But if we manage to dodge a bullet this time, there will be plenty more opportunities for the next great public health crisis to emerge in the coming years.
Which is why we spend so much time focusing on pandemic preparedness in this blog. When the next pandemic does emerge, it will probably provide us very little warning.While we ponder this inevitability, a few recent blogs on pandemic preparedness to revisit include:
HCWs Willingness To Work During A Pandemic
ECDC: Health Emergency Preparedness for Imported Cases of High-Consequence Infectious Diseases
The JHCHS #Event201 (Fictional) CAPS Pandemic Scenario
#NatlPrep: Personal Pandemic Preparedness
WHO/World Bank GPMB Pandemic Report : `A World At Risk'
