New Coronavirus – Japan (Former China)

On January 15, 2020, the Ministry of Health, Labor and Welfare of Japan (MHLW) reported an imported case of a laboratory-confirmed coronavirus (2019-nCoV) from Wuhan, Hubei Province, China.

The patient is a male, aged 30-39, living in Japan.

The patient traveled to Wuhan, China at the end of December and developed a fever on January 3, 2020 during his stay in Wuhan. He did not visit the Juan Seafood Wholesale or any other live animal market in Wuhan. He stated that he was in a close relationship with a person with pneumonia.

On January 6, he traveled back to Japan and tested for the flu when he visited a local clinic the same day.

On January 10, 2020, due to persistent symptoms of cough, sore throat and fever, he visited a local hospital and was found to have an abnormal chest X-ray with infiltrates. He was admitted to the hospital the same day and remained awful until January 14th. On Jan. 14, his doctor reported the case to a local public health authority under surveillance for “unidentified serious infectious disease.”

Samples were collected and sent to the National Institute of Infectious Diseases (NIID), and polymerase chain reaction (PCR) testing and sequencing were performed twice at NIID, identifying a very small amount of RNA-nCoV on January 15, 2020.

On January 15, the patient was afebile and was discharged from the hospital. Currently resides at home in stable condition.

Public health response

• Local health authorities in Japan are in the process of seeking contacts and other epidemiological investigations;
• On January 16, the Japanese government established a mechanism to coordinate the entire government;
• Since the report of undiagnosed pneumonia in Wuhan, China, MHLW has stepped up surveillance on undiagnosed severe acute respiratory illness;
• On January 6, the MHLW required local health governments to be aware of respiratory diseases in Wuhan using an existing surveillance system for serious infectious diseases of unknown etiology;
• NIID supports local authorities in epidemiological research, including contact seeking;
• Quarantine and screening measures have been stepped up for travelers from Wuhan City on January 7 entry;
• NIID established internal PCR test for nCoV on January 16;
• NIID risk assessment is reviewed, including the definition of a close contact case;
• Public risk communication improved;
• A telephone line was established among the various ministries in the government;
• MHLW works closely with the WHO and other related Member States to encourage mutual investigations and exchanges of information.

WHO risk assessment

This is the second of three exported cases of a new coronavirus from Wuhan, China. Since the initial case report in Wuhan City on December 31, 2019, and since January 12, 2020, 41 have reported 41 laboratory-confirmed cases of nCoV infection, including 2 deaths in cases with basic medical conditions. Two cases have been reported from Thailand.

The source of the outbreak is still under investigation in Wuhan. Preliminary testing found that environmental samples were positive for nCoV at Huanan Seafood Wholesale Market in Wuhan City, but some laboratory-confirmed patients did not report a visit to this market. To date, no infections have been reported among healthcare professionals in China, Thailand, or Japan. Since January 3, no additional cases have been reported in China.

Additional studies are needed to determine how patients are infected, whether human-to-human transmission, mode (s) of transmission, clinical spectrum of disease, and extent of infection have been observed, including the presence of subclinical cases not detected under current surveillance.

It is important to review all available information to fully understand the extent of human transmission and the likelihood of zoonotic overflow.

Tip of WHO

Although the source of the new coronavirus that causes this buildup of pneumonia and the mode of transmission is unknown, it would be prudent to remind the general public and health care professionals of the basic principles for reducing the overall risk of transmission of acute respiratory infections:

• Avoiding close contact with people suffering from acute respiratory infections;
• Frequent hand washing, especially after direct contact with sick people or their environment;
• Avoiding unprotected contact with domestic or wild animals;
• People with symptoms of acute respiratory infection should practice coughing (maintain distance, cover cough and sneeze with disposable tissues or clothing and wash their hands);
• Improve standard infection prevention and control practices in hospitals in healthcare settings, especially in emergency departments;
• WHO does not recommend any specific health measures for travelers. In the case of symptoms suggestive of respiratory illness during or after the trip, travelers are encouraged to seek medical attention and share their travel history with their doctor. Travel guidelines have been updated.

Health authorities should work with the travel, transport and tourism sectors to provide information to travelers to reduce the overall risk of acute respiratory infections through travel health clinics, travel agencies, carriers and point of entry.

Who provided interim instructions for new coronaviruses

WHO advises against applying any travel or trade restrictions to Japan based on currently available information on this event.

For more information on the new coronavirus, see: