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WHO EMRO Weekly Epidemiological Monitor: Volume 13, Issue no 5; 2 February 2020

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2019-nCoV - Public Health Emergency of International Concern (PHEIC)

The emergence of new deadly pathogen in China, 2019-nCoV, has been a significant global health challenge. Its rapid proliferation in China and global human-to-human transmission has necessitated convening the Emergency Committee by Director General and declare it as a PHEIC on 30 January 2020.

Editorial note

Coronavirus (CoV), a large group of viruses, is named due to the circular-shaped protein spikes that surround its genetic material in the centre. The new pathogen is a member of the family of Coronavirus; therefore, named as novel Coronavirus (2019-nCoV); other lethal siblings (viruses) are Severe Acute Respiratory Syndrome, SARS-CoV, first identified in China in 2002 and the Middle Eastern Respiratory Syndrome-MERS-CoV in Saudi Arabia in 2012. Different from both SARS-CoV and MERS-CoV that are transmitted by civet cats and dromedary camels respectively, the aetiology of the recent member of this family is still unknown. However, what is known are the commonalities of their symptoms, which includes cold, difficulty in breathing, and in severe cases pneumonia and kidney failure can also occur. Case fatality rate (CFR) frequently changes with the number of deaths caused by the virus but it is currently 2.1%. 2019-nCoV is spreading rapidly in China and has infected people globally, resulting global total to 14 545 confirmed cases out of which 14 411 cases are from China with 304 deaths as reported as of 02 February 2020.

Furthermore, the transmission has been reported in 5 WHO regions (see table) involving 19 countries. In Eastern Mediterranean region (EMR), first 4 confirmed cases are reported from United Arab Emirates (UAE) on 29 January, 2020. All 4 cases belongs to the same family and have travel history to Wuhan, China- the epicenter of 2019-nCoV. Subsequently, it is more likely that other EMR countries may see the importation of new cases in the near future; thus, EMR Office has developed a Strategic Response Plan to scale up preparedness and operational readiness to prevent, early detect, and rapidly respond to the virus in the regional countries.
Keeping in view the global transmission of the new virus, WHO Director General convened an Emergency Committee under the IHR (2005) for three times in the last two weeks and finally agreed upon and announced the outbreak as a PHEIC on 30 January 2020. However, the committee further said that the announcement should be taken as a support to Chinese people and emphasized on global coordination to enhance preparedness in other regions which are in need of additional support.

Additionally, WHO has warned the international exportation of cases in any country; therefore, advised them to prepare for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of the virus along with sharing full information with WHO. In addition WHO has developed interim guidance for laboratory diagnosis, clinical management, IPC in health care settings, home care for patients with suspected 2019-nCoV, risk communication and community engagement. Moreover, the R&D Blueprint has been activated as response to the outbreak to accelerate diagnostics, vaccines, and therapeutics for this novel coronavirus. Based on the similarity of 2019-nCoV with SARS-CoV and MERS-CoV, the public is advised similar measures to use facemasks, covering mouth and nose when coughing and sneezing, frequent handwashing after unprotected contact with farm animals and with the patients having respiratory illness and consuming thoroughly cooked animal products to reduce virus transmission.There are no travel or trade restrictions based on available information. However, travelers are advised to seek medical attention and share their travel history, if they have any respiratory illness.