Thailand has recorded its first human-to-human transmission of the coronavirus after a taxi driver was apparently infected by a traveller, heightening concern over the virus’s potential to spread across the globe.
The taxi driver was among five new patients confirmed on Friday in the worst-hit country outside China, bringing the total number of cases in Thailand to 19.
Thailand is among the most popular holiday destinations for Chinese people celebrating the lunar new year, and officials have warned that an outbreak in its tourism hotspots is possible.
In other developments on Friday:
The death toll increased to 258, with more than 11,000 cases confirmed in mainland China.
The UK, Russia and Spain recorded their first cases.
The US declared a public health emergency and announced it will temporarily bar entry for people traveling from China unless they are Americans or immediately related to US citizens.
More than 25,000 people arrived in Thailand from Wuhan, the centre of the outbreak, and other affected Chinese cities between 3 and 27 January.
Most of the Chinese visitors are believed to have returned home, although on Friday afternoon China’s foreign ministry said it would send charter flights to Thailand and Malaysia to bring back residents of virus-affected regions who may have been stranded after sweeping travel restrictions were introduced across China last week.
Tanarak Plipat, the deputy director general of the department of disease control, said the taxi driver had not recently travelled to China, adding “It is likely that he was infected [by] a sick traveller from China.”
As concerns grew about a wider epidemic, the US drew China’s wrath after it issued advice not to travel to China, raising the warning for China to the same level as Afghanistan and Iraq, potentially worsening supply problems for Chinese businesses.
Beijing, which has only just started to mend trade relations with the US, criticised the move, saying that it went against WHO recommendations. “The World Health Organization urged countries to avoid travel restrictions, but very soon after that, the United States did the opposite,” Chinese foreign ministry spokeswoman Hua Chunying said in a statement. “It’s truly mean.”
Japan also advised citizens to put off non-urgent travel to China, while Bahrain recommended no travel to any country hit by the virus, and Iran urged a ban on all travellers from China.
As well as Russia and Britain, Spain, Sweden and Italy also reported their first cases; Rome declaring its own national emergency as it sought to reconstruct the itinerary of two infected Chinese tourists.
The number of confirmed infections in China is likely to represent a small fraction of those actually infected.
What is the virus causing illness in Wuhan?
It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals, or possibly seafood. New and troubling viruses usually originate in animal hosts. Ebola and flu are examples.
What other coronaviruses have there been?
Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals.
What are the symptoms of the Wuhan coronavirus?
The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died are known to have been already in poor health.
Is the virus being transmitted from one person to another?
Human to human transmission has been confirmed by China’s national health commission. As of 3 February, 361 people have died in China, and one in the Philippines. Confirmed infections in China are 17,238, and the official Chinese figures include Taiwan, Hong Kong and Macau. Outside of China, infections stand at more than 150.
Two members of one family have been confirmed to have the virus in the UK, after more than 160 were tested and found negative. The actual number to have contracted the virus could be far higher as people with mild symptoms may not have been detected. Modelling by World Health Organization (WHO) experts at Imperial College London suggests there could be as many as 100,000 cases, with uncertainty putting the margins between 30,000 and 200,000.
How worried are the experts?
There were fears that the coronavirus might spread more widely during the week-long lunar new year holidays, which start on 24 January, when millions of Chinese travel home to celebrate, but the festivities have largely been cancelled and Wuhan and other Chinese cities are in lockdown.
At what point should you go to the doctor if you have a cough, say?
Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that there is generally no need to visit a doctor for a cough unless it is persistent or you are having other symptoms such as chest pain, difficulty breathing or you feel very unwell.
Should we panic?
No. The spread of the virus outside China is worrying but not an unexpected development. It increases the likelihood that the World Health Organization will declare the outbreak to be a public health emergency of international concern on Thursday evening. The key concerns are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital.
Sarah Boseley Health editor and Hannah Devlin
A new analysis, published in The Lancet on Friday, estimated that as many as 75,800 people in Wuhan may have been infected as of 25 January and that several major Chinese cities might already have enough people infected to initiate local epidemics. “It is possible that epidemics could be already growing in multiple major Chinese cities, with a time lag of one to two weeks behind the Wuhan outbreak,” said the lead author, Prof Joseph Wu of the University of Hong Kong.
Evacuations of foreign nationals from Wuhan have been stepped up: a plane carrying more than 100 British and other EU nationals trapped in Wuhan travelled to the UK after Chinese spouses and partners were given permission to travel. Germany said on Friday it was sending a military plane to China to evacuate more than 100 of its citizens. South Korea evacuated 367 of its citizens on Friday.
The virus is believed to have a two-week incubation period, and it is thought that those infected can pass on the illness before they show symptoms such as fever, coughing and breathing difficulties.
As the virus in these cities spreads faster than in Wuhan itself and other sites outside a lockdown zone, the first dismissal of a senior health official in Hubei has spurred authorities to push for more effective measures.
Wuhan’s Communist party chief, Ma Guoqiang, said in a nationally televised interview on Friday that the impact of the virus on the rest of China and the world “would have been less” if containment measures had been implemented sooner. “Right now I’m in a state of guilt, remorse and self-reproach,” he said.
Thai officials have stepped up measures at airports and other tourist areas after criticism that the government had failed to act quickly to stop the virus and that tourism profits were being prioritised over public health.
Screening for people working in the tourism industry, as well as all passengers travelling from China, has been introduced. In Bangkok’s public transport system, and some of its big shopping malls, free hand sanitiser is being handed out.
On Tuesday the public health minister, Anutin Charnvirakul, told Sky News he expected the number of infections to rise, warning: “We are not able to stop the spread.”
Associated Press and Reuters contributed to this report
