WHO Declares Coronavirus an International Public Health Emergency as US Reports First Human-to-Human Transmission

The World Health Organization (WHO) has declared the new coronavirus (2019-nCoV) to be a public health emergency of international concern,¹ as the CDC announced the 6th case of the virus in the United States, as well as the country’s first documented person-to-person transmission. In a tele-briefing Thursday, the CDC also reiterated that the threat to the general public in the US is still low.²

“Over the past few weeks, we have witnessed the emergence of a previously unknown pathogen which has escalated into an unprecedented outbreak, and which has been met by unprecedented response,” said Tedros Adhanom, PhD, director general of WHO, during a press conference Thursday.¹

Adhanom said there are now 98 confirmed cases in 18 countries, besides China, including 8 cases of human-to-human transmission in 4 countries. There have been no deaths from the virus outside of China, which has seen more than 7000 cases of infection.¹

While the WHO’s declaration does not have the force of law, it serves as a notice to all United Nations member states that the organization’s leaders think the situation is serious. Governments then make their own decisions about responses, including whether to close their borders, cancel flights, screen people arriving at airports, or to take other protective measures.¹

In the US, Illinois and California each have confirmed 2 cases of the 2019-nCoV, while Arizona, and Washington State each have a single case.²

According to CDC director Robert Redfield, MD, and Nancy Messonnier, MD, director of the National Center for Immunization and Respiratory Diseases, the latest US case of the virus is the 2nd in Illinois, and the first involving person-to-person transmission. The patient identified in this latest case was in close contact to the individual from the first confirmed US case.²

The first US case in Illinois was a woman aged in her 60s that had returned from Wuhan, China, where the virus is believed to have originated in humans. Her husband, who had been in close contact with her while she had been presenting symptoms, is being monitored, and has presented symptoms as well, leading health officials to determine that it is the first person-to-person transmission of 2019-nCoV within the US. In the second case, underlying illness has been confirmed.²

This transmission of the virus makes the US the fifth country where the infection is now spreading through human-to-human contact, joining China, Germany, Japan, and Vietnam.³

Chinese health authorities were the first to post the full genome of the 2019-nCoV, which as first detected in Wuhan City, Hubei Province. Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. The 2019-nCoV is a betacoronavirus, like MERS and SARS, all of which have their origins in bats.³

CDC officials reported 21 pending cases of possible 2019-nCoV within Illinois, according to the CDC. The Illinois Public Health Department is actively monitoring the individuals at risk but has reiterated that the general public is not at risk. Illinois public health officials are not recommending the general public to cancel activities or to wear face masks.¹

Current recommendations from the World Health Organization for people with 2019-nCoV include⁵:

• The patient should be provided with a face mask and placed in a closed room, preferably with structural safeguards against airborne transmission.
• Anyone entering the room should follow standard, contact, and airborne precautions.
• Patients managed at home should self-isolate in a single area, preferable with a separate bathroom, and should continue to wear a face mask during any contact with others.
• The patient and anyone in contact with them should follow strict hygiene, including diligent hand washing, and cough hygiene.

“This is a serious public health threat. The fact that this virus has caused severe illness and sustained person-to-person spread in China is concerning, but it’s unclear how the situation in the United States will unfold at this time,” according to the CDC website.³

Adhanom said the declaration of a public health emergency should not cause panic, but instead urged the global community to help prepare countries who may have weaker health systems which are less prepared for such a viral outbreak.

“Our greatest concern is the potential for the virus to spread to countries with weaker health systems,” Adhanom said.²

The ongoing goal of the WHO, CDC, and affiliating public health departments is to contain the 2019-nCoV outbreak. More information on this developing situation can be found on the CDC’s website and the WHO website.

REFERENCES

• WHO Press Conference, January 30, 2020.
• CDC Telebriefing. January 30, 2020. https://www.cdc.gov/media/.
• 2019 Novel Coronavirus (2019-nCoV) in the United States. CDC website. Updated January 30, 2020. https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html. Accessed January 30, 2020.
• Novel Coronavirus (2019-nCoV) Situation Report. World Health Organization. Published January 27, 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200127-sitrep-7-2019--ncov.pdf. Accessed January 30, 2020.
• Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected. World Health Organization, January 25, 2020. https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125. Accessed January 27, 2020.