The World Health Organisation (WHO) is holding emergency talks Thursday in Geneva to decide whether a deadly virus outbreak in China constitutes a "public health emergency of international concern".

The designation is rare and only used for the gravest outbreaks which are considered "serious, sudden, unusual or unexpected".

The classification would imply that the disease, which has killed nine people so far, risks spreading further internationally and requires an international response.

The terms are set out in the International Health Regulations that were adopted following heavy criticism of the way in which the outbreak of SARS (Severe Acute Respiratory Syndrome) was handled in 2003.

The responsibility of making the determination rests on WHO Director-General Tedros Adhanom Ghebreyesus, and it gives him the power to issue recommendations that countries must act on, such as travel bans.

Once declared, the designation is reviewed every three months by the WHO's Emergency Committee, a group of international experts.

- Used five times -

The public health emergency designation has only been used five times since the new system took effect in 2007:

2009 - "Swine flu" (H1N1 pandemic): The WHO declared a public health emergency for the first time on June 11 -- about six weeks after the virus was first recognised in Mexico and Asia.

It triggered a rash of costly emergency measures to guard against infection and a rush on doctors in some countries, but public concern about swine flu fizzled out later in the year as it proved to be less severe than feared.

The emergency categorisation was lifted in 2010 after the pandemic had killed around 18,500 people.

The virus continues to emerge in winter and is part of a group of seasonal flus that kill thousands every year.

2014 - Polio: Issued on May 5, 2014, this emergency declaration was a response to a resurgence of the crippling disease, including in Afghanistan and Pakistan.

The WHO said there was evidence that the virus, which affects mainly children under the age of five and had long been thought on the road to extinction, was spreading to countries such as Iraq and Syria.

The Emergency Committee this month extended the measures for another three months.

2014 - Ebola: The first suspected cases were detected in Guinea in late 2013, and outbreaks were confirmed in Guinea and Liberia in March 2014. But the WHO only declared a public health emergency on August 8 following cases in Europe and the United States. WHO was heavily criticised for the delay.

In total, about 11,000 people died of the disease -- mostly in Guinea, Liberia and Sierra Leone.

The virus is highly contagious and has an average fatality rate of around 50 percent. It spreads only through close contact with the blood, body fluids, secretions or organs of an infected person.

The emergency designation was lifted in March 2016.

2016 - Zika: Issued on February 1, this was the first time the designation was declared for a mosquito-borne disease. The virus, which takes its name from a Ugandan forest where it was first identified in a monkey, can also be spread through sexual contact.

Zika is a particularly high risk for pregnant women as it can cause congenital abnormalities such as microcephaly, a birth defect that leaves the baby's head smaller than normal.

The declaration was lifted in November 2016.

2019 - Ebola: After months of pressure, the WHO on July 17 declared the Ebola outbreak in the Democratic Republic of Congo an international public health emergency. The Emergency Committee said the risk of global spread was "still low" but there were "worrying signs of possible extension of the epidemic".

According to the latest toll, more than 2,230 people have died of the disease in this latest outbreak -- the second worst after 2014.

How the new coronavirus developed
Paris (AFP) Jan 22, 2020 - A new coronavirus, a mysterious SARS-like disease, has spread around China and three other Asian countries since first emerging in the central Chinese city of Wuhan.

A timeline:

- Alarm raised -

The World Health Organization (WHO) is alerted on December 31, 2019, by the Chinese authorities of a string of pneumonia-like cases in Wuhan, a city of 11 million people.

Patients are quarantined and work begins on identifying the origin of the pneumonia.

The US Centers for Disease Control and Prevention (CDC) identifies a seafood market suspected to be at the centre of the outbreak. It is closed on January 1, 2020.

- New coronavirus -

On January 9, the WHO says that the outbreak in Wuhan was caused by a previously unknown type of coronavirus, which is a broad family ranging from the common cold to more serious illnesses like SARS.

- First death -

The Chinese health authorities say a first person has died of the virus on January 11. They revise downwards the number of sick people to 41.

- Spreads beyond China -

On January 13, the virus spreads beyond China's borders for the first time with a case emerging in Thailand, according to the WHO. The victim is a Chinese woman diagnosed with mild pneumonia who was returning from a trip to Wuhan.

On January 15 China's health commission says no human-to-human transmission of the virus behind the Wuhan outbreak has been confirmed so far, but the possibility "cannot be excluded".

The next day a first case of the virus is confirmed in Japan in someone who had stayed in Wuhan in early January.

- US controls -

On January 17, a second person, a 69-year-old man, dies in Wuhan, according to the authorities.

The same day, the CDC announces that it will begin screening passengers arriving from Wuhan at three airports: San Francisco, New York's JFK and Los Angeles.

- Human to human transmission confirmed -

On January 20, a third death and more than 100 new cases are announced in China, sparking concerns ahead of the annual Lunar New Year holiday which begins January 25 and sees hundreds of millions of Chinese people travel nationwide.

