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Over the past few hours considerably more information has been released by the Wuhan Health Commission on their recently discovered pneumonia cluster, including the fact that one patient (61 y.o. male with comorbidities) has died and - now that a test is available - they report a reduction in the number of confirmed hospitalized cases (n=41).
The real-time outbreak thread on FluTrackers, which at this writing has over 150 entries, is doing a terrific job collecting and collating data as it comes in. Highly recommended.Our tour of the new information begins with a short synopsis excerpted from a Hong Kong CHP Statement.
CHP provides latest information on cluster of pneumonia cases in Wuhan
The Centre for Health Protection (CHP) of the Department of Health (DH) today (January 11) received notification from the National Health Commission (NHC) on the latest information of the cluster of pneumonia cases detected in Wuhan, Hubei Province. The public is again urged to maintain strict personal, food and environmental hygiene both locally and during travel.
After the preliminary determination that the pathogen of "viral pneumonia with unknown cause" is a novel coronavirus, the National and Provincial Expert Groups have immediately revised and improved the protocols on diagnosis, treatment and surveillance of viral pneumonia with unknown cause. The Wuhan Municipal Health Commission has arranged the samples of existing patients to be tested for nucleic acid of the pathogen, and the Expert Groups have made overall assessments on the patients hospitalised for observation and treatment, taking into considering of information on clinical picture, epidemiological information and laboratory testing results, etc. As at yesterday (January 10), 41 patients have been diagnosed to have infection of the novel coronavirus. Among them, two patients have been discharged, seven patients are in serious condition and one died, while the remaining patients are in stable condition.
A total of 739 close contacts have been identified and 419 of them are healthcare workers. All have been put under medical surveillance, and no related cases have been detected so far. There have been no new cases since January 3. For the time being, the Mainland's investigation has neither identified any infection of healthcare workers nor definite evidence of human-to-human transmission.
According to information from the NHC, investigation, epidemiological investigations revealed that the patients are mainly business operators at a market called "Hua Nan Seafood Wholesale Market" in Wuhan, which has been closed since January 1.(Continue . . . . )
Given the amount of influenza and other respiratory illness now circulating, the exclusion of 18 previously `confirmed cases' is not unexpected. It is also possible that some of the 18 `dropped cases' had already cleared the virus from their system or that the sensitivity of this new test is less than 100% (quite common), and therefore they tested negative.
Either way, it beats the alternative; that the number had grown substantially since the last update.The full (translated) report from the Wuhan Health Commission follows:
Wuhan Municipal Health and Health Commission's Report on Unexplained Viral Pneumonia
Issuing authority: Wuhan City health committee | Published: 2020-01-11 07:04:11 | Hits: 17074 |
After the pathogen of "unknown cause of viral pneumonia" was initially determined to be a new type of coronavirus, the national, provincial and municipal expert groups immediately revised and improved plans for diagnosis, treatment, and monitoring of unexplained viral pneumonia. The Wuhan Municipal Health and Health Committee has organized tests on existing patient specimens. As of 14:00 on January 10, 2020, pathogenic nucleic acid testing has been completed.
The national, provincial and municipal expert groups comprehensively judged the clinical manifestations, epidemiological history, and laboratory test results of patients admitted to the hospital for treatment, and 41 cases of pneumonia with a new coronavirus infection were initially diagnosed, of which 2 were discharged, Seven cases were severe and one died. The remaining patients were in stable condition. All 739 close contacts, including 419 medical staff, have undergone medical observation and no related cases have been found.
Since the outbreak, with the support of the state and Hubei Province, Wuhan has cooperated with relevant departments to carry out the prevention and treatment in an orderly manner.
- First, we have tried our best to treat patients. Develop a diagnosis and treatment work plan, and effectively achieve early detection, early diagnosis, early isolation, and early treatment, and focus on experts and resources to give full treatment.
