बुधवार, 19 फ़रवरी 2020

Chinese CDC study finds Covid-19 virus to be more contagious than SARS or MERS

A comprehensive study of more than 72,000 confirmed and suspected cases of the novel coronavirus by Chinese scientists has revealed new information about the deadly infection which has brought much of the country to a halt.

Carried out by a group of experts at the Chinese Center for Disease Control and Prevention and published in the Chinese Journal of Epidemiology on Monday, the study is the largest and most comprehensive examination of coronavirus cases so far.


It found that the novel coronavirus is more contagious than the related viruses which cause SARS and MERS. While the resulting disease, Covid-19, is not as fatal on a case-by-case basis, its greater spread has already led to more deaths than its related coronaviruses.
    The new study examined data from 72,314 patients, 44,672 of which were confirmed cases of the virus (61.8%), along with 10,567 clinically diagnosed cases (14.6%) and 16,186 suspected cases (22.4%). An additional 889 cases examined did not show any symptoms.
    "Clinically diagnosed cases," are patients who demonstrate all the symptoms of Covid-19 but have either not been able to get a test or are believed to have falsely tested negative.
    Of the 44,672 confirmed cases, the Chinese CDC said there were 1,023 deaths, a crude mortality rate of 2.3%, which is in line with other studies and projections. By comparison, SARS had a mortality rate of 9.6% during the 2003 outbreak, while MERS has a case fatality of 35%. Seasonal influenza, which is highly contagious and effects tens of millions of people, has a mortality rate of around 0.1%, according to the most recent estimates from the US Centers for Disease Control.
    International experts have cautioned that early numbers may not tell the whole story. Case fatality rates may come down as officials discover milder cases who don't seek medical care.

    "My sense and the sense of many of my colleagues, is that the ultimate case fatality rate ... is less than 2%," Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, told CNN's Jim Sciutto on "New Day" Tuesday. "What is likely not getting counted is a large number of people who are either asymptomatic or minimally symptomatic, so the denominator of your equation is likely much much larger."
    "So I would think at tops it's 2% and it likely will go down when all the counting gets done to 1% or less. That's still considerable if you look at the possibility that you're dealing with a global pandemic," he added.
    Because the Covid-19 virus has infected far more people than the viruses that caused SARS and MERS, the number of people who have died from it so far has already overtaken both viruses. The SARS outbreak claimed the lives of 774 people, while MERS has killed at least 828 people since 2012.
    Even so, flu has led to far more deaths than all of these viruses combined -- killing tens of thousands of people in the US each year -- due to its massive spread.
    The latest death toll from Covid-19 is over 1,800, all but five of which occurred in mainland China, where the worst of the outbreak is centered.
    Many of those deaths have been among older people and those with preexisting conditions that make them more susceptible to serious illness from viral infections. The Chinese CDC study found that among patients aged 80 and above, the crude fatality rate is 14.8%. Among those with pre-existing conditions, those with cardiovascular disease were found to be most at risk, with a fatality rate of 10.5%.
    The contagious nature of the virus has also put medical workers at risk -- as of February 11, more than 3,000 hospital staff or other medics had been reported to have been infected with the virus, among whom 1,716 had been confirmed by nucleic acid tests. Of the confirmed cases, only a small number has resulted in death -- roughly 0.3%, according to the authors.
    Release of the study comes as Chinese officials were hailing what seemed to be the turning of a corner in the fight against the virus. Outside of Hubei province, the epicenter of the outbreak, the number of new cases reported has fallen for the past 14-days.
    However, scientists previously warned of self-sustaining epidemics in Chinese cities, and both Beijing and Shanghai remain on tight lockdown to guard against the virus' spread.
    While the number of new reported cases have gone down in China and some other countries, the World Health Organization (WHO) has warned that new data must be analyzed "cautiously."
    "This trend must be interpreted very cautiously. Trends can change as new populations are affected. It's too early to tell if this reported decline will continue. Every scenario is still on the table," Tedros Adhanom Ghebreyesus, director-general of WHO, said during a press conference Monday.
      Tedros added that more than 80% of patients "have mild disease and will recover."
      "In about 14% of cases, the virus causes severe diseases including pneumonia and shortness of breath. And about 5% of patients have critical diseases including respiratory failure, septic shock and multiorgan failure," he said. "In 2% of reported cases, the virus is fatal, and the risk of death increases the older you are. We see relatively few cases among children. More research is needed to understand why."


