2019–20 outbreak of novel coronavirus (2019-nCoV)

From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

2019–20 China pneumonia outbreak
Wuhan location.png
Wuhan, China
Date12 December 2019 -
LocationOrigin: Wuhan, Hubei, China
Casualties
Cases
Country Reported Cases Deaths Last update
China 201 3[1]
Japan 1[2]
Thailand 2[2]
Total 204 3 As of 20 January 2020

The 2019 – 2020 China pneumonia outbreak, also known as Wuhan pneumonia (simplified Chinese: 武汉肺炎; traditional Chinese: 武漢肺炎; pinyin: Wǔhàn fèiyán) began in mid-December 2019 in the city of Wuhan in central China, as an emerging cluster of people with pneumonia of unknown cause, linked primarily to stallholders who worked at the Huanan Seafood Market (華南海鮮市場), which sold live animals. Chinese scientists subsequently isolated a new coronavirus, the 2019-nCoV, which has been found to be at least 70% similar in genetic sequence to SARS-CoV, and later mapped and made available its gene sequence.[3][4][5]

The first suspected cases were reported on 31 December 2019,[6] with the first symptoms appearing just over three weeks earlier on 8 December 2019.[7] The market was closed off on 1 January 2020 and people with the symptoms were isolated.[6] Over 700 people, including more than 400 healthcare workers, who came into close contacts with suspected cases were subsequently monitored.[8] With the development of a specific diagnostic PCR test for detecting the infection, the presence of 2019-nCoV was then confirmed in 41 people in the Wuhan cluster,[3] of which two were later reported to be a married couple, one of whom had not been to the market, and another three who were members of the same family that worked at the market's seafood stalls.[9][10] On 9 January 2020, the first death occurred in a 61-year-old affected man in Wuhan.[11] On 16 January 2020, Chinese authorities announced that another 69-year-old man in Wuhan, who was confirmed with the illness, had died the previous day.[12][13][14]

Confirmed cases outside of China include two women in Thailand and one man in Japan.[2][15][16] Based on these developments and assumptions such as international travel statistics, British scientists on 17 January estimated that the true number of infections could be around 1,700.[17][18] As of 20 January, the number of laboratory-confirmed cases stands at 204, including 201 in China, two in Thailand, and one in Japan.[19][20][21][22]

Since human-to-human transmission has yet to be ruled out, the World Health Organization (WHO) warned that a wider outbreak could occur.[23] There were also concerns of further spreading during China's peak travel season around Chinese New Year.[24]

Overview[edit]

As the cluster of cases with 'pneumonia of unknown cause' had centred around a wholesale animal and fish market, which had 1000 stalls selling chickens, cats, pheasants, bats, marmots, venomous snakes, spotted deer and the organs of rabbits and other wild animals, it led to the suspicion that the cause may be a novel coronavirus from an animal source.[4][25][26][27]

Coronaviruses mainly circulate among animals, but have been known to evolve and infect humans, as has been seen with SARS, MERS and four other coronaviruses found in humans which cause mild respiratory symptoms like in the common cold. All six can spread from human-to-human.[28][29] In 2002, with an origin in civet cats from live animal markets, an outbreak of SARS started in mainland China, and with the help of a few superspreaders and international air travel, reached as far as Canada and the US, resulting in over 700 deaths worldwide. The last case occurred in 2004.[28][30][31] At the time, China was criticised by the WHO for its handling of the epidemic.[32] Ten years after the onset of SARS, the dromedary camel related coronavirus, MERS, resulted in 750 deaths over 27 countries.[28] The Wuhan outbreak's association with a large seafood and animal market, which sells animals for consumption, has led to the possibility of the illness having an animal source.[29] This has resulted in the fear it would be similar to the previous SARS outbreak,[30][33] a concern exacerbated by the expectation of a high numbers of travellers for Chinese New Year, which begins on 25 January 2020.[34]

