BEIJING (BLOOMBERG, REUTERS) - The Chinese city of Wuhan at the centre of a widening respiratory virus outbreak suspended outbound flights and rail service as China ramped up efforts to contain an illness that has killed at least 17 people and infected nearly 600.
Following the travel halt, Taiwan's China Airlines said it had suspended flights to Wuhan while Hong Kong's MTR Corp said it had suspended sales of high-speed rail tickets to and from Wuhan. MTR Corp said in a statement that the decision had been made after communicating with its railway partners in China and passengers with valid tickets could opt for a full refund.
Wuhan's local government said earlier it would shut down all urban transport networks and suspend outgoing flights from 10am on Thursday. Domestic media said some airlines were operating after the deadline, however.
State media on Thursday broadcast images of one of Wuhan's key transport hubs, the Hankou rail station, nearly deserted, with gates blocked or barred. The government is urging citizens not to leave the city, except in special circumstances.
Chinese authorities have confirmed 571 cases as of end-Wednesday, China's National Health Commission said on Thursday. The commission said another 393 suspected cases had been reported.
All of the 17 deaths were in Hubei province whose capital is Wuhan, a city of 11 million people and a transportation hub as well as central China's main industrial and commercial centre.
Vice-Premier Sun Chunlan said during a visit to Wuhan that authorities needed to be open about the spread of the virus and their efforts to contain it, the official Xinhua news agency reported on Thursday, comments likely to reassure global health experts.
Health officials around the world are racing to control the virus that first appeared last month.
There are eight other known cases around the world - Thailand has confirmed four cases, while the United States, Taiwan, South Korea and Japan have each reported one.
There were two "preliminary positive" reports of the pneumonia-causing virus in Hong Kong and patients under examination in Mexico and Russia.
On Wednesday, the World Health Organisation delayed a decision on whether to declare the outbreak a public health emergency of international concern, a designation used for complex epidemics that can cross borders.
The United Nations agency said it would meet again on Thursday to determine a strategy.
"This is an evolving and complex situation," said Mr Tedros Adhanom Ghebreyesus, director-general of the WHO, in a briefing with reporters in Geneva. "To proceed, we need more information."
At the briefing in Geneva, Mr Ghebreyesus commended China's response to the outbreak but said the WHO nevertheless has a team in the Asian nation working with the authorities.
In a briefing in Beijing on Wednesday, health officials said China has stepped up monitoring of transportation links and ordered a near-complete shutdown of Wuhan, where the virus originated.
Officials acknowledged that they are still grappling to understand the pathogen, which has infected multiple medical workers.
"We are still on a learning curve," said Mr Gao Fu, head of Chinese Centre for Disease Control and Prevention. "The disease will continue to develop."
It has already changed from the early stages of detection, he said in the briefing.
China said it had seen no evidence yet of "super spreaders", infected people who pass on the disease rapidly to many other people, but could not rule out that some would emerge. Super spreaders played a key role in the Sars pandemic 17 years ago, which killed almost 800 people and hurt economies across the region.
Global efforts to check for infected travellers arriving at airports and other travel hubs could also be complicated by new details released by China's National Health Commission.
The commission's data showed that five of the 17 people who died after being infected with the novel coronavirus displayed other symptoms such as breathing difficulty, chest tightness and coughing but not a fever.
About 4,000 people in Wuhan may be currently infected, based on the number of known cases and the estimated mean time between infection and detection, according to a study by Mr Neil Ferguson, a researcher at Imperial College London.
While Mr Ferguson's group released an estimate of 1,700 infections over the weekend, the new total doesn't mean that the outbreak has doubled in size, according to the study. Factors such as delays in reporting and confirming cases make it difficult to estimate the epidemic's growth rate, the researchers said.
Hundreds of millions of people are poised to travel for the holidays in the biggest annual migration of humans on the planet.
Many Chinese were cancelling trips, buying face masks, avoiding public places such as cinemas and shopping centres, and even turning to an online plague simulation game as a way to cope.
Symptoms include fever, cough or chest tightness, and difficulty breathing. Both the Wuhan virus, known as 2019-nCoV, and Sars belong to the family of coronaviruses, so called because of their crown-like shape. Many such viruses cross the barrier between animals and humans.
Mr Gao said in the Beijing briefing that the source of 2019-nCoV was wild animals sold in so-called wet markets. Some of the first group of patients in Wuhan worked or shopped at a seafood market where live animals and wildlife parts were reportedly sold.
A WHO declaration of a public health emergency can help mobilise an international response and focus government attention. The body most recently declared such an emergency last year as an Ebola outbreak worsened in Congo.
An emergency declaration for the Wuhan virus case could include recommendations to restrict travel or trade. Such a move would come as concern grows that the virus could spread rapidly during China's Chinese New Year break, which starts at the end of this week.
The WHO has formed teams at its Geneva headquarters to study the virus, its spread and its symptoms and is sending experts to China to help gather information, according to Mr David Heymann, an infectious disease researcher in Britain who advises the agency.
As they did during the Sars and Ebola outbreaks, health officials and scientists globally are tracking patients and testing samples of saliva and other fluids to determine the exact cause and severity of their ailments.
They are identifying and monitoring people with whom the patients were in contact to see if the virus is spreading easily from person to person. And they are placing restrictions on travel to try to limit the exposure to scores of new people.
The US Centres for Disease Control and Prevention, or CDC, expanded its inspection of airline passengers who had spent time in China to airports in Atlanta and Chicago on Tuesday, building on the 1,200 people who had been screened in California and New York over the weekend. No new cases were uncovered.
The US case is a man in his 30s who was travelling in Wuhan and arrived back in the US on Jan 15, Washington state health officials said on a call with the CDC on Tuesday.
The resident of Snohomish, Washington, said he had not spent any time at the live-animal market where the virus is believed to have originated and did not have contact with anyone who was sick.
The man sought care quickly after monitoring news about the virus and is in good condition, though he has been hospitalised out of an abundance of caution, the officials said.
At least 16 people who had close contact with a Washington state man diagnosed with the virus and are being monitored.
President Donald Trump told reporters at the World Economic Forum in Davos that the US has a plan to deal with the virus.
"The CDC has been terrific," he said. "We're in very good shape and I think China is in very good shape also."
Australia and Britain are among the countries that have advised citizens against all but essential travel to Wuhan.
Japan on Thursday raised its infectious disease advisory level for Wuhan to two from one, urging its citizens to avoid non-urgent trips to the city.
British health officials raised the risk level of the virus to low from very low and issued guidance to airports. The focus of concern is about three flights a week that arrive from Wuhan at London Heathrow, according to a statement from the Department of Health and Social Care.
A message will be broadcast during those flights to encourage reporting of illness, and the planes will be received in an isolated area of the airport. Passengers will be met by health officials who will check for symptoms.
The European Centre for Disease Control and Prevention said there's a "moderate likelihood of imported cases being detected" in Europe.
"This is an evolving situation," said Ms Nancy Messonnier, director of the US CDC's National Centre for Immunisation and Respiratory Diseases.
"We do expect additional cases in the United States and globally."