The two close contacts and four other persons (all Germans travelling together) were put under home quarantine and follow-up by local health authorities in La Gomera island on 29 January. On 30 January morning, five out of the six persons developed mild fever and were then isolated in the local hospital. Samples were taken and sent to the Spanish National Centre for Microbiology for analysis. One of the two persons with history of close contacts with the confirmed case in Germany tested positive for 2019-nCoV.

As of 6 February, all six (6) German citizens had either recovered or remained healthy. The positive case is kept under isolation and the remaining five persons are in home quarantine on the Canary Islands. In re-sampling, the case was still positive and remains in isolation. The remaining five people were also re-tested and remained negative and kept in quarantine. All the people in this group will be tested again in the following days for 2019-nCoV. Quarantine precautions will be kept until 14 days after the last contact with the case.

The rapid spread within China and the exportation of cases to several countries demonstrates the potential for international spread.  Additional cases of 2019-nCoV infection imported by travellers are reported by other countries. Exported 2019-nCoV cases are expected to occur, particularly given the degree of international travel from China. Human to human transmission has been described, thus further spread of the disease cannot be excluded. Nevertheless, control measures implemented around this imported case had reduced the risk of international spread of the disease from Spain to other countries.

The number of confirmed cases continues to rise in China, and with the anticipated large-scale population movement over the Chinese New Year season, the risk of exportation outside of China is high. Further spread of the disease cannot be excluded.

2020-02-04

United States of America (the)

Infectious

Coronavirus Infection (Novel Coronavirus 2019)

These are the first 6 diagnosed cases of 2019-nCoV infection in the United States of America, and the first confirmed instance of human-to-human transmission in the country.   

PHEIC

Between 24-26 January 2020, US CDC announced 4 additional confirmed cases of 2019-nCoV, all imported from Wuhan, China, in Arizona (1 case in Maricopa County), California (1 case in Orange County and 1 case in Los Angeles County), and Illinois (1 case in the city of Chicago).

On 30 January 2020, US CDC reported the first confirmed case due to human-to-human transmission in the United States, in a male in his 60s and is the spouse of the imported confirmed case identified in Illinois. This newly identified case had no travel history to Wuhan, China, and had close contact with his wife after she developed symptoms. Public health officials identified this case through contact tracing; both of these epidemiologically-linked cases are hospitalized but in stable condition. This brings the total number of confirmed cases of 2019-nCoV to 6 in the United States.

2020-02-03

Viet Nam

Infectious

Coronavirus Infection (Novel Coronavirus 2019)

PHEIC

The second case is a 28-year-old male resident of Wuhan city, Hubei province, China; son of the first case. He has been working in Long An province and in the past four months he has not gone back to Wuhan or China. He accompanied his father from 17 January after they met in Nha Trang. On 20 January, he developed fever and was admitted to Cho Ray hospital on 22 January, together with his father.

The following three additional cases are workers in the same company who were sent to Wuhan City, Hubei province, China for a training two months ago. They all came back to Ha Noi on the same flight on 17 January 2020.

The third case is a 25-year-old female, resident of Thanh Hoa province. On arrival in Noi Bai international airport on 17 January 2020 she did not present with symptoms. On 24 January she developed fever and cough. She was admitted to Yen Dinh district general hospital in Thanh Hoa province then was referred to the provincial hospital, still with fever and cough, where she has been isolated since. The patient is reportedly in stable condition.

The fourth case is a 29-year-old male, resident of Vinh Phuc province. On arrival in Noi Bai international airport on 17 January 2020 he did not present with symptoms. On 21 January, he developed some respiratory symptoms and went to a private clinic in Tam Duong district, Vinh Phuc province. As his symptoms did not improve, he was admitted to the general hospital of Vinh Phuc province on 23 January 2020, but his health condition did not improve.  On 26 January, he was referred to the National Hospital for Tropical Diseases in Ha Noi for treatment. Currently he is in a stable condition.