Wuhan is the seventh-largest city in China, with a population of more than 11 million people. It is a major transportation hub in central China, approximately 700 miles south of Beijing,[35] 500 miles west of Shanghai, and 600 miles north of Hong Kong.[36] Direct flights from Wuhan also connect with Europe: six flights per week to Paris, three weekly to London, and five weekly to Rome.[37]

On 17 January, an Imperial College group in the UK published an estimate that there had been 1,723 cases (95% confidence interval, 427–4,471) with onset of symptoms by 12 January 2020. This was based on the pattern of cases seen outside China. They also concluded that "self-sustaining human-to-human transmission should not be ruled out".[17][18]

Epidemiology[edit]

Chronology[edit]

30 December 2019: An "urgent notice on the treatment of pneumonia of unknown cause" was issued the Medical Administration and Medical Administration of Wuhan Municipal Health Committee.[38]

31 December 2019: 27 people with pneumonia of unknown cause were reported to the WHO. Most were stallholders from the Wuhan South China Seafood Market. Seven were in a serious, life-threatening state. As a result, Hong Kong, Macau and Taiwan tightened their border surveillance.[4][39]

1 January 2020: The fish and animal market suspected of being linked to the pneumonia cases was closed for cleaning and disinfection.[4]

3 January 2020: Thailand began screening passengers arriving from Wuhan at four different airports.[40][41][42]

5 January 2020: Early investigations into the cause of the pneumonia ruled out seasonal flu, SARS, MERS and bird flu.[3][25] The number of suspected cases reached 59 with seven in a critical condition. All were quarantined and 163 contacts commenced monitoring. At this time, there were no reported cases of human-to-human transmission or presentations in healthcare workers.[43][44]

6 January 2020, The US Centers for Disease Control and Prevention (CDC) issued a travel watch at level 1, with recommendations on washing hands and the advice to avoid animals, animal markets, and contact with unwell people if travelling to Wuhan.[43][25]

9 January 2020: The WHO confirmed that a novel coronavirus had been isolated from one person who was hospitalised.[45][46] On the same day, the European Centre for Disease Prevention and Control posted its first risk assessment.[47] The WHO also reported that Chinese authorities had acted swiftly,[45] identifying the novel coronavirus within weeks of the onset of the outbreak, with the total number of positively tested people being 41.[48] The first death from the virus occurred in a 61-year-old man who was a regular customer at the market. He had a number of significant medical conditions, including chronic liver disease and he died from heart failure and pneumonia. The incident was reported in China by the health commission via Chinese state media on 11 January 2020.[8][11][37][49]

10 January 2020: The gene sequencing data of the isolated Wuhan coronavirus, a virus from the same family as the SARS coronavirus, was posted on Virological.org by researchers from Fudan University, Shanghai. A further three sequences from the Chinese Center for Disease Control and Prevention, one from the Chinese Academy of Medical Sciences, and one from Jinyintan Hospital in Wuhan were posted to the Global Initiative on Sharing All Influenza Data (GISAID) portal.[8][50][40] The same day, Public Health England issued its guidance.[47]

11 January 2020: In China, more than 700 close contacts of the 41 confirmed cases, including more than 400 healthcare workers, had been monitored, with no new cases reported in China since 5 January 2020.[43][25][8][51] The WHO published initial guidance on travel advice, testing in the laboratory and medical investigation.[8]

13 January 2020: The CDC announced that the genome had been posted on the NIH genetic sequence database, GenBank.[29] On the same day, Thailand witnessed the first confirmed case of 2019-nCoV, the first outside China.[16] The affected 61-year-old Chinese woman, who is a resident of Wuhan, had not visited the Huanan Seafood Market, but was noted to have been to other markets. She had arrived in Bangkok on 8 January 2020.[7]

14 January 2020: Two of the 41 confirmed cases in Wuhan were reported to include a married couple, raising the possibility of human-to-human transmission.[7][52]

15 January 2020: A second death in a 69 year old man occurred in China.[12][53]

The WHO published a protocol on diagnostic testing for 2019-nCoV, developed by a virology team from Charité Hospital.[12]

