Concern is growing over the spread of Wuhan Coronavirus, which has killed at least nine people in China. In addition a case has been confirmed in Seattle, Washington. The traveller had arrived in the US from China.

At least 440 cases have been confirmed, with a dozen or more medical workers infected through human-to-human contact.

The outbreak began at a market in Wuhan. Most cases are in the central China city itself, but the disease has also been reported in Shanghai and Beijing, with cases also reported in Japan, Thailand and South Korea.

There will also be a special area set up at Heathrow airport for arrivals from Wuhan.

Imperial College’s MRC Centre for Global Infectious Disease Analysis believes the actual number of cases is far higher. By 12 January 2020, the centre estimates there were at least 1.723 cases.

With millions of people on the move for the Chinese New Year on 25 January and the Spring Festival, the World Health Organization (WHO) predicts many more cases will occur.

These are the key questions for travellers.

What is this virus?

It is a “novel coronavirus”. The term “novel” simply means that the strain is newly identified. A coronavirus (abbreviated to CoV) is so-called because, under a microscope, it appears to have a circular fringe.

Typically a coronavirus causes a runny nose, cough, sore throat, headache, fever and what the US Centers for Disease Control (CDC) calls “a general feeling of being unwell”. It adds: “Most people get infected with these viruses at some point in their lives. These illnesses usually only last for a short amount of time.”

But coronaviruses can cause lower-respiratory tract illnesses, notably pneumonia, especially among very young or old people and those with weakened immune systems or existing cardiopulmonary disease.

This appears to have been the primary cause of death for the victims of the Wuhan Coronavirus, which is known as WN-CoV.

How is it transmitted?

Public Health England says: “As WN-CoV has only been recently identified, there is currently limited information about the precise routes of transmission.

“Coronaviruses are mainly transmitted by large respiratory droplets and direct or indirect contact with infected secretions.”

Until more evidence emerges, it is wise to assume that it can be contracted by airborne particles or contact with an ill person.

How soon does the infection become apparent?

The MRC Centre says that the delay between infection and detection is 10 days – made up of an incubation period of five to six days, and an estimated four- or five-day delay from the onset of symptoms to the detection and hospitalisation of a case.

China’s National Health Commission vice-minister Li Bin, said: ”Though the transmission route of the virus is yet to be fully understood, there is a possibility of virus mutation and a risk of further spread of the epidemic.”

Is this related to Sars?

To a degree. The “severe acute respiratory syndrome” was a coronavirus that spread, mainly in east Asia, in late 2002 and 2003. Nearly 800 people died during the outbreak, but no cases have been reported since 2004.

Another coronavirus, Mers (“Middle East respiratory syndrome”) has affected people in the Middle East, particularly the Arabian Peninsula, since 2012.

What is being done to prevent the spread?

The World Health Organization says: “Based on currently available information, WHO does not recommend any restriction of travel or trade.” 

Travellers from China to three airports in the US – Los Angeles, New York JFK and San Francisco – are having their temperatures taken and filling out a “symptom questionnaire” that asks if they are suffering with a fever, a cough or breathing difficulties. But such procedures are of questionable value since they cover only a tiny proportion of travellers.

Australia has said that it will screen arrivals from Wuhan. Airports in the UAE, where many passengers transfer, say they are on standby to implement precautions.

There are three flights a week from Wuhan to Heathrow, and arriving passengers will enter a separate area to prevent the virus from reaching the UK, said transport secretary Grant Shapps.

Where are the key airports where infected travellers might be?

According to analysis of airline schedules by John Grant of OAG, Bangkok is the most popular international destination from Wuhan, followed by Hong Kong, Tokyo, Seoul and Taipei.

For domestic connections, Guangzhou is the leading airport for travellers from Wuhan.

What precautions can I take?

“Regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs,” says WHO. 

“Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.”

I am travelling to China. Should I cancel?

No, even if you are going to Wuhan itself. Public Health England (PHE) says: "The risk to the UK population is very low and the risk to travellers to Wuhan is low."

Dr Nick Phin, deputy director of PHE's National Infection Service, says: “People travelling to Wuhan should maintain good hand, respiratory and personal hygiene and should avoid visiting animal and bird markets or people who are ill with respiratory symptoms."

“Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK, informing their health service prior to their attendance about their recent travel to the city.”

What about the rest of Asia?

While there will undoubtedly be more cases transmitted by travellers from China in the region – and worldwide – there is no reason to cancel.

Should you choose to do so, you have no entitlement for a refund from your travel organiser or from travel insurance.

But what if the Foreign Office were to warn against travel to anywhere in the region?

In that highly unlikely event, travellers who are on a package holiday organised by a British firm should be able to cancel without penalty for a full refund.

Airlines are not obliged to refund tickets whatever the Foreign Office advice, but in the past they have offered some flexibility. 

A spokesperson for the Association of British Insurers said: “Travel insurance may cover some out-of-pocket losses, and also help you to leave the area if a warning to return back to the UK comes into effect while you are there, if you are unable to get assistance from any other source.”

Conversely, travelling to an area against the advice of the Foreign Office will invalidate most insurance policies.

What if I feel ill when I return?

Dr Phin says: “Travellers should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan.”

Before you turn up at your GP’s surgery or A&E, though, call ahead to tell them about your symptoms and recent travels.

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