A series of maps has revealed how the coronavirus outbreak has spread through China and leaped to at least 26 other countries around the world.
More than 74,000 people have now been infected with the virus in China and 2,006 people have died there, but international cases continue to crop up.
They have been found in 26 countries and three Chinese territories, Hong Kong, Macau and Taiwan.
Iran today became the latest country to declare the infection had spread there, confirming there are now two patients being treated in Qom, south of Tehran.
And South Korea almost doubled its number of patients from 31 to 51 overnight, making it one of the worst affected places alongside Japan and Singapore.
Experts say they expect international cases to keep appearing as the number of patients continues to soar in China and that it would be ‘unwise’ and ‘complacent’ to assume the outbreak was under control.
The maps below show a time lapse of the dates when each country or region of China declared its first confirmed case of the coronavirus
Thailand was the first place the virus was confirmed outside the Hubei province, where the outbreak officially began on December 31.
Cases were diagnosed in the country, which is popular with Chinese travellers, on January 13, before any other province in China confirmed the infection.
Japan followed suit three days later and, over the next 10 days, all of China’s remaining 30 provinces declared the infection had spread there.
At the same time, travellers carrying the disease became ill in the US, South Korea, Taiwan, Macau, Hong Kong and Singapore.
International cases have slowed down in recent weeks.
Since the beginning of February only three countries – Belgium, Egypt and Iran – have announced infections.
But the University of Hong Kong’s Professor Malik Peiris said: ‘It could be unwise for anybody in China, or outside China, to be complacent that this is coming under control at this point in time,’ the New York Times reported.
Professor Christl Donnelly, from Imperial College London, added: ‘In our modern interconnected world, it is not surprising for imported COVID-19 cases to be detected in previously unaffected countries.’
Chinese airlines are continuing to fly out of the country, although most international flight companies have stopped travelling into it.
The first case in Egypt, which was the first in Africa, triggered alarm and concerns the illness would spread further through the impoverished country.
Nations there do not have the health resources of Western or East Asian countries and the virus could spread uncontrollably if it breaks out, as has been seen with Ebola.
Dr Bharat Pankhania, from the University of Exeter, said: ‘We know there’s a lot of travel between China and Africa, so it’s no surprise that the first case of the virus has been detected in Africa.
‘It must now be an urgent priority to contain person-to-person transmission and ensure the virus does not spread to poorer parts of the continent, where the infrastructure and crowded living conditions would make containment strategies via quarantine impossible.
‘We urgently need all nations to share their combined logistical and diagnostic expertise together with expert clinical and epidemiological and public health support.
‘We need the global community working on the ground alongside African organisations to contain this virus and stop it spreading to a degree that could have serious global implications.’
The coronavirus outbreak began in the city of Wuhan in China’s Hubei province in December last year. It originated from an animal at a market
Thailand was the first place outside of China to declare the infection and also confirmed a case before any other provinces of China
Japan was the second place to declare an infection. It now has at least 74 confirmed cases
By mid-January other regions of China had started to find the virus had spread there – this was before any major quarantine measures were put in place
The US and South Korea declared cases in travellers from China
Provinces all over China officially declared infections on January 21, showing the virus was spreading rapidly out of Wuhan
The dramatic spread inside China continued and local authorities started to shut down public transport systems to stop people travelling
The city of Wuhan had gone into total lockdown by January 23 and authorities were stopping anyone from entering or leaving the city. The measures are still in place today
More international cases appeared and a confirmed infection in France marked the illness’s spread to Europe – the third continent
As more overseas spread became evident as January went on, airlines and international governments started blocking flights to and from China
Germany became the second European country to be affected, when a woman visiting from China for work infected a male colleague before noticing she was ill on her flight home
The United Arab Emirates on January 29 became the first Middle East country to declare an infection. It now has nine confirmed patients
Tibet, the last unaffected region of China, confirmed the infection had spread there at the end of January
The UK declared its first confirmed case on January 31 in a student at the University of York and his mother, who were staying in a hotel together in the city
The Diamond Princess cruise ship, which is moored off the coast of Yokohama, Japan, now has more cases than all countries outside of China combined, first noticed the disease was on-board at the start of February
Belgium became the first country to declare a case in February
On Valentine’s Day, Egypt became the first country in Africa to confirm a coronavirus case. This triggered fears among the international community because the virus could devastate Africa’s poorer areas where healthcare is almost non-existent
Iran today became the latest country embroiled in the global battle. Two people, about whom no details have been released, are being treated in Qom, 86miles south of Tehran
WHAT DO WE KNOW ABOUT THE CORONAVIRUS?
