Initial Cluster of Novel Coronavirus (2019-nCoV) Infections in Wuhan, China Is Consistent with Substantial Human-to-Human Transmission

Abstract

Reanalysis of the epidemic curve from the initial cluster of cases with novel coronavirus (2019-nCoV) in December 2019 indicates substantial human-to-human transmission. It is possible that the common exposure history at a seafood market in Wuhan originated from the human-to-human transmission events within the market, and the early, strong emphasis that market exposure indicated animal-to-human transmission was potentially the result of observer bias. To support the hypothesis of zoonotic origin of 2019-nCoV stemming from the Huanan seafood market, the index case should have had exposure history related to the market and the virus should have been identified from animals sold at the market. As these requirements remain unmet, zoonotic spillover at the market must not be overemphasized.

Keywords: cluster; epidemiology; exposure; statistical inference; transmissibility; zoonosis.

Figure 1

The epidemic curve and estimated reproduction number by generation. Generation 1 represents the index case. (A) The epidemic curve by date of illness onset [1]. A constant 8 days, counted from 10 December 2019, was used to define the generation-dependent number of cases. (B) The expected number of cases in each subsequent generation was assumed to follow a Poisson distribution, and the 95% confidence intervals of the reproduction number (whiskers) were derived from the profile likelihood.