On 31 December 2019, the World Health Organization (WHO) China country office reported a cluster of pneumonia cases in Wuhan City, Hubei Province of China. The cause has since been confirmed as a novel coronavirus (2019-nCoV).
As of the 21 January 2020, 270 cases have been confirmed including at least 4 deaths in Wuhan City in China. In addition, 21 cases in other cities have been reported in China (5 in Beijing, 14 in Guangdong and 2 in Shanghai) and 4 cases outside China (2 in Thailand, 1 in Japan and 1 South Korea). The majority of the cases from Wuhan were epidemiologically linked to seafood, poultry and live wildlife market (Huanan Seafood Wholesale Market) in Jianghan District of Hubei Province. This suggests that the novel coronavirus has a possible zoonotic origin. The cases reported from outside Wuhan, had links in Wuhan, either contact with a sick person in Wuhan or worked or visited a market in Wuhan. There is evidence of limited person-to-person transmission among close contacts of infected cases and 15 cases have been identified among healthcare workers in China. There is no evidence of sustained person-to-person transmission. There are no direct flights from Wuhan to South Africa, however, it is possible that individuals could travel to South Africa from Wuhan via other countries. The risk of an imported case remains low. South Africa is conducting active surveillance to identify any potential imported cases.
Clinical presentation and case management
Since this novel coronavirus has only been recently identified, there is limited information regarding the mode/s of transmission, clinical features, and severity of disease at this stage. The main clinical signs and symptoms are fever and cough with a few patients presenting with difficulty in breathing and bilateral infiltrates on chest X-rays. Treatment is supportive, as no specific therapy has been shown to be effective.
On 17 January 2020, an alert on 2019-nCoV was published on the NICD website; this covered the following:
- Case definitions for suspected cases
- Guidance for case notification
- Guidance on which samples to collect and where to send the samples for testing
- Precautions for health care workers and travellers to Wuhan District in China
The alert is available at http://www.nicd.ac.za/novel-coronavirus-outbreak-in-wuhan-city-hubei-province-of-china/
Situation updates will be published on the NICD website regularly.
The Centre for Respiratory Diseases and Meningitis (CRDM) at NICD is developing assays for 2019-nCoV detection.
The WHO’s Emergency Committee on 2019-nCoV is scheduled to meet on 22 January 2020 to determine the international public health implications of this outbreak; the outcome of that meeting will direct the global response strategy.