Someone who is infected with the coronavirus can spread it with just a simple cough or a sneeze, scientists say.
Over 2,000 people with the virus are now confirmed to have died and more than 75,000 have been infected. But experts predict the true number of people with the disease could be as high as 350,000 in Wuhan alone, as they warn it may kill as many as two in 100 cases. Here’s what we know so far:
What is the coronavirus?
A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.
The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.
Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.
The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019. The virus itself is called SARS-CoV-2.
Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals.
‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses).
‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’
The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.
By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.
The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.
Just a week after that, there had been more than 800 confirmed cases and those same scientists estimated that some 4,000 – possibly 9,700 – were infected in Wuhan alone. By that point, 26 people had died.
By January 27, more than 2,800 people were confirmed to have been infected, 81 had died, and estimates of the total number of cases ranged from 100,000 to 350,000 in Wuhan alone.
By January 29, the number of deaths had risen to 132 and cases were in excess of 6,000.
By February 5, there were more than 24,000 cases and 492 deaths.
By February 11, this had risen to more than 43,000 cases and 1,000 deaths.
A change in the way cases are confirmed on February 13 – doctors decided to start using lung scans as a formal diagnosis, as well as laboratory tests – caused a spike in the number of cases, to more than 60,000 and to 1,369 deaths.
More than 75,000 people have now been infected with the virus and 2,012 have died
Where does the virus come from?
According to scientists, the virus has almost certainly come from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.
The first cases of COVID-19 came from people visiting or working in a live animal market in the city, which has since been closed down for investigation.
Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat.
A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent similar to a coronavirus they found in bats.
However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.
Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.
‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’
So far the fatalities are quite low. Why are health experts so worried about it?
Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.
It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs.
Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.
Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.
‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’
If the death rate is truly two per cent, that means two out of every 100 patients who get it will die.
‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.
‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’
How does the virus spread?
The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.
It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky.
Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.
There is now evidence that it can spread third hand – to someone from a person who caught it from another person.
What does the virus do to you? What are the symptoms?
Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.
If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients – at least 97 per cent, based on available data – will recover from these without any issues or medical help.
In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.
What have genetic tests revealed about the virus?
Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world.
This allows others to study them, develop tests and potentially look into treating the illness they cause.
Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.
However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.
This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.
More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.
How dangerous is the virus?
The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.
However, experts say the true number of patients is likely considerably higher and therefore the death rate considerably lower. Imperial College London researchers estimate that there were 4,000 (up to 9,700) cases in Wuhan city alone up to January 18 – officially there were only 444 there to that date. If cases are in fact 100 times more common than the official figures, the virus may be far less dangerous than currently believed, but also far more widespread.
Experts say it is likely only the most seriously ill patients are seeking help and are therefore recorded – the vast majority will have only mild, cold-like symptoms. For those whose conditions do become more severe, there is a risk of developing pneumonia which can destroy the lungs and kill you.
Can the virus be cured?
The COVID-19 virus cannot currently be cured and it is proving difficult to contain.
Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.
No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.
The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.
Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.
People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.
And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).
However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.
Is this outbreak an epidemic or a pandemic?
The outbreak is an epidemic, which is when a disease takes hold of one community such as a country or region.
Although it has spread to dozens of countries, the outbreak is not yet classed as a pandemic, which is defined by the World Health Organization as the ‘worldwide spread of a new disease’.
The head of WHO’s global infectious hazard preparedness, Dr Sylvie Briand, said: ‘Currently we are not in a pandemic. We are at the phase where it is an epidemic with multiple foci, and we try to extinguish the transmission in each of these foci,’ the Guardian reported.
She said that most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.