The fifth case is a 23-year-old female, resident of Vinh Phuc province. On arrival in Noi Bai international airport on 17 January 2020 she did not present with symptoms. On 25 January, she was reportedly having symptoms and admitted to the National Hospital of Tropical Diseases in Ha Noi for treatment on the same day. Currently she is in a stable condition.

The sixth case is a 25-year-old female, who is a Vietnamese national, she is a resident of Van Ninh district, Khanh Hoa Province and works as a receptionist at a local hotel. On 16 January, she received two Chinese travelers who arrived to check into the hotel.  The two Chinese travelers (cases one and two) were diagnosed positive with 2019-nCoV as stated above.

On 18 January, the sixth case developed a light cough and fever, once reportedly taking two doses of medication (not clear what type of medication), her fever subsided but cough persisted. On 24 January 2020, her cough remained, and she was referred to the hospital for tropical diseases in Khanh Hoa Province where she has been treated and isolated since.

This is the second reported case in Viet Nam reporting human-to-human transmission and the first confirmed case of 2019 nCoV transmitted to a local Vietnamese individual.

Both the Pasteur Institute in Ho Chi Minh city and Pasteur Institute Nha Trang conducted the laboratory tests for the case using Real time RT- PCR (Charite–Universitätsmedizin Berlin protocol, including E gene, RdRp genes) and showed positive results for 2019-nCoV.

2020-02-03

Saudi Arabia

Infectious

Coronavirus Infection (MERS-CoV)

Since 2012 until 31 December 2019, the total number of laboratory-confirmed MERS-CoV infection cases reported globally to WHO is 2502 with 861 associated deaths. The global number reflects the total number of laboratory-confirmed cases reported to WHO under IHR to date. The total number of deaths includes the deaths that WHO is aware of to date through follow-up with affected member states.

Public Health Risk

·         A 65-year-old male national, retired and living in Alqaisumah city, Eastern region. He developed fever, cough, and shortness of breath on 1 December and was admitted to a hospital on 3 December. A chest X-ray confirmed a diagnosis of pneumonia. A nasopharyngeal swab was collected on 3 December and tested positive for MERS-CoV by RT-PCR (UpE and Orf1a genes) at the Eastern regional laboratory on 4 December.

Case reported on 12 December

A 66-year-old male national, retired and living in Abha city, Assir region. He developed fever, cough, and shortness of breath on 3 December and was admitted to a hospital on 9 December. A chest X-ray confirmed the diagnosis of pneumonia. A nasopharyngeal swab was collected on 10 December and tested positive for MERS-CoV by RT-PCR (UpE and Orf1a genes) at the Jeddah regional laboratory on 11 December. The patient was in critical condition in the ICU and passed away on 21 December. Investigation of 7 household contacts was completed and no secondary cases were identified.

·         Case reported on 14 December

A 72-year-old female national, house-wife and living in Riyadh city, Riyadh region. She developed fever, cough, and shortness of breath on 2 December and was admitted to a hospital on 12 December. A chest X-ray confirmed the diagnosis of pneumonia. A nasopharyngeal swab was collected on 12 December and tested positive for MERS-CoV by RT-PCR (UpE and Orf1a genes) at the Riyadh regional laboratory on 13 December. She has diabetes mellitus and hypertension as comorbid conditions. She has no clear history of exposure to any of the known risk factors. The patient was in critical condition in the ICU, she has now recovered and was discharged. Investigation of 5 household contacts was completed and no secondary cases were identified.

·         Case reported on 14 December

A 70-year-old male national, retired and living in Hafer Albatin city, Eastern region. He developed fever, cough, and shortness of breath on 15 December and was admitted to a hospital on 18 December. A chest X-ray confirmed the diagnosis of pneumonia. A nasopharyngeal swab was collected on 18 December and tested positive for MERS-CoV by RT-PCR (UpE and Orf1a genes) at the Eastern regional laboratory on 19 December. He had history of contact with dromedaries and consumption of their raw milk in the 14 days prior to the onset of symptoms. The patient was in critical condition in the ICU and passed away on 23 December. Investigation of 11 household contacts was completed and no secondary cases were identified. Ministry of Agriculture was informed and investigation of camels was conducted. The identified positive camels were quarantined.