Op-Ed: The Chinese novel Coronavirus outbreak and how its spread could affect Africa, by Adam Mustapha PhD
31 January 2020
Dr Adam Mustapha
The world was ushered into the New Year, 2020, by a novel and unusual virus that is associated with pneumonia-like symptoms of zoonotic origin. The virus first-emerged from the Wuhan province of China, in a seafood market where assorted wild animals are sold. The timeline of tracking the unknown virus started in late December, 2019.
Not much was known about the nature of the virus in the early emergence of the virus; but thanks to the early genetic sequencing of the virus which revealed a new strain of Coronavirus as the etiological agent, which is about 80 % related to the SARS-CoV.
Coronaviruses are named for the crown-like appearance when viewed under electron microscopes and they are the second most prevalent cause of common cold after rhinoviruses. Like the prominent member of the family, SARS, the new coronavirus is suspected to have jumped from animals to humans. Wild animals are breeding hubs for genetic mutations of infectious diseases which led to evolution and emergence of new strains of the infectious agents. As our understanding of the virus increases, a new form of transmission was uncovered in which human-to-human transmission is confirmed. The infected persons are mostly above 40 years old with existing underlying medical conditions.
As the world turned into a global village, the transmission of infectious diseases became faster and easier. Not long after the virus was reported in Wuhan, it spread to other parts of China. The virus spread increased drastically, for example as at 30 January, 2020, over 9500 cases with 210 deaths in China were reported. First international cases were reported shortly in Singapore, Vietnam, Thailand, Taiwan, Japan, South Korea, Malaysia, Nepal and then USA and Canada. Other countries reported confirmed cases of the virus including France and Australia, with direct links to the history of travel to Wuhan, China. Now, the number of countries with confirmed cases are about 18 countries worldwide. Consequently, WHO has declared the virus as a public health emergency of international concern.
Air travel contributes to the spread of infectious diseases; thousands of flights are operated daily between different countries which can be a potent source of dissemination of infections. In 2003, the rapid spread of SARS was connected to the travel of the index case and infected others, which subsequently traveled to other parts of the world.
The 2019-nCoV within the span of 29 days has been reported in three continents; Asia, Europe and America, the cases have all history of travel from the epicenter of the virus. Experts have analyzed the possible dissemination of the virus through commercial air travel, this investigation is based on the pattern of travel from the epicenter of the disease, Wuhan, for anticipating the routes of the dispersion of the infection to the next country.
Flight history from Wuhan of 2018 was used, based on international Air Transport Association (IATA) record to generate the number of passengers from Wuhan international airport and their top destinations. The first five top destinations of passengers were Bangkok, Hong Kong, Tokyo, Taipei, and Phuket, all these cities are in Asia. Interestingly, the first international case of the virus was reported in Thailand in an older patient with travel history to Wuhan, on the 13th January, 2020, shortly after that, another imported case was reported by the Japanese health authorities of a suspected case with no record of visiting the hotpots of the outbreak, but visited a hospitalized family member in Wuhan.
This case increases the assertion of human-to-human transmission route. Similarly, another report case of the infection was reported in Bangkok, a top ranking destination of passengers from Wuhan on the 13th January, 2020. A week later, Seoul, South Korea confirmed the imported case. Going by the timeline of the international transmission, all occurred within 14 days after the virus was officially confirmed by the Chinese authorities. This pattern of the transmission rhymes with the pattern of air travels between Wuhan city and the top passenger destinations.
Every year, thousands of passengers do travel between China and many African countries, for many reasons to include Business, education, technology and tourism. Many Chinese businesses have established their firms in African countries and Chinese travel for business as well as leisure. In African part, Nigeria for example, where many board flights to China in most major international airports for business and other reasons.
Top ranking African countries visited by Chinese travelers are Nigeria, Egypt, South Africa, Kenya and Mauritius. In general, the air travel between China and African countries increased exponentially in recent times to about 600%. This trend of air travels between the countries has potential of importing the virus, although there is no African city among the first 20 top passenger destination from Wuhan, however, the potential of imported case will not be overlooked, because the virus has spilled to other Chinese cities that are frequently visited by Africans, for example Guangzhou and Shanghai and the Chinese that start their travels from the Wuhan’s neighboring cities.
As a preventive measure, the city of Wuhan has been locked down and travel out of the city is restricted, however, the city authorities had confirmed that over 5 million had already left to other cities before the restriction. Those people are potential carriers of the virus as it has an incubation period of two weeks which they can transmit the infection.
Surveillance systems in airports from highly suspected destinations should be on alert. In 2014, the case of Ebola virus disease (EVD) from a highly suspected traveler was intercepted, thanks to the medical personnels and airport officials on duty, otherwise the disease would have spread beyond control.
Now, it's yet another season that requires alertness on screening travelers and increased preparedness planning as the new coronavirus is highly suspected to have reached Ivory Coast from a woman that arrived in the country from China on 26th January, 2020. suspected case tests negative, however, if the virus reaches Africa, it will greatly hit the continent due to its weak and deficient monitoring system.
Adam Mustapha, PhD., FASLN, Clinical and Medical Microbiologist, Department of Microbiology, University of Maiduguri, Adam Mustapha is a fellow of the African Science Literacy Network (ASLN).