Additional European countries report coronavirus cases since Jan. 2020. Local transmission in some areas; maintain basic health precautions.

Severity: Informational Alert

The locations affected by this alert are:

  • Belarus
  • Italy
  • Lithuania
  • Switzerland
  • Las Palmas de Gran Canaria
  • London, England
  • Paris
  • Rome
  • Brussels
  • Seville
  • Lyon
  • Munich
  • Florence
  • Barcelona
  • Zagreb
  • Copenhagen
  • Birmingham, England
  • Manchester, England
  • Tallinn
  • Bordeaux
  • Tbilisi
  • Bonn
  • Cologne
  • Dusseldorf
  • Milan
  • Turin
  • Venice
  • Belfast, Northern Ireland
  • Gothenburg
  • Skopje
  • Thessaloniki
  • Chita, Zabaykalsk Kray
  • United Kingdom
  • Liverpool, England
  • Palermo
  • Essen
  • San Marino
  • Newcastle, England
  • Catania (Sicily)
  • Bristol, England
  • Innsbruck
  • Bologna
  • Dunkirk
  • Tromso
  • Dortmund
  • Clermont-Ferrand
  • Reims
  • Timisoara
  • Linkoping
  • Verona
  • Lugano
  • Muenster
  • Duisburg
  • Tyumen', Tyumen' Oblast'
  • Rovaniemi, Finland
  • Tenerife
  • Padua

This alert began 28 Feb 2020 22:19 GMT and is scheduled to expire 29 Feb 2020 23:59 GMT.

  • Incident: Coronavirus disease (COVID-19): imported cases, limited local transmission
  • Affected Area(s): Europe and Russia (map)
  • Period: January-February 2020

Russia and several countries and territories in Europe have identified imported cases of coronavirus disease (COVID-19), and in some instances, limited human-to-human transmission from those imported cases. As of Feb. 28, the following countries and territories have identified confirmed COVID-19 cases:

  • Austria: Two imported cases in Tyrol. No local transmission.


  • Belarus: Single imported case. No local transmission.
  • Belgium: Single imported case in Brussels. No local transmission.
  • Croatia: Single imported case in Zagreb. No local transmission.
  • Denmark: Single imported case. No local transmission.
  • Estonia: Single imported case, likely in Tallinn. No local transmission.
  • France: 38 cases reported among the following regions: Auvergne-Rhone-Alpes, Grand-Est, Hauts de France, Ile-de-France, and Nouvelle-Aquitaine. Limited local transmission.
  • Finland: Two imported cases in Rovaniemi. No local transmission.
  • Georgia: Single imported case in Tbilisi. No local transmission.
  • Germany: 46 confirmed cases in the vicinity in Bavaria and North Rhine-Westphalia. Limited local transmission.
  • Greece: Single imported case in Thessaloniki. No local transmission.
  • Italy: 655 cases reported nationwide. Cases reported in Lombardy, Veneto, Emilia Romagna, Piedmont, Tuscany, Sicily, Liguria, Marche, Campania, Bolzano, Abruzzo, and Lazio regions. Most local transmission reported in Lombardy (403 cases) and Veneto (111 cases). US CDC maintains an "Alert-Level 2" travel health notice. This is the second of three levels and indicates authorities recommend enhancing usual precautions, including avoiding sick people and using strict hand hygiene measures. For older adults and those with chronic medical conditions, who face an increased risk for severe symptoms, consider delaying any nonessential travel to Italy. Lockdown areas of northern Italy:
    • Lombardy: Codogno, Castiglione d'Adda, Casalpusterlengo, Fombio, Maleo, Somaglia, Bertonico, Terranova dei Passerini, Castelgerundo, and San Fiorano.
    • Veneto: Vo' Euganeo
  • Lithuania: Single imported case. No local transmission.
  • Netherlands: Single imported case. No local transmission.
  • North Macedonia: Single imported case in Skopje. No local transmission.
  • Norway: Single imported case in Tromso. No local transmission.
  • Romania: Single imported case in Timisoara. No local transmission.
  • Russia: Two imported cases, one each in Tyumen and Zabaykalsky regions. No local transmission.
  • San Marino: Single imported case. No local transmission.
  • Spain: 17 cases reported. Single imported case in La Gomera, Canary Islands. Single imported case in Mallorca. Single imported case in Barcelona. Local transmission reported in Sevilla.
  • Sweden: Single imported case in Jonkoping. No local transmission.
  • Switzerland: Nine imported cases reported in Aargau, Basel Stadt, Graubünden, Geneva, Ticino, Zurich. No local transmission.
  • UK: Twelve imported cases, plus one locally acquired case, for a total of 13 cases in England. Single imported case in Belfast, Northern Ireland. No further local transmission. According to a statement issued Feb. 25, anyone arriving in the UK since Feb. 19 from Iran, specific areas of northern Italy and South Korea, or from Hubei Province in China are required to self-isolate and monitor for symptoms for 14 days upon arrival in the UK. The specific areas of Italy include any areas north of Pisa. The specific areas of South Korea include Daegu and Cheongdo.

Background and Analysis
Health authorities expect imported cases of this disease to increase as surveillance continues globally. Older individuals, infants, and those with chronic illness are more susceptible to infection and are at increased risk for severe complications. Human-to-human transmission is occurring, though it remains unclear how easily the virus spreads between people. Preliminary investigations indicate the course of illness is not as severe as seasonal influenza, nor as contagious.

COVID-19 is a viral respiratory disease caused by infection with the SARS-CoV-2 virus (previously known as 2019-nCoV). Symptoms occur 1-14 days following exposure (average of 3-7 days). These symptoms include fever, fatigue, cough, difficulty breathing, sometimes worsening to pneumonia and kidney failure - especially in those with underlying medical conditions.

On Jan. 30, the WHO declared the ongoing outbreak a Public Health Emergency of International Concern (PHEIC). This indicates COVID-19 requires a coordinated international response, primarily due to the potential for the virus to spread to countries with weaker health systems that would be ill-equipped to contain it.

Emphasize basic health precautions, especially frequent handwashing with soap and water, or an alcohol-based hand sanitizer if soap and water are unavailable. Practice good coughing/sneezing etiquette (i.e., covering coughs and sneezes with a disposable tissue, maintaining distance from others, and washing hands). There is no evidence that the influenza vaccine, antibiotics, or antiviral medications will prevent this disease, highlighting the importance of diligent basic health precautions.

WHO advice for international travel

WHO coronavirus knowledge base

US CDC Travel Health Notice for Italy


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