The outbreak of a virus in the same family has raised the spectre of the Sars epidemic of 2003 that killed nearly 800 people and sickened thousands. At the time, Chinese officials cut the traditionally week-long May Day national holiday to just one day to discourage people from travelling, but were also criticised for playing down the severity of the outbreak.

This time around there are similar suspicions, with public health experts telling the South China Morning Post the true number of victims of the coronavirus outbreak could be higher than officially stated.

The outbreak of the virus ahead of the Lunar New Year – often labelled the ‘world’s largest migration’ – has prompted transport authorities in Asia, home to four of the world’s top 10 busiest air transit hubs, to step up temperature screenings and checks on passengers as they prepare for a surge in Chinese tourists at the end of the month.

But even with these checks, infectious disease experts warn they have little information to go on.

“At this stage, the details that the international medical community have to work with are very limited,” said Masayuki Saijo, head of the virology division of Japan’s National Institute of Infectious Diseases. “We do not have any clinical information on patients.”

He added that pressure to monitor arrivals from China and elsewhere in Asia would increase should the illness continue to spread.

PREVENTIVE MEASURES

In Hong Kong, officials have set up a protocol to board all trains entering from Wuhan and temperature screen inbound passengers.

Health authorities across East and Southeast Asia have called for anyone who has recently visited China to report to a doctor immediately if they show symptoms, which include fever and difficulty breathing.

Chinese worker in South Korea diagnosed with pneumonia

All known patients in China are currently in isolation, and people who have been in close contact with them are being watched for symptoms.

On January 1, officials in hazmat suits shut down the seafood wholesale market where some of the patients in Wuhan were employed.

Leong Hoe Nam, an infectious disease expert at Mount Elizabeth Novena Hospital in Singapore, said the country’s infectious disease act allowed the government to apprehend anyone suspected of carrying the illness and keep them in quarantine. Leong said that under special circumstances in the past, the government had allowed foreigners to access free treatment if necessary.

Leong said hospitals had been directed to ready isolation beds and be prepared to cancel any elective surgeries.

“We have been holding annual drills for highly transmissible viruses to prepare,” said Leong, who identified Singapore’s first case of the Zika virus.

Singapore reports first suspected pneumonia case linked to Wuhan

The health ministry on Wednesday said the cause of the outbreak was “under investigation and there are many uncertainties at this time”. It called for anyone arriving from China with symptoms such as coughing or a high temperature to immediately consult a doctor.

Posters in Japanese, Chinese and English were put up at ports and airports across the country with the same advice.

LESSONS FROM PAST OUTBREAKS

South Korea on Wednesday reported its first suspected case of the illness. According to the Korea Centres for Disease Control and Prevention (KCDC), a 36-year-old Chinese woman who had visited Wuhan last month showed symptoms and has been quarantined for treatment. “She is doing fine now,” said a KCDC spokesperson.

Body temperature scanners have been set up at the entry doors for all flights from Wuhan. Some 1,800 passengers have entered South Korea from the Chinese city since Tuesday last week, according to officials.

“If passengers turn out to have a high body temperature, they would be asked whether they have visited the Huanan fisheries market in Wuhan and if they did so, they would be immediately put in quarantine,” said an official at the Korea Centres for Disease Control and Prevention, which has set up a 50-member quarantine task force and warned travellers to Wuhan not to touch wild animals or poultry or visit local markets.

Experts say that lessons learned from the Sars outbreak are being applied in China and Japan. The rapid spread of the highly infectious respiratory illness at the time lead authorities to develop protocols that they could rely on now, said Saijo at the National Institute of Infectious Diseases in Japan.

UNKNOWN TRANSMISSION

According to infectious disease experts, it is possible the risk of a large outbreak is low if it can be confirmed that the virus is not spread through human to human transmission.

“If it is limited in scale, that will make the job a lot easier, but we do have to monitor very closely not only people arriving from Wuhan, but also from other parts of China and even other parts of the world,” said Saijo, who oversees research on some of the world’s most dangerous diseases, including Ebola, Marburg and Lasa haemorrhagic fevers.

Leong in Singapore recommended individuals wear a mask to combat the spread of the virus. Chinese state media announced Thursday that scientists had identified the pathogen and confirmed 15 of the patients in China had the new virus.

Hong Kong to add Wuhan pneumonia to list of notifiable infectious diseases

However, Leong said the level of transparency on the part of authorities in Hong Kong, where authorities quickly kept the public informed about the hospital cases, shows an appropriate level of responsiveness.

Additional reporting by Park Chan-kyong, Julian Ryall and Tashny Sukumaran