China nCoV cases continue at stable rate; concerns rise about spread in Singapore

China added nearly 3,400 new novel coronavirus (2019-nCoV) cases today, a pace that the World Health Organization (WHO) said has been stable over the past 4 days. Outside of China, concerns are growing about possible sustained transmission in Singapore.

In other developments, France today reported a case cluster in a British family who stayed at a ski resort, the US Centers for Disease Control and Prevention (CDC) released guidance for businesses, and the WHO received more support for the outbreak response, with the latest pledge coming from the United Kingdom.

China deaths approach SARS total

China today reported 3,399 cases, up slightly from yesterday's 3,143 daily number, according to the latest update from the country's National Health Commission (NHC). Also, China reported 86 more deaths and 1,280 severe cases. The developments push the outbreak totals to 34,546 cases, 722 deaths, and 6,101 serious infections. So far, 2,050 people have been discharged from the hospital.

The number of deaths is set to pass the 774 recorded globally during the severe acute respiratory syndrome (SARS) epidemic in 2003.

In a related development, the first American death from the outbreak has been reported from Wuhan, the New York Times reported today, citing the US Embassy in Beijing.

At a media telebriefing today, WHO director-general Tedros Adhanom Ghebreyesus, PhD, said though cases haven’t risen significantly in Hubei province over the last 4 days, the trend should be interpreted with caution. He said epidemiologic curves can quickly shoot up, especially when there are super spreader events and community transmissions.

WHO officials said that though the number of 2019-nCoV infections have crossed the 1,000-case mark in Guangdong and Zhejiang provinces, activity outside of Hubei province also seems stable, and though they track the locations of cases China reports each day, it's tough to draw conclusions without illness onset dates.

Mike Ryan, MD, heads of the WHO's health emergencies program, said numbers grow slowly day by day. "Again, it's very, very, very early to make any predictions about the outbreak."

In other developments from China, the country has submitted several more genetic sequences to the GISAID (Global Initiative on Sharing All Influenza Data) database covering the Jan 10 to Feb 5 time span, and sequences have also been added by 13 other countries.

On Twitter, Jeremy Farrar, MD, PhD, director of Wellcome Trust, said the samples are important for understanding different aspects of the outbreak, including the evolution of the virus, the outbreak's scale, and transmission dynamics.

However, he said there haven't been any sequences from Wuhan since Jan 4, and that it's critical to have genetic information from the epicenter, where evolutionary pressure is greatest and information is needed to guide public health response steps.

Family cluster in France, Singapore tracks local spread

France's health ministry yesterday and today reported six new cases, part of a cluster linked to a British citizen who had recently traveled to Singapore and returned to England at the end of January. The other five patients linked to the man are all British and include four adults and one child.

The group, which included 11 family members, was staying at a ski resort in Contamines-Montjoie in Haute-Savoie department.

Recent cases in other countries have been linked to a business meeting in Singapore.

Meanwhile, Singapore's health ministry today reported seven more cases, raising its total to 40. Two of the newly infected patients were a taxi driver and a private-hire car driver. Two of the people had attended the same private business meeting at the Grand Hyatt as an earlier confirmed case. One was a close contact of an earlier case, and exposures for two others was unclear.

Singapore has received praise from outside experts for its contact tracing details and transparency. In today's update, health officials said they had uncovered connections among earlier announced cases, including five linked to a possible church cluster and nine linked to another possible cluster at the same address.

WHO officials said today that they are keeping a very close eye on clusters reported both in and outside of China to learn more about the virus and how it transmits. Singapore isn't the only country outside linked to suspected exported case; others such as Thailand have been linked to a handful of similar cases.

Elsewhere, Japan's health ministry today reported three more illnesses passengers on the quarantined Diamond Princess cruise ship, raising the total to 64. The boat has been quarantined at sea since it arrived in Yokohama port on Feb 3.

In its daily situation report today, the WHO said it received 18 more reports of cases outside of China over the past 24 hours, raising the total to 288 in 24 countries.

CDC business guidance, UK outbreak support

The US Centers for Disease Control and Prevention (CDC) yesterday released interim guidance for businesses and employers. It said the documents offer advice for preventing 2019-nCoV and other respiratory illnesses in nonmedical workplace settings.

It also covers planning considerations if there are widespread community outbreaks of 2019-nCoV in the United States.

The United Kingdom today announced £5 million ($6.4 million) in response to the WHO's recent $675 million appeal to fund the outbreak response over the next 3 months. In a statement today, the country also said it would fund the deployment of additional experts.

At today's media briefing, Tedros thanked the countries and groups that have stepped forward, which he said also includes the United States, the Bill and Melinda Gates Foundation, the Netherlands, the Czech Republic, Japan, and the Wellcome Trust.

See also:

Feb 8 China NHC daily update

Feb 8 New York Times report

Feb 8 Jeremy Farrar tweet

Feb 8 UK government announcement

Feb 8 French health ministry statement

Feb 8 Singapore health ministry update

Feb 8 Japanese health ministry statement

Feb 8 WHO daily situation report

Feb 7 CDC guidance

Feb 8 UK government statement

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