16 January 2020: The WHO was informed by Japan's Ministry of Health, Labour and Welfare, that a 30-year-old male Chinese national had tested positive to 2019-nCoV during a hospital admission between 10 and 15 January 2020. He had not visited the Huanan Seafood Market, but possibly had close contact with an affected person in Wuhan.[15][54]

17 January 2020: Thailand's second confirmed case was reported in a 74 year old woman who arrived in Bangkok on a flight from Wuhan.[2][55] The number of laboratory-confirmed cases rose to 45 in China.[56]

18 January 2020: China reported 17 additional laboratory-confirmed cases, with three cases in critical condition. The number of laboratory-confirmed cases rose to 62 in China, with the ages ranging from 30 to 79, of which 19 were discharged and eight remain critical.[19]

19 January 2020: China reported 136 additional laboratory-confirmed cases, bringing the total number of laboratory-confirmed cases in China to 201. [57]

Global: Reported cases and responses[edit]

Following 31 December 2019, some regions and countries near China tightened their screening of selected travellers.[39] The US Centers for Disease Control and Prevention (CDC) later issued a Level 1 travel watch.[43][25] Guidances and risk assessments were shortly posted by others including the European Centre for Disease Prevention and Control and Public Health England.[47] In China, airports, railway stations and coach stations installed infrared thermometers. People with fevers are subsequently taken to medical institutions after being registered and given masks.[19]

Top 20 flight routes from Wuhan with data on the Infectious Disease Vulnerability Index for each country

An analysis of air travel patterns was used to map out and predict patterns of spread, and was published in the Journal of Travel Medicine in mid-January 2020. Based on information from the International Air Transport Association (2018), Bangkok, Hong Kong, Tokyo, and Taipei had the largest volume of travellers from Wuhan. Dubai in the United Arab Emirates and Sydney and Victoria in Australia were also reported as popular destinations for people travelling from Wuhan. Using the validated tool, the Infectious Disease Vulnerability Index (IDVI), to assess ability of managing a disease threat, Bali was reported as least able in preparedness, while cities in Australia were most able.[7][58]

[59]

Hong Kong[edit]

Reported suspected cases of novel coronavirus in Hong Kong

Hong Kong's Centre for Health Protection (CHP) added the term "unidentified pneumonia" to their list of notifiable diseases to expand their authority on quarantine. The government also shortened hospital visits and made it a requirement for visitors to wear face masks. Screening was tightened at airports and train stations with connections to Wuhan.[31] In the first week of 2020, 30 unwell travellers from Wuhan were tested. Most were found to be positive for other respiratory viruses.[43][51]

Singapore[edit]

Singapore's Ministry of Health issued a health advisory on the pneumonia outbreak on 2 January 2020, and implemented temperature checks for passengers arriving in Changi Airport from Wuhan the following day.[60] The 2019-nCoV was ruled out in the first five suspected cases in Singapore, while the sixth suspected case is undergoing assessment.[61]

Taiwan[edit]

Eight people in Taiwan were reported with mild symptoms, half of whom were confirmed with chiefly seasonal flu.[43][25]

South Korea[edit]

A suspected case was reported in South Korea on 8 January 2020, with the person isolated as a result.[50]

Thailand[edit]

In Thailand, screening passengers arriving from Wuhan at four different airports began on 3 January 2020, and a number of suspected cases have been found to have other common respiratory conditions.[16][40][62]

On 13 January 2020, Thailand witnessed the first confirmed case of 2019-nCoV outside China. The affected 61-year-old Chinese woman, who is a resident of Wuhan, had not visited the Huanan Seafood Market, but was noted to have been to other markets. She developed a sore throat, fever, chills and a headache on 5 January, flew directly with her family and a tour group from Wuhan to Suvarnabhumi airport in Bangkok on 8 January, where she was detected using thermal surveillance and was hospitalised that same day. Four days later, using RT-PCR, she tested positive for the new coronavirus.[7][63][64][65]