      बुधवार, 5 फ़रवरी 2020

      Texting more dangerous for pedestrians than listening to music or speaking on the phone

      चंद शब्दों तक सीमित सन्देश भेजने के माध्यम को आजकल हम टेक्स्टिंग या टेक्स्ट -मेसेजिंग

      के नाम से जानते हैं। मोबाइल और पाठ सन्देश आजकल ईश्वर की तरह सर्व -व्यापी हो गए हैं यहां तक के ज़ेब्रा क्रॉसिंग करते वक्त भी हम पाठ सन्देश में तल्लीन होते हैं। इसके खतरे अब खुलकर सामने आने लगें हैं। रिसर्चरों का ध्यान अब इस नए एडिक्शन की तरफ तेज़ी से जा रहा है। अनेक अध्ययन भी इसे लेकर ज़ारी है ऐसे ही अनेक अध्ययनों का निचोड़ हम  आप के साथ साझा कर रहे हैं। आप भी इसे शेयर कर सकते हैं अपनी वाल पर दर्शा सकते हैं।

      'इंजरी प्रिवेंशन 'नामी एक कनाडाई अध्ययन में बतलाया गया है पैदल चलने वाले पथिकों के लिए उन पैदल यात्रियों के बनिस्पत किसी से टकराने का ख़तरा कहीं ज्यादा हो जाता है जो टेक्स्टमैसेजिंग करते चलते हैं बनिस्पत उन लोगों के जो चलते -चलते संगीत सुन  रहें हैं या मोबाइल पर बतिया रहें हैं।ऐसा करना अपनी सुरक्षा को दाव पर लगाना है।

      'पलट तेरा ध्यान किधर है 'बाएं और दाएं देख लिया कर मेरे भाई! ' जान है तो जहान है' ये ज़ेब्रा क्रॉसिंग है तेरे चक्कर में हम भी दुर्घटना का शिकार हो सकते हैं। 'क्रेश रिस्क' ज्यादा है इस लापरवाही में। 

      'कहीं पे निगाहें कहीं पे निशाना ,जीने ना देगा ये टेक्स्टिंग ज़माना' 'पेडिस्ट्रियन डिस्ट्रेक्शन' आज एक बड़ा मुद्दा है -दुनिया भर में इस सबके चलते दो लाख़ सत्तर हज़ार के करीब लोग मारे जाते हैं इस नादानी में। यह सड़कदुर्घटनाओं में मारे जाने वाले कुल यात्रियों का पांचवा हिस्सा है।' हेंड हेल्ड 'हो या कोई ' हेंडफ्री - डिवाइस'  सब 'एक ही थाली के चट्टे बट्टे' हैं। यह आंकड़ा इन सब को  मिलाकर ही  है।  

      कुल तेईस संपन्न अध्ययनों में से कनाडाई शोधकर्ताओं ने १४ से आँकड़े जुटाए  जिनमें कुलमिलाकर ८७२ लोग शामिल थे जो दाए बाए से बेखबर 'अपनी धुन मैं रहता हूँ मैं भी तेरे जैसा हूँ 'अंदाज़ में मिले। इसके अलावा आठ और अध्ययनों का पुनरीक्षण अध्ययन ,'रिव्यू ', किया गया। 

      पता चला संगीत सुनते चलना उतना ख़तरे का वॉयस कभी नहीं बनता ,मौज़ू है यह टहलकदमी रास्ता चलते पैदल -पैर  इन  इस्मार्ट -फोनियों में,' ध्यान -च्युत' होकर चलने का ख़तरा १२ से लेकर ४५ फीसद तक देखा गया.जेंडर ,दिन का पहर कौन सा है उस वक्त , आप अकेले हैं या टोली में हैं ऐसा करते हुए ये तमाम बातें शामिल थीं आखिरी विश्लेषण में.

