- Priority now must be to stop emergence of ‘super-spreader’, with one carrier already infecting more than a dozen medical personnel, specialist says
- Authorities in Wuhan, the epicentre of the coronavirus outbreak, report a third death and more than 130 new cases over the weekend
One of China's leading specialists in communicable diseases has warned that human-to-human transmission is responsible for some cases of a previously unknown coronavirus that has killed three people in the Chinese city of Wuhan.
After visiting the city, Zhong Nanshan, director of the State Key Laboratory of Respiratory Disease and a specialist in severe acute respiratory syndrome (Sars), said human-to-human transmission was not only behind at least one confirmed case in Wuhan but also infections in two families in Guangdong province.
He said 14 medical staff contracted the virus from one carrier.
"The key to controlling the spread of the disease now is about preventing the emergence of a super-spreader (of the virus)," Zhong said, referring to infected patients who quickly help spread the virus, especially among medical workers.
According to Zhong, a top priority now should be for Wuhan " a city of 11 million people in the central province of Hubei " to curb the disease's spread, in part by banning people with symptoms from leaving the city.
China's post-Sars reporting system may explain long delays in announcing new cases of Wuhan virus
He said that a number of the cases in Guangdong involved patients who had not travelled to Wuhan.
"At present, there is no special cure for this new coronavirus and (we are) conducting some tests with animals," Zhong said. "We expect the number of infected cases will increase over the Lunar New Year travel period and we need to prevent the emergence of a super-spreader of the virus."
Zhong's warning came as Chinese President Xi Jinping called on officials to do everything they could to stop the disease.
State broadcaster CCTV quoted Xi as saying that the virus must be "resolutely contained" and "the safety of people's lives and their physical health should be given top priority".
Premier Li Keqiang also announced the creation of a national leading group to coordinate the fight against the disease.
The virus, which causes pneumonia-like symptoms and had sickened 218 people in China as of Monday night, is thought to have originated in a seafood and animal meat market in Wuhan.
Earlier on Monday, the World Health Organisation (WHO) also warned that human-to-human transmission might have been behind the infection cases in China but it did not change its earlier advice that it did not see grounds to restrict travel to or trade with China.
The WHO China office said a team of experts was meeting officials in Wuhan to discuss the outbreak.
"The mission is part of ongoing information sharing between the government of China and the WHO," a spokesman said.
In statements via Twitter earlier on Monday, the WHO said: "An animal source seems the most likely primary source of this novel coronavirus outbreak, with some limited human-to-human transmission occurring between close contacts."
Wuhan medical authorities said on Monday that a third patient had died from the infection at a hospital in the city, while also announcing a jump of more than 130 new cases alone over the weekend, taking Wuhan's total to 198.
The number of new cases showed there was human-to-human transmission, Guan Yi, director of the State Key Laboratory of Emerging Infectious Diseases at the University of Hong Kong, Beijing-based news outlet Caixin reported on Monday.
"I admit that the virus did not pass from person to person in the early stage, but the situation has evolved for more than a month, and the number of new cases has risen. 'Human-to-human' is no longer a word game," Guan was quoted as saying.
Guan's work led to the identification of the Sars coronavirus, which killed more than 700 people around the world in a 2002-03 outbreak that originated in China, according to the university's website.
"The virus' ability to spread and adapt to the population, as well as its onset and pathogenicity, is similar to the way Sars developed in the early stage," Guan said in the Caixin report. "I hope we can learn from the lessons of Sars and hope we don't approach prevention and control of the (current) situation in a similar way as Sars, otherwise it will negatively affect people and the world."
University of Hong Kong microbiologist Ho Pak-leung said the transmission methods and origins of the new cases on the mainland had not been disclosed.
"That means it's likely that those cases were spread through limited human-to-human transmission, which has some connection with the movement of people," Ho said.
"Wuhan's top travel destinations are Bangkok, Hong Kong and Tokyo. With imported cases reported in two of those three cities, it is only a matter of time for Hong Kong to have a (confirmed) case."
Ho also welcomed the new measures unveiled by the Hong Kong government on Monday, which include health declaration forms at the airport for visitors arriving on direct flights from Wuhan, and a requirement for local doctors to report suspected cases among people who have visited Hubei " and not just Wuhan " in the last 14 days.
Wuhan pneumonia: how the search for the source of the mystery illness unfolded
China's National Health Commission said five people in Beijing had been confirmed as infected, along with one in Shanghai and 14 in Guangdong, a province bordering Hong Kong. Another six people throughout the country were suspected as having the virus.
