As nCoV cases surge past 2,000, Canada now affected

As novel coronavirus (2019-nCoV) cases in China ballooned past 2,000 today amid signs that control efforts may not be working well, Canada announced its first case, a Toronto resident who recently returned from Wuhan.

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus, PhD, said today that he's en route to Beijing to meet with China's government and health officials to better understand outbreak developments and strengthen the WHO's partnership with Chinese officials in battling the outbreak.

Officials confirmed 688 new cases in 29 of China's 33 provinces and administrative regions, along with 15 more deaths.

Case in Toronto resident

Canada's first patient—a Toronto resident who recently returned from Wuhan—is listed as a presumptive positive and is hospitalized in stable condition, according to a statement from the city of Toronto, which was ground zero for Canada's SARS (severe acute respiratory syndrome) outbreak in 2003.

The patient is a man in his 50s who was mildly ill during the flight back to Canada, and health officials are tracking his fellow passengers, the Canadian Press (CP) reported today, citing Theresa Tam, MBBS, Canada's chief public health officer.

The man is in stable condition in a Toronto hospital.

China cases surge past 2,000

The 688 new cases reported by China's Centers for Disease Control and Prevention (CDC) today boosts the overall outbreak total to 1,975 cases, which includes 324 patients with severe disease. Fifteen more deaths were reported, raising the fatality count to 56.

As of this afternoon, a medical website from China that tallies newly reported cases reflected 2,081 cases.

Roughly half of the cases are from Hubei province, which is home to Wuhan. Guangdong and Zhejiang provinces have each reported more than 100 cases, with dozens of cases reported in major Chinese cities such as Beijing and Shanghai.

The mayor of Wuhan, the city where the outbreak started and by far the hardest-hit location, said today that 5 million people left the city before a lockdown was put in place to curtail the outbreak. The mass exodus left about 9 million in the city. Public transportation has been halted in the city since Jan 22, the South China Morning Post (SCMP) reported.

The central Chinese government imposed a lockdown on Wuhan and several cities on Jan 23 in hopes of curbing the spread of nCoV to other areas. Many people, however, had already left the city for the holiday, while others exited after the lockdown was announced the night before.

Also, the Chinese State Council extended the Lunar New Year holiday from Jan 30 to Feb 2 as another control step and said that schools from kindergarten through college are suspended until further notice from the education ministry.

In related developments, China today temporarily banned wildlife trade, which bars the transport and sale of wild animals in any markets or online, the Associated Press (AP) reported today, citing a state media announcement. Officials also said legal breeding centers will be quarantined.

A virus jump from a wild animal to a human at a market in Wuhan is suspected as the source of the outbreak. In the SARS outbreak, palm civets sold at markets were identified as the intermediate host, with the virus originating in bats.

More cases in Thailand, Japan, Hong Kong

Meanwhile, other locations outside China's mainland reported additional cases, including Thailand, Japan, and Hong Kong.

Thailand now has eight imported cases, and all are tied to people who had been in Wuhan, the country's health ministry said in a statement today. Three are still hospitalized, and five have returned home.

Yesterday, Thai officials said now that no more flights are coming from Wuhan, they will expanding traveler screening of flights coming from Guangzhou in China's Guangdong province, a city that has the second most cases behind Wuhan

Japan's health ministry today announced its fourth case, a male tourist in his 40s who arrived in the country from Wuhan on Jan 22 and developed a fever the following day, NHK News, Japan's national broadcasting organization, reported today.

Also today, Hong Kong's Centre for Health Protection (CHP) today reported three more 2019-nCoV patients, including a 47-year-old man who works in Wuhan, where he first sought case for a fever. He returned to Hong Kong by high-speed rail on Jan 23, though, when his fever subsided. He sought care in Hong Kong again on Jan 25 for a dog bite he sustained on the mainland, and he was admitted to the hospital, where his samples tested positive for the new virus

The other two patients are a 68-year-old woman from Shenzhen who had visited family members in Wuhan during the incubation period and a 64-year-old man whose wife was earlier identified as Hong Kong's third such case. Hong Kong now has eight imported cases.

So far, at least 47 cases have been reported from 14 areas outside of China's mainland.

Europe braces for further impact

In a risk assessment today, after three imported 2019-CoV cases were announced in France on Jan 24, the European Centre for Disease Protection and Control (ECDC) said it's bracing for a potentially high impact of the novel virus on Europe.

"The potential impact of 2019-nCoV outbreaks is high; further global spread is likely," the agency said.

In a news release emailed to journalists, Josep Jansa, the ECDC's principal expert for emergency preparedness and response, said, "Since the original source remains unknown and human-to-human transmission has been documented, further cases and deaths are expected."

He added, "Health authorities in EU/EEA Member States should remain vigilant and strengthen their capacity to respond to such an event. The impact of detecting an imported case in an EU/EEA country late without applying appropriate infection prevention and control measures would be high, as it would increase the risk of further transmission in the community."

Editorial Director Jim Wappes contributed to this report.

See also:

Jan 26 Tedros tweets

Jan 25 City of Toronto press release

Jan 26 CP story

Jan 26 China CDC update

Chinese medical community (DXY) 2019-nCoV tracking website

Jan 26 SCMP article

Jan 26 Thai health ministry statement

Jan 25 Thai health ministry statement

Jan 26 NHK news report

Jan 26 CHP statement

Jan 26 ECDC risk assessment

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