      जो हो स्मार्टफोनिये हों या इतर 'सोशल मीडिया' अप्लाइंस से चस्पां युवा भीड़ जीवन की तमाम गतिविधियों में ये आन  बसें हैं चाहे आप खाना खा रहे हो या मत्याग कर रहे हो- ये अधुनातन पर -प्रेमिकाएँ अपनी अलग जगह बनाये हुए हैं यहां तक के आलिंगन बंधन में बंधे प्रेमी  जोड़ों के  पास तल्लीनता के लिए ये मोबाइल्स हैं। डिजिटल म्युज़िक और वीडिओज़ इस दौर की क्रेज़ बने हुए हैं जिसके असर से बचना मुश्किल ही है आसार इससे भी बदतर हो सकते हैं। 

      सन्दर्भ सामिग्री :

      Texting more dangerous for pedestrians than listening to music or speaking on the phone


      प्रस्तुति :वीरेंद्र शर्मा ,पूर्व प्राचार्य चौधरी धीरपाल गवर्मेंट  पोस्ट ग्रेडुएट कोलिज ,बादली -१२४ १०५ ,(झज्जर ),हरयाणा प्रदेश 
      २४५ /२ विक्रम विहार ,शंकर विहार काम्प्लेक्स ,दिल्ली -छावनी -११० -०१० 
      ८५ ८८ ९८ ७१५० 

      मंगलवार, 4 फ़रवरी 2020

      इस विषाणु का इन्क्यूबेशन पीरियड (उद- भवन- काल ,रोग से आक्रान्त होने यानी संक्रमण लगने और उसके लक्षण प्रकट होने के बीच का समय )चौदह दिन तकरीबन एक पखवाड़ा बतलाया गया है। लिहाज़ा कोरोना वायरस का संक्रमण (छूत )दबे पाँव हो सकता है। ज़रूरी नहीं है मरीज़ का तेज़ बुखार से तपना खाँसना छींकना ,आदिक

      'There's no doubt': Top US infectious disease doctor says Wuhan coronavirus can spread even when people have no symptoms


      इस विषाणु का इन्क्यूबेशन पीरियड (उद- भवन- काल ,रोग से आक्रान्त होने यानी संक्रमण लगने और उसके लक्षण प्रकट होने के बीच का समय )चौदह दिन तकरीबन एक पखवाड़ा बतलाया गया है। लिहाज़ा  कोरोना वायरस का संक्रमण (छूत )दबे पाँव हो सकता है। ज़रूरी नहीं है मरीज़ का तेज़ बुखार से तपना खाँसना छींकना ,आदिक। 

      इसका मतलब यह भी हुआ कोरोना  वायरस से पैदा  संक्रमण चुपके -चुपके बढ़ सकता है,पुष्टि की है संक्रामक रोगों के  माहिर अमरीकी साइंसदानों ने जिसकी अनदेखी करना मुश्किल है।
      जर्मन रिसर्चरों ने इसी क्रम में माँ  -बाप से  पुत्री ,पुत्री से उसके दो मित्रों और उनमें से एक से दो और सहकर्मियों तक ऐसा ही संक्रमण पहुँचने के प्रमाण जुटाए हैं इन सभी व्यक्तियों में रोग बिना लक्षण दर्शाये बढ़ता रहा। चीन के स्वास्थ्य मंत्री भी ऐसे ही कितने मामलों की  तस्दीक कर चुकें हैं।  

