Several countries in Asia, Western Pacific, report COVID-19 cases since Jan. 2020. Local transmission in some areas. Use basic precautions.

Severity: Informational Alert

The locations affected by this alert are:

  • Hong Kong SAR
  • Macau SAR / Zhuhai
  • Singapore
  • Taiwan
  • Tokyo
  • Seoul
  • Sydney
  • Bangkok
  • Metro Manila
  • Brisbane
  • Melbourne
  • Auckland
  • Kuala Lumpur
  • Kathmandu
  • Colombo
  • Ho Chi Minh City
  • Adelaide
  • Sapporo
  • Kyoto
  • Yokohama
  • Johor Bahru
  • Daegu
  • Atsugi
  • Nagoya
  • Sihanoukville
  • Thiruvananthapuram, Kerala State
  • Kochi (Cochin), Kerala State
  • Pohang
  • Komatsu
  • Ulsan
  • Hakone
  • Kawasaki
  • Kozhikode, Kerala State

This alert began 28 Feb 2020 10:50 GMT and is scheduled to expire 29 Feb 2020 23:59 GMT.

  • Event: Imported cases of coronavirus disease (COVID-19), local transmission
  • Location(s): Asia and Western Pacific (map)
  • Period: January-February 2020

Summary
Several countries and territories in Asia and the Western Pacific have identified imported cases of coronavirus disease (COVID-19) from mainland China, 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:

  • Australia: 22 cases, no local transmission.
  • Cambodia: One imported case in Sihanoukville, no local transmission.
  • Hong Kong SAR: 84 confirmed cases, limited local transmission. US CDC maintains a "Watch-Level 1" travel health notice. This level of notice advises travelers to practice usual precautions, including washing hands frequently with soap and water and avoiding contact with sick people.
  • India: Three imported cases in Kerala, no local transmission.
  • Japan: 170 confirmed cases in Aichi, Hokkaido, Ishikawa, Kanagawa, Kumamoto, Kyoto, Nagano, Nagoya, Kyoto, Tokushima, and Tokyo prefectures; most are imported, limited local transmission. Previously quarantined cruise ship in Yokohama reported roughly 600 cases. The 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, which are at increased risk for severe symptoms, consider delaying any nonessential travel to Japan.
  • Macau SAR: 10 confirmed cases, limited local transmission.
  • Malaysia: 22 confirmed cases, limited local transmission in Johor Bahru and Kuala Lumpur.
  • Nepal: One imported case in Kathmandu, no local transmission.
  • New Zealand: One imported case in Auckland, no local transmission.
  • Philippines: Three imported cases in Manila, no local transmission.
  • Singapore: 91 confirmed cases, limited local transmission.
  • South Korea: 977 confirmed cases, local transmission in Daegu, Cheongdo, and limited transmission in Seoul. The US CDC has upgraded its travel health notice to a "Warning-Level 3." This is the highest of three levels and indicates US authorities recommend avoiding all nonessential travel to South Korea. This is due to limited access to medical care in affected areas, where they are redirecting their efforts to COVID-19 response. Diligent use of basic health precautions is recommended, including strict hand and respiratory hygiene.
  • Sri Lanka: Single imported case in greater Colombo, no local transmission.
  • Taiwan: 31 confirmed cases, limited local transmission.
  • Thailand: 37 confirmed cases in Bangkok, limited local transmission.
  • Vietnam: 16 confirmed cases: Ho Chi Minh City and Vinh Phuc Province, some limited local transmission.



Background and Analysis
Health authorities expect imported cases of this disease as surveillance continues globally. Additional countries and territories may be added. 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.

Advice
Emphasize basic health precautions, especially frequent handwashing with soap and water, or an alcohol-based hand sanitizer if soap and water are unavailable. Avoid close contact with noncompanion animals (dead or alive), especially at wet markets. 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 South Korea

US CDC Travel Health Notice for Japan

US CDC Travel Health Notice for Hong Kong

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