The mysterious new pneumonia coronavirus that has emerged in Wuhan, China may also be transmitted between people, health experts in China and Geneva now suspect. Officials are concerned that the outbreak may also spread globally as a new exported cases of the novel virus were confirmed in Thailand on Friday and Japan on Thursday, and local sources reported a second death due to the virus in China.

The outbreak has claimed its second victim, a 69-year old man named ‘Mr. Xiong’ who was reportedly hospitalized on 31 December 2019. The Wuhan Municipal Health Commission said in an official statement that the man’s condition deteriorated on 4 January and died on 15 January at Wuhan JinYinTan Hospital shortly after midnight (translated from Chinese).

The second Thailand case was also in a Chinese national who was found to have fever on arrival at Suvarnabhumi airport on 13^th January. Initially hospitalized for mild pneumonia, Thai and WHO officials have since confirmed the man to be positive for the new viral disease.

Earlier in the week, reports surfaced that the coronavirus, dubbed 2019-nCOV, has been confirmed in family clusters, including at least one family member who had not visited the Wuhan seafood and live animal market that is suspected of being the source of the new infectious agent.

On Thursday Japan’s Health Ministry also reported its first case of the virus in a man who fell ill during a visit to Wuhan earlier in the month, although he had not visited the market, said NHK World News. The man was hospitalized upon his return to Japan on 6 January, and was discharged on Wednesday. Later Thursday, WHO confirmed the report of the Japanese case.

Chinese authorities and researchers are now struggling to pinpoint the original infection reservoir among the live animal species sold in the market; routes of transmission; and confirm definitively if the disease can be spread by person-to-person contact – possibly in a weakened form.

A commission of technical experts from Hong Kong, Macao, and Taiwan visited Wuhan on 13 – 14 January and found two family clusters of confirmed cases – three male family members living together and a husband-wife duo.

The three men were all believed to have contracted the disease from working at the seafood market, Dr Chuang Shuk-kwan, a commission expert from Hong Kong, was quoted saying at a press conference Wednesday morning in the South China Morning Post. However, the wife with a confirmed case of the 2019-nCoV infection had not recently visited the market where her husband worked as a trader, according to a statement by Wuhan authorities (translated from the Chinese). Chuang Shuk-kwan said this could suggest “limited” human-to-human transmission of the virus is occurring.

In Geneva, a WHO official expressed similar concerns: “From the information that we have, it is possible that there is limited human-to-human transmission, especially among families who have close contact with one another,” Maria Van Kerkhove, acting head of WHO’s Emerging Diseases Unit, told journalists at a briefing.

The possibility that the virus is being transmitted between humans – but resulting in asymptomatic or mild cases that remain undetected by the health system – is an important concern for Chinese authorities as hundreds of thousands of people prepare to travel around the country during the Lunar New Year, the annual holiday that begins January 25.

The number of confirmed cases has risen by 44, and caused two deaths. Three cases have now been reported outside of China, in Thailand as well as Japan. Officials are investigating whether the latest Thai case has had contact with the local seafood market where most cases have been traced. The Japanese case, announced publicly Thursday, was a man who fell ill on 3 January and had been in close contact with some of the Wuhan residents who became infected, although he did not visit the suspect live market. He was hospitalized after returning home to Japan and has since recovered. In Thailand, a case was reported on 8 January in a 61- year old Chinese tourist from Wuhan who became sick while traveling to Bangkok for a vacation; she was immediately hospitalized and is also now recovering, according to WHO.

While that patient reported visiting a local fresh market in Wuhan on a regular basis, she had not visited the Huanan Seafood Wholesale Market, where most of the other cases have been traced. Experts say that this means that the source of the infection could be a live animal commonly sold at other markets as well.

Number of New Ebola Cases Stabilizes

Infectious disease outbreaks, epidemics, as well as increasing drug-resistance among certain viruses and bacteria, are among a list of urgent global health challenges for the next decade, WHO said this week.

And along with the emerging coronavirus in China, the new year of 2020 also opened with the world still battling a stubborn, 1.5 year-long Ebola outbreak in the Democratic Republic of the Congo.

The last embers of the Ebola outbreak in the Democratic Republic of the Congo are still smoldering as the response effort moves into the new decade. The deadly virus resurged in December, after a month of civil unrest and armed attacks on health workers in eastern DRC – the epicenter of the outbreak. Although there were signs that numbers may be stabilizing in the new year. Some 14 new cases were confirmed between 8-14 January, compared to 12 new cases the previous week. Case numbers are down again after a small resurgence of 27 cases in the first week of December 2019.

Insecurity and community mistrust have plagued the response, with the International Federation of the Red Cross confirming Wednesday that yet another attack on Ebola responders had occurred at a safe burial conducted in Mambasa. Two Red Cross volunteers were injured.

“Despite an overall improvement in the community’s acceptance, this attack shows that community engagement is crucial to building trust and ending the Ebola outbreak,” IFRC Africa tweeted on Wednesday. On Thursday, WHO reported that several health areas continue to be difficult to reach due to insecurity, including Mandima Health Zone, where there are rumors of several community deaths in Lwemba Health Area.

In 2019, WHO recorded 978 attacks on health care workers and outbreak responders, resulting in 193 deaths. As of 14 January, 3406 Ebola cases have been reported, of which 2236 cases have died.

Story updated 17 January 2020

Image Credits: Arend Kuester/Flickr, IFRC.