      ऐसे में संदेह के दायरे में आने वाले व्यक्तियों की अलहदगी बेहद ज़रूरी हो जाती है जैसा चीन से लौटे साढ़े छः सौ से ज्यादा लोगों को अलग रख के भारत ने किया है।खबर लिखे जाने तक अब तक सवा चार सौ से ज्यादा मरीज़ कोरोना के संक्रमण के बाद चीन के दो नगरों  में मौत के मुंह में जा चुके हैं। चौदह हज़ार से ऊपर लोग संक्रमित हैं। 

      दो दर्जन से ज्यादा अमरीकी इससे संकर्मित हो चुके हैं। भारत के केरल राज्य में चीन प्रवास से लौटे तीन लोगों में इस लक्षण अब तक देखे जा चुके हैं दिल्ली के बेस-अस्पताल (फौजी अस्पताल )में भी एक दो मरीज़ पहुंचे हैं।इन्हें कड़ी निगरानी में रखा जा रहा है.


      दिल्ली चुनाव में सब्ज़बाग दिखाने वाले किसी भी पैंतरे बाज़ ने दस दिन में एक नयाअस्पताल बनाने का हौसला तो दूर चुनावी वायदा भी नहीं किया है जबकि एक अलग अस्पताल बनाने का एहतियाती उपाय कर लेना इस दौर में बहुत ज़रूरी है जबकि अभिनव संक्रामक रोगों की दस्तक तेज़ी से बढ़ रही है। 

      जानवरों की आहत चेतना ने चीन को हतप्रभ कर दिया है। चीन ने अत कर दी थी सांप साही रैकून और चमकादड़ कुछ भी खाएंगे ये लोग। जानवर से बदतर हैं ये जीव पीड़क। वन्यप्राणी भी इनकी उदर में गुम होके विलुप्त प्राय : हो रहेंगे एक दिन ।

       कुदरत के अपने इंतज़ामात हैं जो किसी सी जिनपिंग से बहुत जबर हैं ,कोरोना  वायरस ने हमें यह समझाया है 

      वीरेंद्र शर्मा ,२४५ /२ ,विक्रम विहार ,शंकर विहार कॉम्प्लेक्स ,दिल्ली -छावनी ११० ०१० 

      दूर ध्वनि  :८५ ८८ ९८ ७१ ५० 


          

      The nation's top infectious disease doctor says a new study published Thursday night shows people can spread the Wuhan coronavirus before symptoms set in.

      German researchers found that the virus was transmitted by people without symptoms in five instances in one cluster of people: from a parent to a daughter; from that daughter to two colleagues; and from one of those colleagues to two other coworkers.

      "There's no doubt after reading this paper that asymptomatic transmission is occurring," said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. "This study lays the question to rest."

      For nearly a week, US health officials have debated whether someone can spread the virus during the incubation period, when they are infected but not yet ill. The Chinese minister of health said it could spread asymptomatically, but US authorities had their doubts because Chinese health authorities offered no evidence.
      The question is crucial, because when asymptomatic transmission occurs, officials sometimes need to institute more dramatic control measures, such as tougher quarantines.
      The Wuhan coronavirus, which was first identified in China in December, has killed more than 200 people and infected nearly 10,000 in more than a dozen countries around the world.
      In the study, which published Thursday in the New England Journal of Medicine, German researchers described four business associates who became infected through asymptomatic transmission.
      "They were in workshops together, they went to the company canteen together," Dr. Camilla Rothe, an infectious disease specialist and the lead author of the paper, told CNN.

