Risk assessment: outbreak of acute respiratory syndrome associated with a novel coronavirus, China; First cases imported in the EU/EEA; second update

Risk assessment

A novel coronavirus (2019-nCoV) has been isolated and considered the causative agent of the cluster of 2026 pneumonia cases in the area of Wuhan, Hubei province in China, as well as 38 imported cases monitored from other countries around the world. Fifty six deaths have been reported among the cases.

Executive Summary

On 31 December 2019, a cluster of pneumonia cases of unknown aetiology was reported in Wuhan, Hubei Province China. On 9 January 2020, China CDC reported a novel coronavirus (2019-nCoV) as the causative agent of this outbreak, which is phylogenetically in the SARS-CoV clade.

As of 26 January 2020, a total of 2 026 laboratory-confirmed 2019-nCoV cases have been reported, 1 988 in China and 38 imported cases from other countries around the world. Fifty six deaths have been reported among the cases. Chinese health authorities have confirmed human-to-human transmission outside Hubei province and 16 healthcare workers are reported to have been infected.

Imported cases in Europe

On 24 January 2020, the first imported cases (3) of 2019-nCoV were identified in France.

The rapid increase in the number of reported cases can be partly attributed to the ongoing improved testing protocols and epidemiological investigations of the Chinese authorities; however, since the original source remains unknown and human-to-human transmission has been documented, further cases and deaths are expected. Further cases are also expected among travellers from Hubei Province. Therefore, health authorities in Member States should remain vigilant and strengthen their capacity to respond to such an event.

There are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses.

On the basis of the information currently available, ECDC considers that:

  • the potential impact of 2019-nCoV outbreaks is high;
  • further global spread is likely;
  • there is currently a moderate likelihood of infection for EU/EEA citizens residing in or visiting Wuhan, Hubei province, China;
  • there is a high likelihood of further case importation into countries with the greatest volume of people who have travelled from Wuhan, Hubei Province (i.e. countries in Asia);
  • there is a moderate likelihood of further case importation into EU/EEA countries;
  • adherence to appropriate infection prevention and control practices, particularly in healthcare settings in EU/EEA countries with direct links to Hubei, means that the likelihood of a case detected in the EU resulting in secondary cases within the EU/EEA is low;
  • the impact of the late detection of an imported case in an EU/EEA country without the application of appropriate infection prevention and control measures would be high, therefore in such a scenario the risk of secondary transmission in the community setting is estimated to be very high.