Special Bulletin 20 January 2020

A single case of the 2019-novel coronavirus (2019-nCoV), currently causing an outbreak of respiratory illness and pneumonia in Wuhan, China, has been detected in a Chinese traveller who travelled from Wuhan to Incheon on 19 January.

Background

The 35-year-old female traveller from Wuhan was detected to have a fever on arrival at Incheon International airport. She developed symptoms including fever, chills and muscle pain on 18 January. She has denied having visited the Huanan/ South China Seafood Wholesale Markets or having contact with a confirmed 2019-nCoV patient while in Wuhan. South Korea’s Centers for Disease Control and Prevention (KCDC) have confirmed that the patient is in isolation currently. Co-passengers and airline staff who travelled in the same flight are being monitored.

The World Health Organization (WHO) states that while there is evidence of limited human-to-human transmission, currently there is no clear evidence of sustained transmission between people. At least two possible clusters of human-to-human transmission has been reported so far. No health care workers have been infected; this may indicate that the infection is not transmitting easily between people. The WHO is monitoring the extent of human transmission closely.

International SOS is following the situation closely.

International SOS has advised of enhanced screening for travellers from Wuhan entering several countries. Canada, Hong Kong, India, Indonesia, Italy, Japan, Macao, Malaysia, Myanmar, Nepal, Philippines, Russia, Singapore, South Korea, Taiwan, Thailand, Russia, the United States and Vietnam have activated additional screening at their ports of entry; including airports, seaports or railways (where applicable).

Analysis

International screening to identify spread of new viruses is a critical aspect of their assessment. It is anticipated that more countries will further strengthen their surveillance and detection capabilities.

Among the two possible clusters of human-to-human transmission reported so far, one cluster comprised of three family members, all tested positive for the virus and each had been to the Huanan / South China Seafood Wholesale Market. The other possible cluster involved a man who worked at the market and fell ill. His wife, who denied visiting the market, was also infected.

The identification of a case in South Korea does not change this assessment.

Travellers are advised to:

• Travellers to Wuhan should avoid wet markets or farms.
• Wash your hands frequently.
• Carry hand sanitizer for use when soap and water are not readily available.
• Maintain good personal hygiene.
• Avoid touching your face.
• Keep some distance from people who are obviously sick.
• Avoid direct contact with animals (live or dead) and their environment.
• Do not touch surfaces that may be contaminated with droppings.
• Ensure food, including eggs, is thoroughly cooked.
• Seek medical attention if you develop symptoms, especially fever or shortness of breath.
• Do not travel if you are sick - note that some locations have implemented screening, and travellers may face quarantine and testing.

Assessment

There is a low risk of wide geographic spread. Organisations should review their risk exposure and response plans.

International SOS is monitoring the situation closely.