      The chain of transmission

      The chain of transmission started on January 16 when a woman in Shanghai hosted her parents for a weekend visit, Rothe said.
      As the coronavirus spreads, fear is fueling racism and xenophobia
      Her parents were visiting from Wuhan, the epicenter of the coronavirus outbreak. They were healthy during their visit with their daughter but were later diagnosed as having the coronavirus.
      Three days later, on January 19, the woman left Shanghai and flew to Germany. On Monday, Tuesday and Wednesday she held a series of workshops with employees of an auto parts supply company outside of Munich. She was healthy during those workshops, showing no signs of the disease, according to the New England Journal report.
      On January 22, the woman flew back to China and became ill on the plane.
      She was diagnosed with the virus and alerted the company -- but by then it was too late.
      On January 24, two days after the Shanghai woman flew back home, two of the German employees who had attended her workshops fell ill, according to the report.
      Neither of them was very sick, Rothe said.
      The first, an otherwise healthy 33-year-old, developed a fever of 102.4 degrees, and felt ill for a few days.
      "He stayed in bed for the weekend, but by Monday he felt fine," Rothe said.
      This is where Wuhan coronavirus cases have been confirmed worldwide
      The second one had a "mildly sore throat and a minimal cough," Rothe said. "He was clinically unspectacular."
      Then on January 26, nearly a week after the Shanghai woman infected these two men at the workshops, two more employees became ill.
      These employees had not attended the workshops. But they had spent time with the first German patient before he was showing any symptoms.
      Those two patients were also mildly ill with a minor sore throat and cough.
      All four of these employees later tested positive for the Wuhan coronavirus. They stayed at a hospital not because they were sick, but to contain the spread of the virus.
      Webasto, a German auto supply company, posted a press release on its website about the infections.
      The company temporarily closed down its facility in Stockdorf, Germany, and cancelled business travel to China for at least the next two weeks.
      US authorities doubted asymptomatic transmission was possible
      The German study marks the first time scientific evidence available to the public has shown that the Wuhan coronavirus 
      can be spread before someone develops systems.
      US authorities doubted asymptomatic transmission was possible

      The German study marks the first time scientific evidence available to the public has shown that the Wuhan coronavirus can be spread before someone develops systems.

      First case of person-to-person transmission of Wuhan virus in the US confirmed

      On Sunday, Chinese Health Minister Ma Xiaowei said at a press briefing that they had found people could spread the virus while asymptomatic. Two days later, a Chinese doctor repeated this at a press conference.

      US officials, however, weren't so sure, since the Chinese offered no data to support the claims.

      On Wednesday, when a reporter at a press conference asked about the Chinese officials' statements, a doctor from the US Centers for Disease Control and Prevention expressed doubt.

      "We don't know that. We've heard one Chinese health official say that, but we don't know that that's the case," said Dr. Christopher Braden, deputy director of the National Center for Emerging and Zoonotic Infectious Diseases.

      On Thursday, Dr. Nancy Messonnier, the director of the Center for the National Center for Immunization and Respiratory Diseases at CDC, acknowledged the test for this coronavirus might show up negative if someone is infected but not yet showing symptoms.

      "Is it possible to detect this virus before somebody is symptomatic? And the answer is, we don't know yet and we're looking closely to see if we can," she said.

      Fauci, the NIH doctor, said it might take a period of time after infection for the test to be reliable.

      "There's still much we don't know about this virus," he said.

      Novel coronavirus is a US public health emergency


      Alex Azar, secretary of the US Department of Health and Human Services, declared on Friday that the novel coronavirus is now a public health emergency in the United States.

      Any US citizen who has been in China's Hubei province in the last 14 days will be subject to up to 14 days of mandatory quarantine upon return to the United States. US citizens returning from the rest of mainland China within the last 14 days will undergo screening at US ports of entry and up to 14 days of self-monitoring.

      Everything travelers need to know about Wuhan coronavirus

      T

      he Trump administration also announced it will deny entry to foreign nationals who have traveled in China in the last 14 days. Azar said the US is "temporarily suspending the entry into the United States of foreign nationals who pose a risk of transmitting the 2019 novel coronavirus."

      The ban will go into effect at 5 p.m. ET Sunday on Sunday.