- The second is to carry out in-depth epidemiological investigations. The investigation found that the patients were mainly operating and purchasing staff of the South China Seafood Wholesale Market in Wuhan. On January 1, 2020, the South China Seafood Wholesale Market has been closed and measures have been taken to strengthen the prevention of disease and environmental hygiene in public places in the city, especially the farmers' market. management.
- The third is to widely publicize disease prevention knowledge and enhance public self-protection awareness.
- The fourth is to cooperate with the state and province to carry out pathogenic research.
- The fifth is to cooperate with the National Health and Health Commission to report the epidemic situation information to the World Health Organization in a timely manner.
No new cases have been detected since January 3, 2020. At present, no medical staff infections have been found, and no clear evidence of human-to-human transmission has been found. Our city will continue to strengthen patient treatment, epidemiological investigations, carry out in-depth patriotic health campaigns, do a good job in spreading knowledge of disease prevention, and safeguard the health of the people.
At present, it is in the season of high incidence of infectious diseases in winter and spring. The public must maintain indoor air circulation, try to avoid closed public places and crowded places, and wear masks if necessary. If you have fever, respiratory infection symptoms, especially persistent fever, go to a medical institution in time.(Continue . . . )
The Wuhan Health Commission also published the following (translated) Q & A.
Q: How was this outbreak diagnosed?
Answer: Based on the patient's clinical manifestations, epidemiological history, and pathogenic test results, comprehensive research and judgment.
Q: What are the characteristics of the clinical manifestations of this outbreak?
A: The clinical manifestations are systemic symptoms such as fever and fatigue, accompanied by dry cough, and dyspnea in hospitalized patients is more common. Vital signs were generally stable at the time of admission.
Q: There is currently one death case. What is the specific situation?
A: The patient was a 61-year-old male. He was admitted to the hospital due to respiratory failure and severe pneumonia. He also had abdominal tumors and chronic liver disease. The patient purchases goods from Wuhan South China Seafood Market all year round. After admission to the hospital, symptomatic support, anti-infection, ventilator-assisted breathing, continuous ECMO in vitro life support, and other treatments did not improve his symptoms. On the evening of January 9, 2020, his heartbeat stopped and he died after rescue. Etiological results suggest that the new coronavirus is positive for nucleic acid. The deaths were diagnosed as severe pneumonia, acute respiratory distress syndrome (severe), septic shock, multiple organ failure, severe acid-base metabolism disorders, and cirrhosis. The immediate cause of death was respiratory circulation failure.
Q: What does it mean that the report says "no new cases have been detected since January 3, 2020"?
Answer: According to epidemiological surveys by national, provincial and municipal experts, the incidence of unexplained viral pneumonia in Wuhan this time was between December 8, 2019 and January 2, 2020. Since January 3, 2020, clinical and epidemiological investigations have shown no patients with new infections.
Q: How to understand "No clear evidence of human-to-human transmission"?
A: According to epidemiological surveys by national, provincial and municipal experts, most of the unexplained viral pneumonia cases in Wuhan this time have a history of exposure to the South China seafood market, and no clear evidence of human-to-human transmission has been found. We are further conducting epidemiological investigations and related laboratory tests. In addition, all close contacts, including medical staff, have so far not detected any related cases.
While none of this erases the basic concerns over the emergence of a novel coronavirus in China, it hopefully rolls back some of the more extreme scenarios being promoted on social media. The diagnostic test should be widely available in the days ahead, and that should give us a much better handle on the spread (or hopefully, lack thereof) of this virus.
Information still eagerly awaited include better demographic and epidemiological data on this cluster; ages, genders, comorbidities - the likely source (and place) of exposure - and confirmation of both the natural host (possibly bats) and any intermediate hosts of the virus.
And the old caveat always applies. Viruses evolve, mutate, and adapt. What we can say about this virus today may not hold true tomorrow; its properties, and public health threat can change.
And of course, if it (like MERS) has established itself in an intermediate animal host - then this outbreak is unlikely to be the last.
