Seafood market in Wuhan where the virus is thought to have spread. Photo: Simon Song

Scientists anxious about China’s lack of transparency about a month-old outbreak of pneumonia in the city of Wuhan breathed a sigh of relief after health officials shared an update on the novel coronavirus (nCoV) pneumonia outbreak that has now caused 41 cases and one death. In addition, the World Health Organization (WHO) also released several interim guidance documents, including advice on travel, lab testing, and medical evaluation.

No human-to-human spread

Based on the current reports, there’s no obvious evidence of human-to-human spread yet. Wuhan officials said 41 patients have been diagnosed with nCoV pneumonia, and 2 have been discharged from the hospital. Seven had severe infections, and 1 patient died. The rest are in stable condition.

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dead case report on 9th Jan

1. M, 61, chronic liver disease and tumor in abdomen

2. Often purchasers in the concerned market

3. Severe pneumonia

Coma

Multiple organ failure

Cirrhosishttps://t.co/wSYcsqZeyD — Hayes Luk (@hayesluk) January 11, 2020

The patient who died was a 61-year-old man who had chronic liver disease and was a frequent customer at the market at the center of the investigation, according to a translation of a Chinese media report posted on Twitter by Hayes Luk, a microbiologist at the University of Hong Kong. So far 739 close contacts have been identified for monitoring, 419 of them medical staff. No related cases have been detected.

Genetic findings

All, an initial genome sequence of the coronavirus associated with the Wuhan outbreak is now available at https://t.co/EeqQXCs3n3 here: https://t.co/jdCM9USkSK — Eddie Holmes (@edwardcholmes) January 11, 2020

Chinese scientists submitted the gene sequencing data for posting on Virological.org, a hub for prepublication data designed to assist with public health activities and research. The post was communicated by Edward Holmes with the University of Sydney, on behalf of a Chinese group led by Yong-Zhen Zhang with Fudan University in Shanghai.

Some quick analysis of the new Wuhan CoV sequence:



1) Looks like a group 2B CoV, same family as SARS with about 73% conservation at genome

2)Rough tree puts it between HKU3/273-CoV and SHC014-CoV, a bat virus capable of using human ACE2. — The Menachery Lab (@TheMenacheryLab) January 11, 2020

Vineet Menachery, PhD, with the University of Texas Medical Branch posted on Twitter that nCoV appears to be a group 2B coronavirus, which puts it in the same family as the SARS (severe acute respiratory syndrome) virus.

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Rapid phylogenetic analysis of novel Wuhan China human Coronavirus shows it definitely clusters with the #SARS-related CoV clade. Note: prelim analysis based on 410bp of RdRp. More analyses forthcoming, but great to see seq data being shared by China. @EcoHealthNYC @PeterDaszak pic.twitter.com/M25hCOy5M1 — Kevin J Olival (@nycbat) January 11, 2020

Kevin Olival, VP for research of the EcoHealth Alliance in New York City, published a phylogenetic tree on Twitter and concurred that the new virus “definitely clusters” with the SARS-related coronaviruses.

The new #coronavirus has 89% identity to a SARS-related bat coronavirus (https://t.co/ZgbikQQOvY) in the Sarbecovirus group of betacoronaviruses. But that doesn’t mean it comes from bats. MERS-CoV is 88% identical to the nearest known bat virus and MERS is endemic in camels. — Andrew Rambaut ?????‍♂️ (@arambaut) January 11, 2020

Andrew Rambaut, PhD, administrator of Virological.org and professor of molecular evolution at the University of Edinburgh, said on Twitter that nCoV is 89% similar to SARS-related bat coronavirus in the Sarbecovirus group of betacoronaviruses. “But that doesn’t mean it comes from bats. MERS-CoV is 88% identical to the nearest known bat virus, and MERS is endemic in camels.”

He said that although bat viruses span coronavirus diversity and bats are a dominant host in much of the evolutionary history, the link to bats was a distraction when looking for the source of human MERS-CoV (Middle East respiratory syndrome coronavirus) cases.

Coronaviruses are a large family of viruses with some causing less-severe disease, such as the common cold, and others more severe disease such as MERS and SARS. Some transmit easily from person to person, while others do not. According to Chinese authorities, the virus in question can cause severe illness in some patients and does not transmit readily between people. Globally, novel coronaviruses emerge periodically in different areas, including SARS in 2002 and MERS in 2012. Several known coronaviruses are circulating in animals that have not yet infected humans. As surveillance improves more coronaviruses are likely to be identified.

WHO response, guidance, travel advice

In line with standard protocols for any public health event, an incident management system has been activated across the three levels of WHO (country office, regional office, and headquarters) and the Organization is prepared to mount a broader response, if needed. The WHO also provided preliminary guidance to help countries prepare for nCoV cases, including travel and trade advice. The WHO urges international travelers to practice usual precautions and calls for no restriction on international travel.

According to the WHO, the outbreak had not spread. The seafood market in Wuhan is now closed and no cases have been reported elsewhere in China or internationally.

“The evidence is highly suggestive that the outbreak is associated with exposures in one seafood market in Wuhan. At this stage, there is no infection among health care workers, and no clear evidence of human to human transmission.”

WHO’s coronavirus page has been updated to include case definition, laboratory guidance, infection prevention and control, risk communications, a readiness checklist, and a disease commodity package.