Thailand's second case occurred in a 74-year-old woman who arrived in Bangkok on a flight from Wuhan on 17 January.[2]

Japan[edit]

A 30-year-old Chinese national who had previously traveled to Wuhan, developed a fever on 3 January 2020 and subsequently returned to Japan on 6 January, tested positive to 2019-nCoV during a hospital admission between 10 and 15 January 2020. He had not visited the Huanan Seafood Market, but possibly had close contact with an affected person in Wuhan.[15][54]

Vietnam[edit]

Two suspected cases of pneumonia were detected on 14 January 2020 after two Chinese tourists arrived in Vietnam through Danang International Airport with a fever. The tourists have since been quarantined.[15]

United States[edit]

Between 60,000 and 65,000 people travel from Wuhan to the United States every year, with January being a peak.[56] At San Francisco International, Los Angeles International, and John F. Kennedy International Airport in New York, the three US airports with direct flights from Wuhan, arriving passengers would be screened for symptoms of the virus ahead of the Chinese New Year peak travel season.[66][67]

Canada[edit]

The Canada Border Services Agency (CBSA) said it will not implement extra screening measures, but plans "to implement signage" in Toronto, Vancouver and Montreal airports to raise awareness of the virus. There are no direct flights from Wuhan to Canada.[68]



Clinical presentation[edit]

Reported symptoms have included fever in 90% of cases,[3] fatigue and a dry cough in 80%,[3][69] and shortness of breath in 20%, with respiratory distress in 15%.[43][25][69] Chest x-rays have revealed signs in both lungs.[43][25] Vital signs were generally stable at the time of admission of those hospitalised.[69] Blood tests have commonly shown low white blood cell counts (leucopenia and lymphopenia).[3]

Testing[edit]

On 15 January 2020, the WHO published a protocol on diagnostic testing for 2019-nCoV, developed by a virology team from Charite Hospital.[12]

Prevention[edit]

Recommended prevention measures per the WHO are "regular hand washing, covering mouth and nose when coughing and sneezing... avoid close contact with anyone showing symptoms of respiratory illness (such as coughing and sneezing)."[70][71]

References[edit]

