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expert reaction to reported cases of coronavirus in Germany and Japan in people who hadn’t been in China

There have been initial reports of cases of transmission of coronavirus in Germany and Japan.


Dr Nathalie MacDermott, NIHR Academic Clinical Lecturer, King’s College London, said:

“There has already been one case of coronavirus transmission to someone who had not visited China in Vietnam (Vietnam’s second coronavirus case).  That was the first case of transmission outside of China, announced on 24th January 2020 by the WHO in their situation report.  They were a close relative of the first Vietnam case who had travelled from Wuhan.

“If the cases in Germany and Japan are confirmed to have been through onward transmission it is not a surprise.  As we have heard reports of virus transmission during the incubation period and possibly from asymptomatically infected people it is likely there will be a degree of onward transmission in other countries.  If this becomes significant I imagine that is what will prompt WHO to declare a PHEIC.”


Prof Ian Jones, Professor of Virology, University of Reading, said:

Comment on the latest numbers of cases in China:

“Although the rising death toll is unfortunate it is still a comparatively low number and is expected to rise along with the total number of infections.  What we really need to know is an accurate case fatality rate to help plan what type of response measures need to be put in place.  Is this infection going to be a seasonal flu type situation or something more aggressive?  This will be especially true if significant numbers of secondary infections do occur at the few sites where they have been reported – as there are so few such cases to date it is currently impossible to judge whether or not this virus has the potential to become a global pandemic.”


Dr Michael Head, Senior Research Fellow in Global Health at the University of Southampton, said:

“The reported human to human transmission in Germany and Japan is unsurprising to see.  We will continue to see further similar cases outside of China, but the indications are at this stage that onwards transmission will be limited, so there will likely not be too many cases for example across Europe, and on a much lesser scale than we are seeing in China.”


Prof Paul Hunter, Professor in Medicine, The Norwich Medical School, University of East Anglia, said:

“The recent reports would now bring to a total of three confirmed cases – in Vietnam, Japan and Germany – who have not visited China but only been in contact with cases from China.  The fact that person to person transmission is occurring outside of China is not too surprising.  The Vietnamese case was reported by WHO and he was in contact with his sick father who had returned from China.  The Japanese cases was a tour bus driver who had driven around two groups of Chinese tourists and the German cases had attended a work-based training event also attended by a woman who only became ill two days later during her return to China two days later.  The German case is most worrying because if the Chinese woman was indeed asymptomatic at the time of the training session it would confirm reports of spread before symptoms develop making standard control strategies less effective.

“This new information reinforces the importance of the Public Health England’s current advice that if anyone has returned from Wuhan in the last 14 days they should “stay indoors and avoid contact with other people as you would with other flu viruses” and “contact NHS 111 to inform them of your recent travel to the city”.  I would add that this advice should also be followed by anyone who has been to any other area in China where the infection is known to be common or if they know they have been in contact with a presumed case.”


Comment on the latest numbers of cases in China:

Prof Trudie Lang, Director of the Global Health Network, University of Oxford, said:

“I think the new numbers in China are not a surprise and actually perhaps reassuring as they are in line with the proportions seen so far, in terms of diagnosed cases and outcomes of severe disease, but there are still no many unknowns, and these are key.

“It’s also important to remember that we do know yet know what proportion of those who gets the virus gets severe illness.  The information coming through is that the early deaths appear to have been in those with underlying disease and we do not yet know whether this is the case and most infected in fact have mild disease.  In MERS and SARS the severity of disease ranged markedly from mild to severe.  It’s important to remember that this is an evolving situation and that we still do not yet fully understand how transmittable this new coronavirus is or how the disease manifests in different types of patient.”


All our previous output on this subject can be seen at this weblink:


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