      "While this virus poses a serious public health threat, the risk to the American public remains low at this time, and we are working to keep this risk low," Azar said in a statement. "We are committed to protecting the health and safety of all Americans, and this public health emergency declaration is the latest in the series of steps the Trump Administration has taken to protect our country."

      Also on Friday, the CDC ordered a mandatory 14-day quarantine for nearly 200 Americans who recently returned from Wuhan. This is the first such order by the CDC in more than 50 years.

      The 195 Americans, many of them diplomats and their families, flew from Wuhan to California on Wednesday. They had been staying at March Air Reserve Base since then under a three-day voluntary quarantine.

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      Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

      "We believe that this approach of having quarantine for the incubation period offers the greatest level of protection for the American public," Dr. Martin Cetron, director of CDC's Division of Global Migration and Quarantine, said during a Friday telebriefing with reporters. "That is our primary concern."

      CDC officials thanked quarantined individuals for their flexibility. Cetron said most of the passengers were "exuberant and elated to be out of harm's way," and understand the need for a longer quarantined.

      "We're taking every measure possible to make sure people are treated with dignity and respect," Cetron said.

      One quarantined individual had previously tried to leave the base. CDC officials declined to offer more information about that person.






      'There's no doubt': Top US infectious disease doctor says Wuhan coronavirus can spread even when people have no symptoms


      इस विषाणु का इन्क्यूबेशन पीरियड (उद- भवन- काल ,रोग से आक्रान्त होने यानी संक्रमण लगने और उसके लक्षण प्रकट होने के बीच का समय )चौदह दिन तकरीबन एक पखवाड़ा बतलाया गया है। लिहाज़ा  कोरोना वायरस का संक्रमण (छूत )दबे पाँव हो सकता है। ज़रूरी नहीं है मरीज़ का तेज़ बुखार से तपना खाँसना छींकना ,आदिक। 

      इसका मतलब यह भी हुआ कोरोना  वायरस से पैदा  संक्रमण चुपके -चुपके बढ़ सकता है,पुष्टि की है संक्रामक रोगों के  माहिर अमरीकी साइंसदानों ने जिसकी अनदेखी करना मुश्किल है।
      जर्मन रिसर्चरों ने इसी क्रम में माँ  -बाप से  पुत्री ,पुत्री से उसके दो मित्रों और उनमें से एक से दो और सहकर्मियों तक ऐसा ही संक्रमण पहुँचने के प्रमाण जुटाए हैं इन सभी व्यक्तियों में रोग बिना लक्षण दर्शाये बढ़ता रहा। चीन के स्वास्थ्य मंत्री भी ऐसे ही कितने मामलों की  तस्दीक कर चुकें हैं।  

      ऐसे में संदेह के दायरे में आने वाले व्यक्तियों की अलहदगी बेहद ज़रूरी हो जाती है जैसा चीन से लौटे साढ़े छः सौ से ज्यादा लोगों को अलग रख के भारत ने किया है।खबर लिखे जाने तक अब तक सवा चार सौ से ज्यादा मरीज़ कोरोना के संक्रमण के बाद चीन के दो नगरों  में मौत के मुंह में जा चुके हैं। चौदह हज़ार से ऊपर लोग संक्रमित हैं। 

      दो दर्जन से ज्यादा अमरीकी इससे संकर्मित हो चुके हैं। भारत के केरल राज्य में चीन प्रवास से लौटे तीन लोगों में इस लक्षण अब तक देखे जा चुके हैं दिल्ली के बेस-अस्पताल (फौजी अस्पताल )में भी एक दो मरीज़ पहुंचे हैं।इन्हें कड़ी निगरानी में रखा जा रहा है.