  1. ^ 武汉市卫生健康委员会关于新型冠状病毒感染的肺炎情况通报
  2. ^ a b c d e Wee, Sui-Lee (15 January 2020). "Japan and Thailand Confirm New Cases of Chinese Coronavirus". The New York Times. ISSN 0362-4331. Retrieved 17 January 2020.
  3. ^ a b c d e f Hui, David S.; Azhar, Esam EI; Madani, Tariq A.; Ntoumi, Francine; Kock, Richard; Dar, Osman; Ippolito, Giuseppe; Mchugh, Timothy D.; Memish, Ziad A.; Drosten, Christian; Zumla, Alimuddin (14 January 2020). "The continuing epidemic threat of novel coronaviruses to global health - the latest novel coronavirus outbreak in Wuhan, China". International Journal of Infectious Diseases. 0 (0). doi:10.1016/j.ijid.2020.01.009. ISSN 1201-9712.
  4. ^ a b c d "Undiagnosed pneumonia - China (HU) (01): wildlife sales, market closed, RFI Archive Number: 20200102.6866757". Pro-MED-mail. International Society for Infectious Diseases. Retrieved 13 January 2020.
  5. ^ Pinghui, Zhuang; Wu, Jerry (15 January 2020). "Wuhan pneumonia: how search for source unfolded". South China Morning Post. Retrieved 16 January 2020.
  6. ^ a b "Pneumonia of unknown cause – China. Disease outbreak news". World Health Organization. 5 January 2020. Retrieved 6 January 2020.
  7. ^ a b c d e Schnirring, Lisa (14 January 2020). "Report: Thailand's coronavirus patient didn't visit outbreak market". CIDRAP. Retrieved 15 January 2020.
  8. ^ a b c d e Schnirring, Lisa (11 January 2020). "China releases genetic data on new coronavirus, now deadly". CIDRAP. Retrieved 12 January 2020.
  9. ^ Schnirring, Lisa (15 January 2020). "Second family cluster found in Wuhan novel coronavirus outbreak". CIDRAP. Retrieved 16 January 2020.
  10. ^ Wee, Sui-Lee; Jr, Donald G. McNeil (8 January 2020). "China Identifies New Virus Causing Pneumonialike Illness". The New York Times. ISSN 0362-4331. Retrieved 14 January 2020.
  11. ^ a b Qin, Amy; Hernández, Javier C. (10 January 2020). "China Reports First Death From New Virus". The New York Times. ISSN 0362-4331. Retrieved 11 January 2020.
  12. ^ a b c d Schirring, Lisa; 2020 (16 January 2020). "Japan has 1st novel coronavirus case; China reports another death". CIDRAP. Retrieved 16 January 2020.
  13. ^ Kyodo News. "China announces 2nd death from new coronavirus". Kyodo News+. Retrieved 16 January 2020.
  14. ^ "武汉市卫生健康委员会". wjw.wuhan.gov.cn. 16 January 2020. Retrieved 16 January 2020.
  15. ^ a b c d Walter, Sim (16 January 2020). "Japan confirms first case of infection from Wuhan coronavirus; Vietnam quarantines two tourists". The Straits Times. Retrieved 16 January 2020.
  16. ^ a b c "WHO | Novel Coronavirus – Thailand (ex-China)". WHO. 14 January 2020. Retrieved 15 January 2020.
  17. ^ a b Gallagher, James (18 January 2020). "New Chinese virus 'will have infected hundreds'". BBC News. Retrieved 18 January 2020.
  18. ^ a b Natsuko Imai, Ilaria Dorigatti, Anne Cori, Steven Riley, Neil M. Ferguson. "Estimating the potential total number of novel Coronavirus cases in Wuhan City, China". Imperial College London. Retrieved 18 January 2020.CS1 maint: uses authors parameter (link)
  19. ^ a b c France-Presse, Agence (19 January 2020). "Coronavirus: China reports 17 new cases of Sars-like mystery virus". The Guardian. ISSN 0261-3077. Retrieved 19 January 2020.
  20. ^ Deng, Chao (19 January 2020). "China Reports New Cases of Wuhan Virus as Hectic Travel Period Nears". WSJ. Retrieved 19 January 2020.
  21. ^ 广东确诊1例新型冠状病毒感染的肺炎病例
  22. ^ 北京大兴确诊2例新型冠状病毒感染的肺炎病例
  23. ^ Newey, Sarah (14 January 2020). "WHO refuses to rule out human-to-human spread in China's mystery virus outbreak". The Telegraph. ISSN 0307-1235. Retrieved 17 January 2020.
  24. ^ Cohen, Jon; Normile, Dennis (17 January 2020). "New SARS-like virus in China triggers alarm". Science. 367 (6475): 234–235. doi:10.1126/science.367.6475.234. ISSN 0036-8075.
