On 30 January 2020, WHO Director General declared the current outbreak of 2019-nCoV a public health emergency of international concern (PHEIC), with temporary recommendations issued for all countries.

The number of confirmed cases continue 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.

(Novel Coronavirus 2019)

On 30 January 2020, WHO Director General declared the current outbreak of 2019-nCoV a public health emergency of international concern (PHEIC), with temporary recommendations issued for all countries.

The number of confirmed cases continue to rise in China, and with the large-scale population movement over the Chinese New Year season, the risk of exportation outside of China has been high. However, given that authorities in Sweden have already put in place timely and appropriate public health measures, including patient isolation, contact tracing, surveillance and risk communication, the risk of onwards international spread from Sweden is very low.

2020-02-01

Canada

Infectious

Public Health Risk

The number of confirmed cases continue 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.

Currently, the Government of Canada is recommending that Canadians avoid non-essential travel to China and avoid all travel to Hubei province, given safety and security risks

2020-02-01

United Arab Emirates (the)

Infectious

Coronavirus Infection (Novel Coronavirus 2019)

Public Health Risk

The second case is a 38-year-old female, a Chinese national residing in Wuhan, Hubei province, China. She travelled from Wuhan to UAE on the same flight on 16 January. She developed fever, cough and runny nose on 23 January and then was isolated in a hospital on 27 January. A nasal swab was collected and tested positive for nCoV on 28 January by the Shiekh Khalifa Medical Center laboratory. The case remains in isolation and is in a stable condition.

The third case is a 10-year-old male, a Chinese national residing in Wuhan, Hubei province, China. He travelled from Wuhan to UAE on the same flight on 16 January. He is asymptomatic and did not show any symptoms during the flight or earlier. A nasal swab was collected and tested positive for nCoV on 28 January by the Shiekh Khalifa Medical Center laboratory.

The fourth case is a 36-year-old male, a Chinese national residing in UAE. He travelled from Wuhan to UAE on 4 January. He is asymptomatic. A nasal swab was collected and tested positive for nCoV on 28 January by the Shiekh Khalifa Medical Center laboratory.

The second and third cases were Chinese nationals, from Wuhan City, and visiting France on holiday. The second case was traveling with his wife, both in their thirties. They traveled from Wuhan City to Paris on 18 January, and the second case developed symptoms on 19 January. His wife, the third case, developed symptoms on 23 January. On 24 January, they sought medical attention and were hospitalized in an isolated, negative pressure room and tested positive by PCR. Both individuals presented with mild fever and cough. Contact tracing has identified three individuals potentially exposed to case 2 and 3, and these contacts are under monitoring.

On 28 January 2020, the Minister of Solidarity and Health reported the fourth confirmed case of 2019-nCOV in Paris, France. The case is a 81 year-old male patient, Chinese national, with an onset of symptoms (diarrhea and fever, no respiratory symptoms) on 22 January. He was hospitalized in ER in Paris on 25 January and was later admitted to ICU with acute respiratory distress syndrome (ARDS) on 28 January 2020. The patient arrived with a tourist group in Europe on 16 January and in France on 22 January. He comes from Hubei province, China. The patient is hospitalized in Ile-de-France.

On 29 January 2020, the Minister of Solidarity and Health reported the fifth confirmed case of 2019-nCOV in Paris, France, with symptom onset on 27 January and hospitalization on 28 January. The 2019-nCoV infection was confirmed by PCR on 29 January. The fifth patient is the daughter of the fourth case and travelled together with her father (travel history above). She is in a stable condition. The patient is hospitalized in Ile-de-France.

 On 30 January 2020, the sixth confirmed case of 2019-nCoV in France was notified to WHO. He is a general practitioner who examined two Chinese tourists presenting with respiratory symptoms compatible with a 2019-nCOV infection on 23 January in Paris. These individuals are now considered probable cases of 2019-nCoV. A close contact of these tourists was later diagnosed with 2019-nCoV on 26 January, after her return to Asia. The French patient (6th case) is hospitalized in Ile-de-France. This is the first healthcare worker diagnosed with 2019-nCoV in Europe, and the first domestic 2019-nCOV infection documented in France.