The virus is present in Beijing in the north, Shanghai in the east and Shenzhen in the south. More than 200 cases have been recorded. The virus is also detected in South Korea in a Chinese person who has arrived by plane from Wuhan.

China's President Xi Jinping says that the virus must be "resolutely contained", in his first public comments on the outbreak.

Human-to-human transmission is "affirmative", a top Chinese expert on infectious diseases Zhong Nanshan tells state broadcaster CCTV.

- Trains, planes suspended from Wuhan -

On January 22 European airports from London to Moscow step up checks on flights from Wuhan.

WHO chief Tedros Adhanom Ghebreyesus says he is postponing a decision on whether or not to declare a global health emergency.

"I have decided to ask the emergency committee to meet again tomorrow to continue their discussion," he said, referring to a group of international experts who met for several hours at the WHO in Geneva on Wednesday.

As Chinese authorities say 17 people have died and more than 500 have been infected, air and rail departures from Wuhan are suspended from January 23.

What we know so far about the new China virus
Beijing (AFP) Jan 22, 2020 - A new SARS-like virus has killed 17 people in China, infected hundreds and reached as far as the United States, with fears mounting about its spread as hundreds of millions travel for Lunar New Year celebrations, which start Friday.

Many countries have stepped up screening of passengers from Wuhan, the Chinese city identified as the epicentre, which is home to 11 million people.

Here's what we know so far about the virus:

- It's entirely new -

The pathogen appears to be a never-before-seen strain of coronavirus -- a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS), which killed 349 people in mainland China and another 299 in Hong Kong between 2002 and 2003.

Arnaud Fontanet, head of the department of epidemiology at the Institut Pasteur in Paris, told AFP the current virus strain was 80 percent genetically identical to SARS.

China has already shared the genome sequencing of this novel coronavirus with the international scientific community.

It has been named "2019-nCoV".

- It's being passed between humans -

The WHO said Monday it believed an animal source was the "primary source" of the outbreak, and Wuhan authorities identified a seafood market as the centre of the epidemic.

But China has since confirmed that there was evidence the virus is now passing from person to person, without any contact with the now-closed market.

More than 500 cases of the virus have now been reported, with most in Wuhan, according to officials. Li Bin of China's National Health Commission on Wednesday said 1,394 people were still under medical observation.

Nathalie MacDermott of King's College London said it seems likely that the virus is spread through droplets in the air from sneezing or coughing.

Doctors at the University of Hong Kong published an initial paper on Tuesday modelling the spread of the virus which estimated that there have been about 1,343 cases in Wuhan -- similar to a projection of 1,700 last week by scientists at Imperial College, London.

Both are much higher than official figures.

- It is milder than SARS -

Compared with SARS, the symptoms appear to be less aggressive, and experts say the death toll is still relatively low.

However Antoine Flahault, director of the Institute of Global Health at the University of Geneva, told AFP that the fact that the virus seems milder in the majority of people is "paradoxically more worrying" as it allows people to travel further before their symptoms are detected.

The outbreak comes as China prepares for the Lunar New Year holiday, with hundreds of millions travelling across the country to see family.

- International public health emergency? -

The WHO on Wednesday postponed its decision on whether to declare a global public health emergency, extending talks by a day.

Cases have so far been confirmed in Thailand, Japan, Taiwan, South Korea, Macau and the United States.

The WHO has only used the rare label a handful of times, including during the H1N1 -- or swine flu -- pandemic of 2009 and the Ebola epidemic that devastated parts of West Africa from 2014 to 2016.

The Chinese government announced Tuesday it was classifying the outbreak in the same category as SARS, meaning compulsory isolation for those diagnosed with the disease and the potential to implement quarantine measures on travel.

- Global precautions -

As the number of confirmed deaths and infections has risen, so has concern worldwide about the disease spreading to other countries.

Authorities halted flights and trains from Thursday at 10:00 am out of Wuhan and told residents they should not leave without a special reason.

In Thailand, officials have introduced mandatory thermal scans of passengers arriving at airports in Bangkok, Chiang Mai, Phuket and Krabi from high-risk areas in China.

In Hong Kong, authorities have said they are on high alert, carrying out scans at the city's airport -- one of the world's busiest -- and at other international land and sea crossing points.

The United States had also ordered the screening of passengers arriving on direct or connecting flights from Wuhan, including at airports in New York, San Francisco and Los Angeles.

Taiwan has issued travel advisories, and went to its second-highest alert level for those travelling to or from Wuhan. Vietnam also ordered more border checks on its frontier with China.

In Europe, Britain and Italy introduced enhanced monitoring of flights from Wuhan, while Romania and Russia are also strengthening checks.

Related Links
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S. Korea confirms first case of SARS-like virus from China
Seoul (AFP) Jan 20, 2020
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