  25. ^ a b c d e f g h "Pneumonia of Unknown Cause in China - Watch - Level 1, Practice Usual Precautions - Travel Health Notices | Travelers' Health | CDC". wwwnc.cdc.gov. 6 January 2020. Retrieved 7 January 2020.
  26. ^ Schnirring, Lisa (8 January 2020). "Virologists weigh in on novel coronavirus in China's outbreak". CIDRAP. Retrieved 9 January 2020.
  27. ^ Shih, Gerry; Sun, Lena H. (8 January 2020). "Specter of possible new virus emerging from central China raises alarms across Asia". Washington Post. Retrieved 9 January 2020.
  28. ^ a b c Rogier van Doorn, H.; Yu, Hongji (2019). "33. Viral Respiratory Infections". In Edward T Ryan, David R Hill, Tom Solomon, Timothy P Endy, Naomi Aronson (eds.). Hunter's Tropical Medicine and Emerging Infectious Diseases E-Book (10th ed.). Elsevier Health Sciences. p. 286. ISBN 978-0-323-55512-8.CS1 maint: uses editors parameter (link)
  29. ^ a b c "Novel Coronavirus 2019 | CDC". www.cdc.gov. 13 January 2020. Retrieved 14 January 2020.
  30. ^ a b "Mystery pneumonia virus probed in China". BBC News. 3 January 2020. Retrieved 5 January 2020.
  31. ^ a b "What to Know About the Wuhan Pneumonia Oubreak". Time. Retrieved 8 January 2020.
  32. ^ "China probes pneumonia outbreak for Sars links: State media". The Straits Times. 31 December 2019. Retrieved 6 January 2020.
  33. ^ Gallagher, James (2020). "Mystery Chinese virus: How worried should we be?". BBC News. Retrieved 11 January 2020.
  34. ^ "NaTHNaC - Chinese new year travel advice". TravelHealthPro. 10 January 2020. Retrieved 12 January 2020.
  35. ^ "Outbreak of Pneumonia of Unknown Etiology (PUE) in Wuhan, China". emergency.cdc.gov. Centers for Disease Control and Prevention. 8 January 2020. Retrieved 9 January 2020.
  36. ^ Chan, Ho-him; Mai, Jun (5 January 2020). "China says Wuhan pneumonia not Sars, but virus remains unidentified, more people hospitalised". South China Morning Post. Retrieved 6 January 2020.
  37. ^ a b "Update: Cluster of pneumonia cases associated with novel coronavirus – Wuhan, China – 2019". European Centre for Disease Prevention and Control. 14 January 2020. Retrieved 18 January 2020.
  38. ^ "UNDIAGNOSED PNEUMONIA - CHINA (HUBEI): REQUEST FOR INFORMATION. Archive Number: 20191230.6864153". Pro-MED-mail. International Society for Infectious Diseases. Retrieved 19 January 2020.
  39. ^ a b Parry, Jane (8 January 2020). "Pneumonia in China: lack of information raises concerns among Hong Kong health workers". BMJ. 368. doi:10.1136/bmj.m56. ISSN 1756-1833. PMID 31915179.
  40. ^ a b c Schnirring, Lisa; 2020 (13 January 2020). "Thailand finds Wuhan novel coronavirus in traveler from China". CIDRAP. Retrieved 14 January 2020.
  41. ^ Team, CM1. "Four suspected cases of mystery Chinese viral pneumonia detected at CM Airport | Chiang Mai One". Retrieved 15 January 2020.
  42. ^ CityNews. "Wuhan viral pneumonia alert". Chiang Mai Citylife. Retrieved 15 January 2020.
  43. ^ a b c d e f g h Schnirring, Lisa (6 January 2020). "Questions still swirl over China's unexplained pneumonia outbreak". CIDRAP. Retrieved 7 January 2020.
  44. ^ "China pneumonia: Sars ruled out as dozens fall ill in Wuhan". BBC. 5 January 2020. Retrieved 6 January 2020.
  45. ^ a b Schnirring, Lisa (9 January 2020). "More details emerge on new coronavirus in Wuhan cluster". CIDRAP. Retrieved 9 January 2020.
  46. ^ "WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China". who.int. 9 January 2020. Retrieved 9 January 2020.
  47. ^ a b c Schnirring, Lisa (10 January 2020). "Pressure builds on China to share info on new coronavirus". CIDRAP. Retrieved 11 January 2020.