The German case is a 33-year-old male, who reported having the first contact with the mentioned Chinese female case in a 1-hour workshop on 20 January and a second brief contact on 21 January at his place of employment in Bavaria, Germany. He developed fever and mild respiratory symptoms (productive cough) on 24 January, but his clinical condition was better already on 25 January. He returned to work on 27 January, where he received an email from his company that the Chinese consultant had tested positive for 2019-nCoV upon her return to China. Although already asymptomatic, he went to the hospital. Two throat swabs and a sputum sample were taken at the Tropical Medicine Institute at the Ludwig Maximilian University in Germany and then tested positive for 2019-nCoV at the German Bundeswehr (Armed Forces) Institute of Microbiology late on 27 January. The case is currently in good clinical condition and is hospitalized in isolation. His close contacts (a wife and a 3-year-old child) are currently under quarantine at home and will be hospitalized if symptomatic.

On the evening of 28 January 2020, the Bavarian State Ministry of Health and Care, Germany announced additional three confirmed cases of 2019-nCoV. Information about these cases is under investigation and will be shared by Germany as soon as possible. These patients belong to the group of 40 employees that attended the workshop facilitated by the consultants from Shanghai, China. Further testing among the group is underway.

The number of confirmed cases continue to rise in China, and with the anticipated large-scale population movement over the Chinese New Year season, the likelihood of exportation outside of China is high. However, given that authorities in Germany have already put in place timely and appropriate public health measures, including case isolation, contact tracing, surveillance and risk communication, the risk of further international spread from Germany is low. Nevertheless, the primary case who was the source of the exposure returned to China while ill and may have exposed additional persons.  Further international spread of the disease cannot be excluded.

2020-01-29

Malaysia

Infectious

Poliomyelitis, acute paralytic, vaccine-associated
(Circulating vaccine-derived poliovirus type 1 (cVDPV1))

On 2 November 2019 and 9 January 2020, Confirmed detection of cVDPV1 from 3 AFP Cases while cVDPV1 and cVDPV2 was confirmed detected in a sewage sample.

None/Not applicable

On 9 January 2020, VIDRL confirmed detection of cVDPV1 from another two AFP cases:

·         2. An 11-year-old boy, not immunised against polio, staying in Kinabatangan district in Sabah. VDPV1 was isolated from two stool samples; the viruses have 35 and 34 nucleotide changes from Sabin 1 virus respectively and a divergence rate of 3.76%. The VDPV1 isolate is genetically linked to the VDPV1 sequences from Malaysia (AFP Tuaran PS310/19) and the Philippines, and thus classified as cVDPV1.The case has no history of travelling to Philippines but had history of exposure to visitors from Philippines.

·          

·         3. A 8-year-old boy, not immunised against polio, staying in Sandakan district in Sabah.  VDPV1 was isolated from stool samples with 35 nucleotide changes, resulting in 3.87% divergence. The VDPV1 isolate is genetically linked to the VDPV1 sequences from Malaysia (AFP Tuaran PS310/19) and the Philippines, and thus classified as cVDPV1.  This case has no history of travelling to Philippines but had history of exposure to workers and visitors from Philippines.

On 9 January 2020, MOH Malaysia received confirmation from the VIDRL regarding cVDPV1 and cVDPV2 detected in a sewage sample taken on 18 June 2019 from Sempelang 2 Sewage Pump Station in Kota Kinabalu. The VDPV1 isolate has 36 nucleotide changes (3.98% divergence to Sabin 1) and is genetically linked to the VDPV1 sequence from Malaysian AFP case PS310/19 and isolates reported by the Philippines. The VDPV2 isolate has 64 nucleotide changes (7.1% divergence to Sabin 2) and is genetically linked to the VDPV2 sequence from isolates reported by the Philippines.

·         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. He had no clear history of exposure to any of the known risk factors. The patient was in critical condition in the ICU and passed away on 21 December

·         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 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.

·         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.

The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries