The United Kingdom and Italy are investigating suspected cases of coronavirus, which has killed 26 people in China and put the city at the epicenter of the outbreak on lockdown.
Nine people in the U.K. were awaiting results of their tests on Friday after showing symptoms of coronavirus, the BBC reported. They had all been in the Chinese city of Wuhan in the past two weeks, according to the report. In Italy, a woman has been hospitalized with flu-like symptoms since Wednesday after returning from a tour of the region, which included a stop in Wuhan, according to HuffPost.
If confirmed, they would be the first cases of the illness in Europe.
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Chinese authorities have clamped down on travel in Wuhan and three other cities in the central province of Hubei to prevent further spread of the virus. However, the World Health Organization opted against declaring a global health emergency Thursday evening after two days of heated deliberations by a committee of experts.
With the number of known cases at around 800, and the threat of further spread of the virus putting authorities on high alert, there are plenty of unknowns surrounding the severity, duration and transmission risks, as well as what effectively fights the disease.
Here are four key things to know:
The virus isn’t ‘brand new’ — but the public health risk is a mystery
The Wuhan illness is part of a family known as coronaviruses. They often feel like a common cold or an upper respiratory tract infection, with fever, cough and a runny nose. More severe cases can turn into pneumonia or kidney failure, according to the WHO.
But officials still don’t know how infectious this particular virus is. Britain’s health department issued clinical guidance for the detection and diagnosis of the virus and Public Health England developed a diagnostic test, “making the U.K. one of the first countries outside China to have a prototype specific laboratory test for this new disease,” the department said Wednesday.
U.K. Health Secretary Matt Hancock told MPs on Thursday that the country’s National Health Service was fully prepared to deal with any cases that may arise.
The U.K. is one of three European countries with direct flight connections to Wuhan, and had imposed enhanced monitoring on them before the Chinese authorities shut down those connections.
In Rome’s Fiumicino airport, some 200 passengers who got off a flight from Wuhan were checked in the early morning on Thursday for any signs of the virus, but none of them showed any symptoms, DPA reported.
Italian Health Minister Roberto Speranza said he was in constant contact with the European Health Commissioner Stella Kyriakides, who is coordinating the EU response.
Meanwhile in France, the Chinese embassy issued a warning urging people to comply with airport checks after a woman from Wuhan said she had evaded screenings in order to fly to Paris to visit a restaurant.
Officials still don’t know how easy it is to catch the virus
Coronaviruses are common in animals, and sometimes they evolve and can infect humans, according to the U.S. Centers for Disease Control and Prevention. WHO officials have confirmed this strain can spread from one person to another. So far this was only confirmed in China, and it appears to be limited to family members or health workers caring for infected patients, WHO chief Tedros Adhanom Ghebreyesus said Thursday. “At this time, there is no evidence of human-to-human transmission outside [China], but that doesn’t mean it won’t happen,” he said.
Almost half of the 17 people who died by Thursday were aged 80 or over and most of them had pre-existing health problems, Chinese health authorities said Thursday, according to South China Morning Post. Children have also been infected, but they aren’t highly susceptible to the virus, they said.
The youngest person out of the 17 who died was 48 and the oldest 89, according to the same report.
Patients should be isolated, authorities say
The Italian ministry on Wednesday sent health professionals and other parties a note about the way to proceed if cases arise in Italy.
People suspected of being infected with the virus should be checked in a separate area of the hospital and isolated from other patients. They should also wear a surgical mask if they can tolerate it, the ministry advised. Contact with health workers, family members and visitors should be minimized and registered.
“Health care professionals who look after such cases should, where possible, be dedicated exclusively to these patients to reduce the risk of transmission,” the note said. On top of standard biosecurity measures, they should also use precautions to prevent transmission by air or contact, it said.
That’s in line with the World Health Organization’s interim guidance for suspected coronavirus infections, published January 13. Countries face a “moderate likelihood” of outbreaks if they fail to implement these control measures, according to the European Centre for Disease Prevention and Control. At this point, the Stockholm-based agency is helping EU countries develop guidelines on determining suspected cases and when to start testing.
Widespread travel bans are unlikely
Chinese officials froze travel in the Hubei province, but authorities in the rest of the world and WHO officials have held back on similar moves for now.
It’s very rare for WHO to issue travel warnings for a viral pandemic.
The global health authority sounded the alarm for travel to Chinese cities and Toronto during the deadly 2003 SARS epidemic that killed 774 people and sickened more than 8,000 but refrained during more recent outbreaks of Ebola virus, Middle East Respiratory Syndrome or the Avian flu.
The WHO has to balance public health concerns against the harmful impact that travel restrictions could have on affected countries that need a flow of goods and people to keep their economies running and fight a deadly outbreak.
“Travel bans are not justified from a public health perspective,” said WHO spokesperson Tarik Jašarević. “They will disrupt response and economies and will have a negative impact on response.”
Sarah Wheaton and Ashleigh Furlong contributed reporting.
UPDATE: This story was updated Friday morning to incorporate fresh numbers on the virus’ spread.
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