  48. ^ Lucey, Daniel; Sparrow, Annie (14 January 2020). "China Deserves Some Credit for Its Handling of the Wuhan Pneumonia". Foreign Policy. Retrieved 15 January 2020.
  49. ^ "China reports first death in Wuhan pneumonia outbreak". The Straits Times. 11 January 2019. Retrieved 11 January 2019.
  50. ^ a b Gan, Nectar (9 January 2020). "A new virus related to SARS is the culprit in China's mysterious pneumonia outbreak, scientists say". CNN. Retrieved 9 January 2020.
  51. ^ a b Schnirring, Lisa (7 January 2020). "Nations step up screening and await word on China's pneumonia outbreak". CIDRAP. Retrieved 8 January 2020.
  52. ^ "Novel Coronavirus 2019 | CDC". www.cdc.gov. 15 January 2020. Retrieved 15 January 2020.
  53. ^ "China says second person dies in Wuhan pneumonia outbreak". Reuters. 17 January 2020. Retrieved 17 January 2020.
  54. ^ a b "WHO | Novel Coronavirus – Japan (ex-China)". WHO. Retrieved 17 January 2020.
  55. ^ "CHP closely monitors additional confirmed case of infection of novel coronavirus in Thailand". www.info.gov.hk. 17 January 2020. Retrieved 17 January 2020.
  56. ^ a b Schnirring, Lisa; 2020 (17 January 2020). "As Thailand notes 2nd nCoV case, CDC begins airport screening". CIDRAP. Retrieved 18 January 2020.
  57. ^ "China reports 136 more cases in two days" (in Chinese). Wuhan Municipal Health Commission. 20 January 2020. Retrieved 20 January 2020.
  58. ^ Bogoch, Isaac I.; Watts, Alexander; Thomas-Bachli, Andrea; Huber, Carmen; Kraemer, Moritz U. G.; Khan, Kamran (14 January 2020). "Pneumonia of Unknown Etiology in Wuhan, China: Potential for International Spread Via Commercial Air Travel" (PDF). Journal of Travel Medicine. doi:10.1093/jtm/taaa008.
  59. ^ "China reports 136 more cases in two days" (in Chinese). Wuhan Municipal Health Commission. 20 January 2020. Retrieved 20 January 2020.
  60. ^ Goh, Timothy (2 January 2020). "Travellers arriving at Changi Airport from Wuhan to undergo temperature screening after pneumonia outbreak". The Straits Times. Retrieved 15 January 2020.
  61. ^ hermesauto (18 January 2020). "New suspected Wuhan virus case in Singapore, remaining 5 have tested negative". The Straits Times. Retrieved 19 January 2020.
  62. ^ "Wuhan viral pneumonia alert". Chiang Mai Citylife. 7 January 2020. Retrieved 15 January 2020.
  63. ^ "Novel coronavirus (02): Thailand ex China (HU) WHO. Archive Number: 20200113.6886644". Pro-MED-mail. International Society for Infectious Diseases. Retrieved 14 January 2020.
  64. ^ "Thailand confirms first case of Wuhan virus outside China". South China Morning Post. 13 January 2020. Retrieved 13 January 2020.
  65. ^ "Novel coronavirus (02): Thailand ex China (HU) WHO. Archive Number: 20200113.6886644". Pro-MED-mail. International Society for Infectious Diseases. Retrieved 14 January 2020.
  66. ^ Grady, Denise (17 January 2020). "Three U.S. Airports to Check Passengers for a Deadly Chinese Coronavirus". The New York Times. ISSN 0362-4331. Retrieved 17 January 2020.
  67. ^ Sun, Lena H. (17 January 2020). "Travelers at 3 U.S. airports to be screened for new, potentially deadly Chinese virus". Washington Post. Retrieved 18 January 2020.
  68. ^ "China reports 4 more cases of new strain of coronavirus". Canadian Broadcasting Corporation. 18 January 2020. Retrieved 18 January 2020.
  69. ^ a b c "Experts explain the latest bulletin of unknown cause of viral pneumonia". Wuhan Municipal Health Commission. 11 January 2020. Retrieved 11 January 2020.
  70. ^ "Coronavirus". www.who.int. Retrieved 16 January 2020.
  71. ^ Lyons, Amanda (17 January 2020). "Novel coronavirus: What GPs need to know". News GP. RACGP.

Further reading[edit]

China[edit]

Hong Kong[edit]

UK[edit]

WHO[edit]

European Centre for Disease Prevention[edit]

See also[edit]