The Star - A new respiratory illness identified in central China is emerging as a growing international concern after it killed at least three people and infected more than 200 others, with cases spreading in Asia.

In Wuhan — one of the country’s largest cities and a hub for industry and technology — the yet-to-be-officially-named coronavirus caused an outbreak of severe pneumonia among people who frequented a seafood market there late last month.

Authorities announced Monday that human-to-human transmission has been confirmed in the outbreak, raising fears that the illness could spread more quickly and widely.

The announcement came after a sharp uptick was announced in the number of confirmed cases in Wuhan — with health authorities reporting an additional 136 cases confirmed in the city, raising the total to 198.

Although the market has since been closed and disinfected, according to the New York Times, “the illness had also appeared in people who had not been exposed to the market, raising the possibility that the virus could be present elsewhere in the city.”

The Times reported that a local authority said the virus could be present in particles of saliva, and in one case, a patient appeared to have infected 14 medical workers.

As of Monday morning, there have been 217 confirmed cases of people infected with the disease, which has now spread to other parts of China, including Beijing, Shanghai and Shenzhen. It has also reached South Korea, Thailand and Japan.

Authorities are on high alert this week as millions of people are expected to travel for Chinese New Year.

Canadian public health officials are currently downplaying fears that it could spread to North America. The risk to Canadians visiting Wuhan is assessed as low, according to the latest federal travel notice.

In a media briefing Monday afternoon, Dr. Theresa Tam, Canada’s chief public health officer, said government officials are “actively monitoring” the situation and have consulted international partners including the World Health Organization. There are no confirmed cases of infection in Canada, as three Canadians who travelled to Wuhan and presented flu-like symptoms have been tested and ruled out, Tam said.

She noted reports Monday that the virus has shown it can spread person-to-person but stressed there is no evidence suggesting it is being easily transmitted. The Public Health Agency of Canada’s focus now is providing information to travellers — including signs at the Vancouver, Montreal and Toronto airports to remind people to report flu-like symptoms to customs officers — and preparing Canadian health services for any potential cases.

“We are simply putting in precautionary measures,” Tam said. “It is important to take this seriously and be vigilant and be prepared, but I don’t think there is any reason for us to panic or be overly concerned.”

Dr. Allison McGeer, director of infection control at Mount Sinai Hospital and a professor of public health at the University of Toronto, is no stranger to confronting quick-spreading, deadly global diseases.

She navigated the 2003 SARS crisis in Canada as a renowned health worker and travelled to Liberia in 2015 to help fight the Ebola virus with the World Health Organization.

McGeer is currently working on vaccine research and dealing with organisms that cause severe infections in hospitals.

The Star spoke to McGeer on Monday about what’s going on in Wuhan. Here’s six things we learned:

What are the symptoms of the illness?

Symptoms include fever, cough, sore throat, and generally feeling unwell. If the infection travels to your lungs, you could have trouble breathing.

What do we know about the new coronavirus?

Not much. According to McGeer, it’s a new virus that cause infections in different animals, including in humans.

“We still don’t know where it’s coming from or how easily it’s transmitted from human to human,” she said.

Previous severe outbreaks of human coronaviruses include SARS back in 2002-03, and MERS in 2012-17.

“Coronaviruses are known for their ability to change and evolve,” she said.

McGeer said you can only tell what virus it is by doing lab tests.

She added that “the infections that people get from coronaviruses are indistinguishable from the kind of infections you get from other viruses.”

What’s the risk to Canadians?

According to the Public Health Agency of Canada, there is a low risk that Canadians will be affected by the disease — but it is still too early to tell what potential challenges the new virus may pose.

“(If) this virus has an ongoing source that is not human beings in Wuhan and it’s not that transmissible from human to human — if that’s true, then we really don’t need to worry that much in Canada,” McGeer said.

“If it spreads easily enough from person to person to maintain itself in human populations — and we do not know that yet at all — then it doesn’t matter probably who you are or where you are in the world, it’s going to be a problem and it will be unstoppable.”

How alarming is the latest report out of China?

Although at least two cases of human-to-human disease transmission have been confirmed by Chinese officials, McGeer said the world has to now wait and see if there are more.

“The key issue now is not whether there’s human-to-human spread, but whether the human spread is enough to sustain this virus and populations,” McGeer said.

McGeer noted that the recommendations that the government has made, referencing public health agencies, “have been very sensible. . . . However scary this might be for people, there is a limit to what people can or should do. And I think people have been perfectly reasonable about it so far.”

Has Canada learned any lessons from the 2003 SARS outbreak?

SARS caused a crisis in Toronto back in the early 2000s due to the sheer number of people infected with the disease (in Canada, there were 438 probable or suspect cases, resulting in 44 deaths mostly in the GTA). McGeer noted that the “primary problem with the SARS virus was that it was mostly transmitted when people were very ill in hospitals,” and thus if people weren’t diagnosed as having SARS, then human-to-human transmission was more common.

Since then, she noted that a lot of work has been done to prevent transmission in hospitals.

“Has that made a difference to how, how prepared we are for emerging infectious disease and new outbreaks? Yes, absolutely,” McGeer said.

However, she added that it is “a general truth in Canada that we have underfunded and under resourced public health departments. So are we well prepared to deal with public health crises? No. How will we manage it? Bit hard to tell.”

What else can Canada do to prevent the virus from spreading here?

The Associated Press reported on Friday that the U.S. would start taking temperatures and asking about symptoms of passengers from Wuhan at New York City, Los Angeles and San Francisco airports.

Canada won’t take the temperature of Wuhan passengers, but will only remind them to inform officials of their symptoms through messaging on arrival screens at Toronto, Montreal and Vancouver international airports. An additional health screening question will also be added to the electronic kiosks at those terminals.

If the coronavirus does spread and become a global threat, McGeer wants to emphasize one major point to government officials: do not close the borders.

“If this is transmissible from person to person, we know that closing our borders does not work,” she said. “It causes a substantial amount of harm and it is not effective.”

She added that “if this turns out to be a virus that causes relatively severe disease and is transmitted from person to person, that’s very bad news. But attempting to close our borders is not going to protect us.”

- By Ilya Bañares, Staff Reporter - The Star