ProMED: Pneumonia cases of unknown cause in Wuhan, China

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Undiagnosed pneumonia

The following information is collated from a range of sources:

Pneumonia of unknown cause — World Health Organization Disease Outbreak News, 5 January 2020

Report on Unexplained Viral Pneumonia - Wuhan Municipal Health and Health Committee, 5 January 2020

Wuhan pneumonia first suspect case identified here — The Straits Times, Singapore, 4 January 2020

Hong Kong 8 more suspected cases, none with "unidentified strain" — South China Morning Post, 5 January 2020

Vietnam response to outbreak — VN Express, 3 January 2020



China (Wuhan), Singapore, and Hong Kong

Outbreak Update

From 12-31 December 2019, Wuhan Municipal Health and Health Committee reported a total of 59 patients presented with an unexplained diagnosis of viral pneumonia in Wuhan, China.

At present, 7 patients remain critical ill. Remaining patients' overall vital signs were stable - no deaths have been reported. All patients in Wuhan are currently being isolated in medical institutions. 163 contacts have been followed up for medical observation, and the follow-up of close contacts is still in progress.

9 more patients were found with fever or respiratory symptoms after returning to Hong Kong from Wuhan. All patients were quarantined and are being treated in hospitals in Hong Kong. Four were confirmed to have flu or other related illnesses, while the others were waiting for test results.

A new response mechanism for infectious diseases was launched by the Hong Kong government on 4 January as a result of the cases and it was set to a "serious" level, the 2nd on a 3-tier scale beginning with an alert and ending with an emergency declared at its peak. Doctors are required to report patient cases with fever and acute respiratory symptoms or pneumonia symptoms who had visited Wuhan within 14 days before the onset of the illness, whether or not they had visited any wet markets or seafood markets there.

The Singaporean Ministry of Health has also reported a suspected cause of the virus involving a 3-year-old girl who had pneumonia. She had a travel history to the city of Wuhan. The patient has been warded for further assessment and treatment, and isolated as a precautionary measure. Two airlines which serve Singapore-Wuhan are conducting temperature screening.

An epidemiological survey showed that some patients were operating households in Wuhan South China Seafood City (South China Seafood Wholesale Market). Measures have been taken to suspend the market and carry out environmental sanitation and further hygiene investigations.

As of now, Wuhan Municipal Health and Health Committee report preliminary investigations have shown no clear evidence of human-to-human transmission and no medical staff infections.

Respiratory pathogens such as influenza, avian influenza, adenovirus, infectious atypical pneumonia (SARS) and the Middle East respiratory syndrome (MERS) have been excluded. Pathogen identification and cause-tracing are still underway.

Wuhan is continuing to conduct relevant case searches and retrospective investigations in medical institutions throughout the city.

Other neighbouring countries, such as Vietnam, are closely monitoring the situation on the China border.

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The following information is collated from the following source:

Public Health events and alerts - MERS-CoV - Saudi Arabia Ministry of Health, 3 January 2020


Saudi Arabia

Outbreak Update

During the month of December 2019, there were a total of 4 newly confirmed cases reported in Saudi Arabia including 3 fatalities. The 4th case is still pending information.

The final reported case of the year involved a 70-year-old male in Hafar Albatin city, who had had contact with camels. The suspected date of onset is 20 December 2019. He later died.

Another fatality involved a 66-year-old male from Abha city with an unknown history of camel contact.

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