      दिल्ली चुनाव में सब्ज़बाग दिखाने वाले किसी भी पैंतरे बाज़ ने दस दिन में एक नयाअस्पताल बनाने का हौसला तो दूर चुनावी वायदा भी नहीं किया है जबकि एक अलग अस्पताल बनाने का एहतियाती उपाय कर लेना इस दौर में बहुत ज़रूरी है जबकि अभिनव संक्रामक रोगों की दस्तक तेज़ी से बढ़ रही है। 

      जानवरों की आहत चेतना ने चीन को हतप्रभ कर दिया है। चीन ने अत कर दी थी सांप साही रैकून और चमकादड़ कुछ भी खाएंगे ये लोग। जानवर से बदतर हैं ये जीव पीड़क। वन्यप्राणी भी इनकी उदर में गुम होके विलुप्त प्राय : हो रहेंगे एक दिन ।

       कुदरत के अपने इंतज़ामात हैं जो किसी सी जिनपिंग से बहुत जबर हैं ,कोरोना  वायरस ने हमें यह समझाया है 

      वीरेंद्र शर्मा ,२४५ /२ ,विक्रम विहार ,शंकर विहार कॉम्प्लेक्स ,दिल्ली -छावनी ११० ०१० 

      दूर ध्वनि  :८५ ८८ ९८ ७१ ५० 


          

      The nation's top infectious disease doctor says a new study published Thursday night shows people can spread the Wuhan coronavirus before symptoms set in.

      German researchers found that the virus was transmitted by people without symptoms in five instances in one cluster of people: from a parent to a daughter; from that daughter to two colleagues; and from one of those colleagues to two other coworkers.

      "There's no doubt after reading this paper that asymptomatic transmission is occurring," said Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. "This study lays the question to rest."

      For nearly a week, US health officials have debated whether someone can spread the virus during the incubation period, when they are infected but not yet ill. The Chinese minister of health said it could spread asymptomatically, but US authorities had their doubts because Chinese health authorities offered no evidence.
      The question is crucial, because when asymptomatic transmission occurs, officials sometimes need to institute more dramatic control measures, such as tougher quarantines.
      The Wuhan coronavirus, which was first identified in China in December, has killed more than 200 people and infected nearly 10,000 in more than a dozen countries around the world.
      In the study, which published Thursday in the New England Journal of Medicine, German researchers described four business associates who became infected through asymptomatic transmission.
      "They were in workshops together, they went to the company canteen together," Dr. Camilla Rothe, an infectious disease specialist and the lead author of the paper, told CNN.

      The chain of transmission

      The chain of transmission started on January 16 when a woman in Shanghai hosted her parents for a weekend visit, Rothe said.
      As the coronavirus spreads, fear is fueling racism and xenophobia
      Her parents were visiting from Wuhan, the epicenter of the coronavirus outbreak. They were healthy during their visit with their daughter but were later diagnosed as having the coronavirus.
      Three days later, on January 19, the woman left Shanghai and flew to Germany. On Monday, Tuesday and Wednesday she held a series of workshops with employees of an auto parts supply company outside of Munich. She was healthy during those workshops, showing no signs of the disease, according to the New England Journal report.
      On January 22, the woman flew back to China and became ill on the plane.
      She was diagnosed with the virus and alerted the company -- but by then it was too late.
      On January 24, two days after the Shanghai woman flew back home, two of the German employees who had attended her workshops fell ill, according to the report.
      Neither of them was very sick, Rothe said.
      The first, an otherwise healthy 33-year-old, developed a fever of 102.4 degrees, and felt ill for a few days.
      "He stayed in bed for the weekend, but by Monday he felt fine," Rothe said.
      This is where Wuhan coronavirus cases have been confirmed worldwide
      The second one had a "mildly sore throat and a minimal cough," Rothe said. "He was clinically unspectacular."
      Then on January 26, nearly a week after the Shanghai woman infected these two men at the workshops, two more employees became ill.
      These employees had not attended the workshops. But they had spent time with the first German patient before he was showing any symptoms.
      Those two patients were also mildly ill with a minor sore throat and cough.
      All four of these employees later tested positive for the Wuhan coronavirus. They stayed at a hospital not because they were sick, but to contain the spread of the virus.
      Webasto, a German auto supply company, posted a press release on its website about the infections.
      The company temporarily closed down its facility in Stockdorf, Germany, and cancelled business travel to China for at least the next two weeks.
      US authorities doubted asymptomatic transmission was possible
      The German study marks the first time scientific evidence available to the public has shown that the Wuhan coronavirus 
      can be spread before someone develops systems.
      US authorities doubted asymptomatic transmission was possible

