Ongoing COVID-19 activity in two hot spots outside of China—Italy and Iran—have led to travel-linked cases in four newly affected countries: Algeria, Brazil, Greece, and Pakistan.
Meanwhile, South Korea saw no let-up in its novel coronavirus outbreak, and several already affected countries reported more travel-related cases, plus some that may reflect local spread.
As the numbers of outside China surge, the World Health Organization (WHO) said in its daily update today that, for the first time, the daily number of cases outside of China exceeds those reported within China.
In China, the National Health Commission today reported 406 new cases, raising its overall outbreak total to 78,046 cases. They also reported 52 more deaths and 374 fewer serious cases, putting those respective totals at 2,715 and 8,752.
Global COVID-19 totals have reached 81,322 cases and 2,770 deaths, according to a list curated by Johns Hopkins.
Italy travel noted in Brazil infection
Italy's health ministry today reported 52 new cases, raising its total to 374. It also noted 2 more deaths, putting the fatality count at 12. All but 2 of the cases are from three northern regions: Lombardy, Veneto, and Emilia-Romagna.
In a related development, Brazil today reported its first case, marking the first confirmed appearance of the virus in South America. According to the country's health ministry, the patient is a 61-year-old man in Sao Paulo who had traveled to Italy's Lombardy region. An investigation is under way to identify the man's contacts, including ones at home, the hospital, and the airline he flew on. Today the WHO's Pan American Health Organization urged all countries in the region to brace for the appearance of new cases, based on the detection in Brazil.
Similarly, Algeria confirmed a case linked to Italy travel, marking the first known case in the WHO's African region, according to a statement yesterday from the WHO. (Egypt reported a case earlier this month, but it is in the WHO's eastern Mediterranean region.) The Algeria case involves an Italian citizen who arrived in the country on Feb 17.
Algeria is one of the 13 countries the WHO has prioritized for preparedness, because of its close links with China, and the agency said it is preparing to deploy an expert group to support Algerian authorities.
A health ministry statement said the Italian man, who has underlying health conditions, is from Milan and had been in southern Algeria.
Greece's health ministry today on Twitter reported the country's first case, involving a 38-year-old woman who is a Greek citizen. It said she had traveled to a populated area in northern Italy and that she is in good health and is being monitored by doctors in Thessaloniki.
Meanwhile, four already affected European countries reported more cases, mostly with links to Italy travel:
- France today reported 3 new cases, one of whom involving a person who made frequent trips to Italy's Lombardy region, France24 reported today, citing French health officials. Investigations are still under way into the other 2 cases, which includes a 60-year-old French man who died last night in Paris after he was rushed to the hospital. France now has 15 cases, 2 of them fatal.
- Spain reported more cases since yesterday, El Pais reported today. They include one from Seville, one from Castellon, two in Madrid, another from Catalonia, and more from the Canary Islands of Tenerife, which had reported a recent case linked to Italy travel. The Madrid, Catalonia, and Castellon cases are linked to Italy travel. Spain now has 12 cases, all but 2 reported over the last 2 days.
- Germany reported 2 more cases, in a 25-year-old man in Baden-Wurttemberg state who had traveled to Milan, Italy, and in a man in North Rhine-Westphalia who was hospitalized on Feb 24 and is in critical condition, Reuters reported today.
- Finland today reported a new case, which involves a patient from Helsinki who had recently traveled to Milan, according to a health ministry Finland now has 2 cases.
Iran cases climb, along with exported cases
Iran's health ministry today reported 44 more cases, along with 4 more deaths, raising its total to 139 cases, 19 of them fatal. Fifteen cases were in Qom, the outbreak's epicenter, and 13 in other locations, including 4 in Tehran.
A new estimate from modeling experts in Canada suggests that Iran could have as many as 18,300 cases (range, 3,770 to 53,470). For their analysis, the mathematical modelers examined the first 43 cases reported in Iran in the middle of February, as well as the first 3 exported cases. They also factored in air travel connectivity between Iran and other countries. They estimated that the outbreak might have been under way for the past month and a half. When they reran the numbers with the newest exported cases, they estimated that Iran may have 11,520 to 41,280 cases.
The group warned that Iran's epidemic is concerning, not only to its citizens but to other countries, especially those with lower capacity to respond to outbreaks.
In a new development, Pakistan today reported its first two cases, according to a tweet from the health minister. One patient is a 22-year-old man from Karachi who had visited Iran, Agence France-Presse (AFP) reported, citing a provincial health official. The other is reportedly from Islamabad, AFP said, citing a local media report.
Several other already affected countries reported new cases linked to Iran travel, including:
- Canada today reported its second case linked to an Iran traveler. Ontario's health department said the patient is a woman her 60s in Toronto who sought care at an emergency department on Feb 24 and reported a travel history to Iran. Ontario has now reported 5 cases, and Canada's total is now 12.
- Bahrain today reported 3 more cases, raising its total to 26, the health ministry said on Twitter, adding that the patients are women who had traveled from Iran.
- Kuwait since yesterday has reported 13 new cases, raising its total to 25, Reuters reported today, citing the country's health ministry, which also said the new infections involve people who traveled to Iran.
- Lebanon today reported its second case, in a woman who was on the same flight from Qom, Iraq, as the first confirmed case, the WHO Lebanon office said today on Twitter.
South Korea and Japan's totals climb
South Korea's Centers for Disease Control and Prevention (KCDC) today reported 284 cases, up from 274 new cases reported yesterday, for a total of 1,261 cases. The KCDC also reported 10 more deaths, raising the fatality count to 12.
In a summary of the first 1,146 cases, the KCDC said about half of the cases are from Daegu and are linked to the Shincheonji Church of Jesus, for which health officials have a plan for monitoring the health of all members. An outbreak on Qingdao Daenam Hospital now totals 114 people, 7 of whom died. Most involve patients, but 10 employees were sickened.
The city of Busan now has 50 cases, 23 of them linked to a separate church cluster. In Gyeongbuk, another outbreak hot spot, illnesses have been reported in three nursing homes.
In a related development, the first illness has been detected in a US service member at Camp Carroll in Daegu, according a statement yesterday from US Forces Korea. The patient is a 23-year-old man who is in self-isolation at his off-base home. Earlier this week, the base reported an illness in a dependent.
In Japan, the health ministry reported 20 more cases and 2 asymptomatic carriers, raising its total to 167, though it notes 186 overall cases that include 19 asymptomatic carriers. The latest cases are from Chiba, Hokkaido, Kanagawa, Osaka, Tokyo, Nagoya, and Nagano prefectures.
Also, the country reported 14 more cases on the Diamond Princess cruise ship, 9 in crew members and 5 in passengers, raising the total to 705. The latest group tested included 12 asymptomatic virus carriers. In a separate statement, the ministry also reported two more deaths linked to the cruise ship, a man in his 80s from Tokyo and a patient from Hokkaido whose age and gender aren't listed.
In other Asian developments:
- Singapore today reported 2 more cases, raising its total to 93. The health ministry said investigations are ongoing to see if they have links to earlier cases or China travel. So far, the country has 11 cases with no known links to other cases.
- Thailand today reported 3 more cases, lifting its total to 40, Xinhua, China's state news agency, reported. They involve a man who had traveled to Japan, plus his wife and grandson.
