Airports need to react to Wuhan disease

At first, it looked like the outbreak of a new respiratory disease in China at the end of December had been limited to a few dozen people linked to a seafood market in the central city of Wuhan. The world should have been so lucky. By now, if they haven't done so already, countries should be urgently following the example of Thailand, Singapore, Hong Kong, South Korea and even some US airports and screening all passengers inbound from Wuhan or its connecting airports. Memories of the economic and health-care havoc caused by severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), both respiratory infections caused by earlier types of coronaviruses, should be sufficiently fresh for authorities to be urgently dusting off the thermal-imaging cameras and weeding out all arriving passengers with a high temperature.

Coronaviruses are named for the resemblance of their spiky shape to the outer corona of the sun. There are a large number of them, responsible for everything from the common cold to the SARS epidemic that raged between 2002 and 2004, but a previously undetected strain is always cause for concern.

Coronaviruses originate in animals and are capable of being transmitted to humans, but each one is subtly different, presenting different threats and challenges. SARS, which like the new coronavirus also emerged in China, infected more than 8,000 people in 37 countries and claimed 774 lives. It is thought to have been transmitted to humans via civet cats.

MERS, which since it surfaced in Saudi Arabia in 2012 has seen 2,000 cases and killed a third of its victims in 27 countries, probably jumped to humans from camels. The animal behind the new coronavirus is still unknown. A cluster of cases of what has now been named 2019-nCoV was reported by China to the World Health Organization on December 31. Within a week, Chinese scientists had isolated the virus and developed a test to identify it, quickly shared by the WHO with other member states.

On January 12, a WHO statement radiated cautious confidence. Forty-one cases and one death had been reported in Wuhan. But with no cases anywhere else, the outbreak seemed to have been limited to those who had visited Wuhan's wholesale seafood market. Best of all, there was "no clear evidence" that the virus was capable of spreading from human to human.

Within a day it was clear that this optimistic prognosis was premature. On January 13, Thailand reported that a 61-year-old woman from Wuhan had been intercepted at Bangkok's Suvarnabhumi Airport, suffering from a fever, sore throat and headache. She had been nowhere near the market and the truth began to dawn: like SARS and MERS before it, 2019-nCoV could spread among humans.

There is an object lesson for all airports in Thailand's swift reaction to the WHO alert. The sick passenger was detected only because the authorities had wasted no time setting up thermal cameras at the international airports. Passengers with a high temperature are easily picked out of crowds by thermal cameras. There could be many causes, but a wise policy dictates that each febrile passenger - and all of their traveling companions - should be isolated while screening is carried out.

Thailand's defenses were in place by January 3. The Wuhan passenger, who arrived on a direct flight in a large tour group, was detected on January 8, and all 182 of her fellow passengers and aircrew were isolated and tested. None of the others was carrying 2019-nCoV. But if their fellow passenger hadn't been detected, by now they could be - along with any number of people with whom they'd subsequently come into contact.

Two days later, a second case was detected outside China - in Japan, in a male patient in his 30s who had travelled to Wuhan. He too hadn't visited any market but on his return to Japan on January 10 was hospitalized complaining of a cough, sore throat and fever and tested positive for 2019-nCoV. The disease has now also surfaced in South Korea.

China's National Health Commission says more than 200 infected people have now been positively identified in China.