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WHO, Event Information Site for IHR National Focal

Event Updates: 12 January 2020 to 18 January 2020

Event Updated Country Hazard Disease Event Description IHR Assessment
2020-01-18 Belgium Zoonosis Argentine Hemorrhagic Fever Syndrome 

(A96.0 Junin VHF)

 On 12 January 2020, the IHR National Focal Point (NFP) for Belgium reported one laboratory-confirmed case of Argentine Haemorrhagic Fever (AHF). Public Health Risk
Details of the case/s:
A 41-year-old woman originating from Santa Fe province in Argentina. The occupation of the case is not directly linked with agricultural activities. The likely route of infection is currently not known, but the patient has been regularly jogging in endemic areas in Argentina. 

The onset of influenza-like symptoms was on 28 December 2019 while in Argentina. The case travelled with a friend by air from Buenos Aires, Argentina transiting through Madrid, Spain on 1 January 2020, and then taking a flight to Amsterdam, The Netherlands while symptomatic (sore throat, medium grade fever). In Amsterdam she stayed in a hotel from 2 January until 6 January and continuing travel by bus to Brussels, Belgium. Repeated vomiting started on 4 January (2-3 times a day), followed by aggravation of the health status that resulting in hospitalization on 6 January 2020. Other reported symptoms were chills, malaise, epileptic seizure and bleeding (epistaxis, intraoral and from puncture sites). Patient required respiratory support and was intubated on 11 January.

No vomiting, bleeding and body fluid spillage were reported during travel to Brussels. A close contact accompanying the patient on the way to Belgium continued the journey to France. Both the case and the contact reside in an endemic area for AHF in Argentina and are not vaccinated against Junín virus.

Once hospitalized in Brussels on 06 January, diagnosis of AHF was confirmed through RT-PCR by the Bernhard Nocht Institute, Hamburg, on 11 January, indicating a high viral load.

The patient is currently in stable condition, having been treated with supportive care, transfusion and antibiotics, along with off-label use of ribavirin and favipiravir. The use of hyperimmune serum was deemed of no benefit at the time of evaluation due to the time lapsed from the onset of prodromal symptoms (more than 8 days). As of 17 January, all 134 contacts, including the co-traveller, the patient’s partner and mother (the latter two arriving to Brussels directly from Argentina on 08 January), were reported to be asymptomatic. Between 06 and 10 January, the healthcare personnel and lab technicians in four health care facilities have been exposed to the patient or her clinical samples without adequate protective measures for Junín virus, and one contact developed fever but tested positive for influenza A.
Risk Assessment:
In Argentina, the geographical risk area is limited to the provinces of Buenos Aires, Cordoba, Santa Fe, Entre Rios and La Pampa. There is no significant risk of international disease spread, as person-to-person transmission of Junín virus is possible, but unlikely. Considering incubation period and volume of international travel between South America and Europe, sporadic importation to Europe or other regions may not be ruled out. There have been no secondary cases reported to date, with all high-risk contacts being asymptomatic as of 17 January, except one testing positive for influenza A.
WHO advice/recommendations:
Given the nonspecific presentation of viral haemorrhagic fevers, isolation of ill travellers and consistent implementation of standard precautions are key to preventing secondary transmission. When consistently applied, these measures can prevent secondary transmission even if travel history information is not obtained, not immediately available, or the diagnosis of a viral haemorrhagic fever is delayed.
Interference with International travel or trade:
No
  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2020-01-16

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Japan

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Infectious

 Corona-virus Infection (nCoV) On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan (MHLW) reported an imported case of laboratory-confirmed 2019 novel coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Public Health Risk
Details of the case/s:
The case is a male is between the age of 30-39 years old and living in Kanagawa Prefecture, Japan. He traveled to Wuhan, China from 20 December 2019 to 6 January 2020. While in China, he was staying with his family and did not visit the Huanan Seafood Wholesale Market or any other live animal markets in Wuhan. He went to Wuhan Zoo on 22 December with his parents, his brother, and his children. He developed fever on 3 January 2020 and took antibiotics. He traveled on 6 January 2020 by a direct flight from Wuhan to Tokyo-Narita. He visited a local clinic on 6 January and got a prescription (antibiotics and antipyretics) due to the negative result of influenza. The case went to work on 9 and 10 January with body temperature 39°C, with dry cough and sore throat. On 10 January 2020, as his symptoms continued, including cough, sore throat and fever of 38 °C, he visited a local hospital and was found to have abnormal chest x-ray with an infiltrative shadow in the right lower lung. He was admitted to the hospital on the same day. He has remained febrile until 14 January. On 14 January, his attending doctor notified the patient to a local public health authority as a compatible case with “Unidentified Serious Infectious Illness”. 

Throat swab samples were sent to the National Institute of Infectious Diseases (NIID) and at NIID, PCR testing and direct sequencing have been done twice, which identified very small amount of nCoV RNA on 15 January 2020.

The patient was well on 15 January and discharged from the hospital. Currently, the case is staying at home in a stable condition.
Risk Assessment:
The imported case from China to Japan amplifies the risk of international spread. However, there is no clear evidence of sustained human-to-human transmission and no evidence that nCoV passes easily between people. Preliminary investigations in China have not yet identified the source of the outbreak.
WHO advice/recommendations:
WHO does not recommend any specific health measures for travelers. In case of symptoms suggestive of respiratory illness either during or after travel, the travelers are encouraged to seek medical attention and share their travel history with their health care provider.
Interference with International travel or trade:
No
  

 

 

 

 

 

 

 

 

 

 

2020-01-14

   

 

 

 

 

 

 

 

 

 

 

Thailand

   

 

 

 

 

 

 

 

 

 

 

Infectious

   

 

 

 

 

 

 

 

 

 

Corona-virus Infection (nCoV)

 On 13 January 2020, The Ministry of Public Health of Thailand reported the first imported case of lab-confirmed novel coronavirus (nCoV) from Wuhan, Hubei Province, China.   

