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May 20: The novel coronavirus is behaving differently in patients in northeast China who have contracted it recently compared with early cases, indicating it is changing as it spreads, a prominent doctor said.

China, which has largely brought the virus under control, has found new clusters of infections in the northeastern border provinces of Jilin and Heilongjiang in recent weeks, raising concern about a second wave.

Qiu Haibo, an expert in critical care medicine who is part of a National Health Commission expert group, said the incubation period of the virus in patients in the northeast was longer than that of patients in Wuhan, the central city, where the virus emerged late last year.

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"This causes a problem, as they don't have any symptoms. So when they gather with their families they don't care about this issue and we see family cluster infections," Qiu told state broadcaster CCTV in a programme broadcast late on Tuesday.

Patients in the northeastern clusters were also carrying the virus for longer than earlier cases in Wuhan, and they were taking longer to recover, as defined by a negative nucleic acid test, he said.

Patients in the northeast also rarely exhibited fever and tended to suffer damage to the lungs rather than across multiple organs, he said.

He said the virus found in the northeastern clusters was probably imported from abroad, which could account for the differences.

He did not say where he though they might have come from but both Jilin and Heilongjiang border Russia.

China reported five new coronavirus cases on Wednesday, down from six a day earlier.

Four of the new cases were local transmissions and one was imported by a traveller coming from abroad, the commission said in a statement, compared with three imported cases reported the previous day.

China's total number of coronavirus infections stands at 82,965, while the death toll 4,634. 

Jan 30: The death toll rose to 170 in the new virus outbreak in China on Thursday as foreign evacuees from the worst-hit region begin returning home under close observation and world health officials expressed “great concern” that the disease is starting to spread between people outside of China.

Thursday’s figures cover the previous 24 hours and represent an increase of 38 deaths and 1,737 cases for a total of 7,711. Of the new deaths, 37 were in the epicenter of the outbreak in Hubei province and one in the southwestern province of Sichuan.

The news comes as the 195 Americans evacuated from Wuhan, the Hubei province city of 11 million where the outbreak originated, are undergoing three days of testing and monitoring at a Southern California military base to make sure they do not show signs of the virus.

A group of 210 Japanese evacuees from Wuhan landed Thursday at Tokyo’s Haneda airport on a second government chartered flight, according to the foreign ministry. Reports said nine of those aboard the flight showed signs of cough and fever. Three of the 206 Japanese who returned on Wednesday tested positive for the new coronavirus, Prime Minister Shinzo Abe said during a parliamentary session. Two of them showed no symptoms of the disease.

France, New Zealand, Australia and other countries are also pulling out their citizens or making plans to do so.

The World Health Organization emergencies chief said the few cases of human-to-human spread of the virus outside China — in Japan, Germany, Canada and Vietnam — were of “great concern” and were part of the reason the U.N. health agency’s director-general was reconvening a committee of experts on Thursday to assess whether the outbreak should be declared a global emergency.

The new virus has now infected more people in China than were sickened there during the 2002-2003 SARS outbreak.

Dr. Michael Ryan spoke at a news conference in Geneva on Wednesday after returning from a trip to Beijing to meet with Chinese President Xi Jinping and other senior government leaders. He said China was taking “extraordinary measures in the face of an extraordinary challenge” posed by the outbreak.

To date, about 99% of the cases are in China. Ryan estimated the death rate of the new virus at 2%, but said the figure was very preliminary. With fluctuating numbers of cases and deaths, scientists are only able to produce a rough estimate of the fatality rate and it’s likely many milder cases of the virus are being missed.

In comparison, the SARS virus killed about 10% of people who caught it. The new virus is from the coronavirus family, which includes those that can cause the common cold as well as more serious illnesses such as SARS and MERS.

Scientists say there are many questions to be answered about the new virus, including just how easily it spreads and how severe it is.

In a report published Wednesday, Chinese researchers suggested that person-to-person spread among close contacts occurred as early as mid-December.

“Considerable efforts” will be needed to control the spread if this ratio holds up elsewhere, researchers wrote in the report, published in the New England Journal of Medicine.

More than half of the cases in which symptoms began before Jan. 1 were tied to a seafood market, but only 8% of cases after that have been, researchers found. They reported the average incubation period was five days.