Meanwhile, Taiwanese health authorities said a one-year-old boy suspected of having the virus was being treated in a hospital isolation ward.
"Doctors have already sent the samples of the pathogen for testing, and the results will be known within days," a spokeswoman for the Taiwan Centres for Disease Control said.
Reports that the virus was spreading raised particular concern with hundreds of millions of people travelling across China this week for the Lunar New Year holiday. Wuhan itself has a population of about 11 million people " more than New York or London " and is one of the country's major rail hubs.
The Chinese Centre for Disease Control and Prevention said on Saturday that the infection was "preventable and controllable". The virus was not Sars, the centre said on Saturday.
The WHO's comments about some limited human-to-human transmission in the Wuhan virus is a shift from previous statements in which the body and China's health authorities said they had found no evidence of human-to-human transmission but could not rule it out.
In a written response to the South China Morning Post early on Monday, the WHO China office said there was "no clear evidence of sustained human-to-human transmission" and it had no information on medical staff being infected by the virus.
"To date, Chinese authorities have reported no infections among health care workers, which is an indicator used to ascertain the transmissibility of a disease (or the degree to which a disease is contagious), as health care workers are among the more exposed groups," it said.
Wuhan virus: three US airports to screen passengers from China for deadly coronavirus outbreak
The WHO said China had reported 139 new cases of the coronavirus to the organisation over the previous two days.
The agency attributed the jump to "increased searching and testing" for the virus among people showing symptoms of respiratory illness.
Confirmation of infections in other cities in China came as several countries and regions in Asia reported finding the virus in visitors since the Wuhan medical authorities first raised the alert on December 30 about what was then a mystery illness.
South Korea confirmed on Monday that a woman who had arrived from Wuhan had the virus. Two Chinese tourists in Thailand and a Chinese man working in Japan had previously been confirmed as infected. Authorities in Singapore, Vietnam, Nepal, Hong Kong and Taiwan have said they are monitoring a number of suspected cases.
No deaths have been reported overseas among the infected.
The US on Friday began screening travellers from Wuhan at airports in San Francisco, New York and Los Angeles.
"I think that this is a situation where we're going to see additional cases all around the world as people look for it more," Nancy Messonnier, director of the US' National Centre for Immunisation and Respiratory Diseases, a branch of the Centres for Disease Control and Prevention (CDC), said on Saturday.
"I think it's highly plausible that there will be at least a case in the United States, and that's the reason we're moving forward so quickly with this screening," she said, adding that the threat to the general public was "low".
In its statement, the WHO said it "is proposing studies on the novel coronavirus that can be done in China and elsewhere to better understand transmission, risk factors and where the virus is".
"These studies take time and resources" it said, noting that some of these studies were already under way.
Messonnier, at the CDC, said: "We don't have all the information at the level of detail that our scientists would prefer. You know CDC scientists, and we, want to see every titbit of data ourselves, and that's not the situation we're in right now. We are in more of a waiting mode, waiting to see what our colleagues from China are releasing."
Wuhan's health authorities said the city's third death from the virus had occurred on Saturday, and reported 59 new infections on Saturday and 77 on Sunday.
The two infected people in Beijing had recently travelled to Wuhan, according to the Daxing district health committee. They were under quarantine in hospital and in a stable condition, The Beijing News reported.
People who had come into close contact with the two patients were under medical observation and had not had fever-like symptoms, the local health authority said.
The health authority for Shenzhen in the southern province of Guangdong said its first confirmed case was a 66-year-old man. He had visited relatives in Wuhan at the end of last month and developed fever and fatigue on January 3. He went to a doctor in Shenzhen the next day, then was admitted to hospital, where he was quarantined, on January 11.
His condition was stable and the authority was monitoring people who had been in close contact with him, the authority said.
The Zhejiang health authority said that the five patients it had reported as showing symptoms had recently visited Wuhan.
In Malaysia, authorities were on "high alert" for the disease, with response teams at all international arrival entry points.
Additional reporting by Lawrence Chung in Taipei and Victor Ting
Sign up now for our 50% early bird offer from SCMP Research: China AI Report. The all new SCMP China AI Report gives you exclusive first-hand insights and analysis into the latest industry developments, and actionable and objective intelligence about China AI that you should be equipped with.
Copyright (c) 2020. South China Morning Post Publishers Ltd. All rights reserved.
