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:

  • Andorra
  • Austria
  • Belarus
  • Belgium
  • Croatia
  • Czech Republic
  • Denmark
  • Estonia
  • Finland
  • France
  • Germany
  • Greece
  • Iceland
  • Italy
  • Latvia
  • Lithuania
  • Luxembourg
  • North Macedonia
  • Monaco
  • Netherlands
  • Norway
  • Portugal
  • Romania
  • San Marino
  • Spain
  • Sweden
  • Switzerland
  • Armenia
  • Georgia
  • Azerbaijan
  • Ireland
  • Chita, Zabaykalsk Kray
  • United Kingdom
  • San Marino
  • Tyumen', Tyumen' Oblast'

This alert began 02 Mar 2020 02:56 GMT and is scheduled to expire 07 Mar 2020 23:59 GMT.

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

Summary
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 March. 2, the following countries and territories have identified confirmed COVID-19 cases:

  • Andorra: Single imported case. No local transmission.
  • Armenia: Single imported case. No local transmission.
  • Austria: 16 reported cases, nine of which are in Vienna. Limited local transmission.
  • Azerbaijan: Three imported cases. No local transmission.
  • Belarus: Two imported cases. No local transmission.
  • Belgium: Eight cases reported in Flanders and Brussels. Limited local transmission.
  • Croatia: Eight cases reported in Croatia, five cases in Rijeka and three in Zagreb. Limited local transmission.
  • Czech Republic: Three imported cases. No local transmission.
  • Denmark: Four cases reported. Limited local transmission.
  • Estonia: Single imported case, likely in Tallinn. No local transmission.
  • France: 178 cases reported throughout the country. Localized outbreaks reported in Oise department in northeast France and Haut-Savoie near the Swiss border. Authorities have banned all indoor gatherings of more than 5,000 people.
  • Finland: Six cases reported. Limited local transmission reported.
  • Georgia: Three imported cases in Tbilisi. No local transmission.
  • Germany: 157 confirmed cases throughout the country. Local transmission reported. More than half the cases are reported in North Rhine-Westphalia. Bavaria and Baden-Wurtemberg also heavily affected.
  • Greece: Seven imported cases in Thessaloniki and Athens. Limited local transmission reported.
  • Iceland: Three imported cases. No local transmission.
  • Ireland: Single imported case. No local transmission.
  • Italy: 1,835 cases reported nationwide. Cases reported in Lombardy, Veneto, Emilia Romagna, Piedmont, Tuscany, Sicily, Liguria, Marche, Campania, Bolzano, Abruzzo, Puglia, Umbria, and Lazio regions. Most local transmission reported in Lombardy (1,254 cases) Emilia Romagna (335 cases) and Veneto (273 cases). US CDC maintains an "Alert-Level 3" travel health notice. This is the third of three levels and indicates authorities recommend avoiding non-essential travel to the country. Delta Airlines and American airlines have suspended flights to and from Milano starting March. 2. 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
  • Latvia: Single imported case. No local transmission.
  • Lithuania: Single imported case. No local transmission.
  • Luxembourg: Single imported case. No local transmission.
  • Monaco: Single imported case. No local transmission.
  • Netherlands: 18 cases reported. Limited local transmission.
  • North Macedonia: Single imported case in Skopje. No local transmission.
  • Norway: 17 cases reported. Local transmission reported.
  • Portugal: Two cases in Porto. No local transmission.
  • Romania: Three imported cases. Two in Timisoara, and one in Maramurures. No local transmission.
  • Russia: Two imported cases, one each in Tyumen and Zabaykalsky regions. No local transmission.
  • San Marino: Eight cases identified. Local transmission reported.
  • Spain: 119 cases reported throughout the country. 10% of cases reportedly due to local transmission.
  • Sweden: 14 imported cases. No local transmission. Authorities have temporarily banned flights to and from Iran on March 2.
  • Switzerland: 24 cases reported throughout the country. Limited local transmission. Authorities have imposed a ban large-scale events involving more than 1,000 people as of Feb. 28.
  • UK: 40 cases reported with limited local transmission. Single imported case in Belfast, Northern Ireland. Imported cases reported in Scotland. 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.

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.

Advice
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.

Resources
WHO advice for international travel

WHO coronavirus knowledge base

US CDC Travel Health Notice for Italy

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