      The German study marks the first time scientific evidence available to the public has shown that the Wuhan coronavirus can be spread before someone develops systems.

      First case of person-to-person transmission of Wuhan virus in the US confirmed

      On Sunday, Chinese Health Minister Ma Xiaowei said at a press briefing that they had found people could spread the virus while asymptomatic. Two days later, a Chinese doctor repeated this at a press conference.

      US officials, however, weren't so sure, since the Chinese offered no data to support the claims.

      On Wednesday, when a reporter at a press conference asked about the Chinese officials' statements, a doctor from the US Centers for Disease Control and Prevention expressed doubt.

      "We don't know that. We've heard one Chinese health official say that, but we don't know that that's the case," said Dr. Christopher Braden, deputy director of the National Center for Emerging and Zoonotic Infectious Diseases.

      On Thursday, Dr. Nancy Messonnier, the director of the Center for the National Center for Immunization and Respiratory Diseases at CDC, acknowledged the test for this coronavirus might show up negative if someone is infected but not yet showing symptoms.

      "Is it possible to detect this virus before somebody is symptomatic? And the answer is, we don't know yet and we're looking closely to see if we can," she said.

      Fauci, the NIH doctor, said it might take a period of time after infection for the test to be reliable.

      "There's still much we don't know about this virus," he said.

      Novel coronavirus is a US public health emergency


      Alex Azar, secretary of the US Department of Health and Human Services, declared on Friday that the novel coronavirus is now a public health emergency in the United States.

      Any US citizen who has been in China's Hubei province in the last 14 days will be subject to up to 14 days of mandatory quarantine upon return to the United States. US citizens returning from the rest of mainland China within the last 14 days will undergo screening at US ports of entry and up to 14 days of self-monitoring.

      Everything travelers need to know about Wuhan coronavirus

      T

      he Trump administration also announced it will deny entry to foreign nationals who have traveled in China in the last 14 days. Azar said the US is "temporarily suspending the entry into the United States of foreign nationals who pose a risk of transmitting the 2019 novel coronavirus."

      The ban will go into effect at 5 p.m. ET Sunday on Sunday.

      "While this virus poses a serious public health threat, the risk to the American public remains low at this time, and we are working to keep this risk low," Azar said in a statement. "We are committed to protecting the health and safety of all Americans, and this public health emergency declaration is the latest in the series of steps the Trump Administration has taken to protect our country."

      Also on Friday, the CDC ordered a mandatory 14-day quarantine for nearly 200 Americans who recently returned from Wuhan. This is the first such order by the CDC in more than 50 years.

      The 195 Americans, many of them diplomats and their families, flew from Wuhan to California on Wednesday. They had been staying at March Air Reserve Base since then under a three-day voluntary quarantine.

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      "We believe that this approach of having quarantine for the incubation period offers the greatest level of protection for the American public," Dr. Martin Cetron, director of CDC's Division of Global Migration and Quarantine, said during a Friday telebriefing with reporters. "That is our primary concern."

      CDC officials thanked quarantined individuals for their flexibility. Cetron said most of the passengers were "exuberant and elated to be out of harm's way," and understand the need for a longer quarantined.

      "We're taking every measure possible to make sure people are treated with dignity and respect," Cetron said.

      One quarantined individual had previously tried to leave the base. CDC officials declined to offer more information about that person.