 

 

 

 

 

 

 

 

 

Public Health Risk
Details of the case/s:
The case is a 61-year-old Chinese female living in Wuhan City, Hubei Province, China. On 5 January 2020, she developed fever with chill, sore throat and headache; on 8 January 2020, she took a direct flight to Thailand from Wuhan together with her 5 family members in a tour group of 16 tourists (included the imported case). The case was detected on the same day by a thermal surveillance and interviewed by port health officers at Suvarnabhumi Airport (BKK) and hospitalized on the same day. Her initial temperature measured at the arrival gate was 38.6°C. After initial assessment she was transferred to Bamrasnaradura Infectious Disease Institute (BIDI). Clinical presentation at BIDI included sore throat and coryzal symptoms with no dyspnea or diarrhea. Vital signs were normal, and the case had injected pharynx and normal lung sounds. The chest X-ray results were compatible with pneumonia. The patient’s full exposure history is under investigation. She reported a history of visiting local fresh market in Wuhan in regular basis prior to the onset of illness on 5 January 2020 but reported not to visit the Huanan South China Seafood Market. Her samples tested positive for coronaviruses by conventional nested RT-PCR for upper respiratory tract specimen and sputum on 12 January 2020. The genomic sequencing analysis performed by Emerging Infectious Diseases Health Science Center, The Thai Red Cross Society (EID-TRC) and The Thai National Institute of Health (Thai NIH), Department of Medical Sciences confirmed that the patient is infected with the nCoV (ascertain number MN908947) which was isolated in Wuhan, China. 

Currently, the case is in a stable condition and in hospital.
Risk Assessment:
The imported case from China to Thailand exemplifies the risk of international spread. However, there is no clear evidence of sustained human-to-human transmission and no evidence that nCoV passes easily between people. Preliminary investigations in China have not yet identified the source of the outbreak.
WHO advice/recommendations:
WHO does not recommend any specific health measures for travelers. In case of symptoms suggestive to respiratory illness either during or after travel, the travellers are encouraged to seek medical attention and share travel history with their healthcare provider.
Interference with International travel or trade:
No
  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2020-01-12

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

China

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Infectious

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corona-virus Infection

(nCoV)

 On 31 December 2019, a cluster of pneumonia of unknown etiology was reported in Wuhan City, Hubei Province of China. Some patients were operating dealers or vendors in Huanan Seafood Market. The concerned market in Wuhan was closed on 1 January 2020 for environmental sanitation and disinfection. The source of infection is under further investigation. On January 7, 2020, a novel coronavirus was detected in some cases and isolated from one patient sample, and as of 11 January nucleic acid test of the novel coronavirus was tested positive among 41 pneumonia cases in Wuhan City.   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Public Health Risk
Details of the case/s:
As of 24:00 11 January 2020, 41 cases with pneumonia with positive nucleic acid tests for a novel coronavirus were detected in Wuhan City, Hubei Province of China, including 7 cases in severe condition and one death. The fatal case was a 61-year-old male with severe underlying medical conditions, with frequent contact with the Huanan Market, who was admitted to the hospital with respiratory failure. The remaining cases are in stable condition. The dates of onset range between 8 December 2019 and 2 January 2020. At present, six cases have been discharged and other cases are receiving treatment and are isolated in Wuhan medical institutions. The clinical presentation includes fever, in some cases difficulty breathing, and chest radiographs show bilateral pneumonic infiltrations. So far, 763 close contacts have been followed up and placed under medical observation. Among them, 46 have been discharged from medical observation, 717 are under current medical observation and no secondary cases have been found among all the close contacts. The preliminary investigation revealed that there is no infection among health care workers and no clear evidence of human-to-human transmission. Some clustered cases are still under investigation. 

A new type of coronavirus (novel coronavirus, nCoV) was detected on 7 January 2020, and the genetic sequence of this virus had been shared with WHO by China on 12 January. A total of 41 positive results of nCoV have been detected by nucleic acid test. Other respiratory pathogens such as influenza, avian influenza, adenovirus, Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), Middle East Respiratory Syndrome coronavirus (MERS-CoV) have been excluded.

The source of the outbreak is under further investigation. According to preliminary epidemiological investigations, most patients either visited or worked in the Huanan Seafood Wholesale market, Wuhan City. Live wild and farmed animals were also sold at the market and authorities in China are investigating whether any animals were infected with nCoV.
Risk Assessment:
Currently, there is no clear evidence of human-to-human transmission. All close contacts have been under medical observation and no cases have been found. The source of the new virus and the modes of transmission are currently under further investigation. Preliminary investigations have found no evidence of significant human-to-human transmission, no reports so far of transmission to health workers.
WHO advice/recommendations:
WHO does not recommend any specific health measures for travelers. In case of symptoms suggestive to respiratory illness either during or after travel, the travellers are encouraged to seek medical attention and share travel history with their healthcare provider.
 Interference with International travel or trade:
 No

*A public health risk is something that is (or is likely to be) hazardous to human health or could contribute to a disease or an infectious condition in humans