Coronavirus could attack immune system like HIV by targeting protective cells, warn scientists


  • Researchers in China and the US find that the virus that causes Covid-19 can destroy the T cells that are supposed to protect the body from harmful invaders
  • One doctor said concern is growing in medical circles that effect could be similar to HIV

The study suggests coronavirus can infect T cells. Photo: Shutterstock


The coronavirus that causes Covid-19 could kill the powerful immune cells that are supposed to kill the virus instead, scientists have warned.

The surprise discovery, made by a team of researchers from Shanghai and New York, coincided with frontline doctors’ observation that Covid-19 could attack the human immune system and cause damages similar to that found in HIV patients.

Lu Lu, from Fudan University in Shanghai, and Jang Shibo, from the New York Blood Centre, joined the living virus, which is officially known as Sars-CoV-2, on laboratory-grown T lymphocyte cell lines.

T lymphocytes, also known as T cells, play a central role in identifying and eliminating alien invaders in the body.

They do this by capturing a cell infected by a virus, bore a hole in its membrane and inject toxic chemicals into the cell. These chemicals then kill both the virus and infected cell and tear them to pieces.

To the surprise of the scientists, the T cell became a prey to the coronavirus in their experiment. They found a unique structure in the virus’s spike protein that appeared to have triggered the fusion of a viral envelope and cell membrane when they came into contact.

The virus’s genes then entered the T cell and took it hostage, disabling its function of protecting humans.

The researchers did the same experiment with severe acute respiratory syndrome, or Sars, another coronavirus, and found that the Sars virus did not have the ability to infect T cells.

The reason, they suspected, was the lack of a membrane fusion function. Sars, which killed hundreds in a 2003 outbreak, can only infect cells carrying a specific receptor protein known as ACE2, and this protein has an extremely low presence in T cells.

Further investigations to the coronavirus infection on primary T cells would evoke “new ideas about pathogenic mechanisms and therapeutic interventions,” the researchers said in a paper published in the peer-reviewed journal Cellular & Molecular Immunology this week.

T-cells attack harmful cells, such as cancers. Photo: Shutterstock

A doctor, who works in a public hospital treating Covid-19 patients in Beijing, said the discovery added another piece of evidence to a growing concern in medical circles that the coronavirus could sometimes behave like some of the most notorious viruses that directly attack the human immune system.“More and more people compare it to HIV,” said the doctor who requested not to be named due to the sensitivity of the issue.

In February, Chen Yongwen and his colleagues at the PLA’s Institute of Immunology released a clinical report warning that the number of T cells could drop significantly in Covid-19 patients, especially when they were elderly or required treatment in intensive care units. The lower the T cell count, the higher the risk of death.This observation was later confirmed by autopsy examinations on more than 20 patients, whose immune systems were almost completely destroyed, according to mainland media reports.Doctors who had seen the bodies said the damage to the internal organs was similar to a combination of Sars and Aids.The gene behind the fusion function in Sars-CoV-2 was not found in other coronaviruses in human or animals.But some deadly human viruses such as Aids and Ebola have similar sequences, prompting speculation that the novel coronavirus might have been spreading quietly in human societies for a long time before causing this pandemic. But there was one major difference between Sars-CoV-2 and HIV, according to the new study.

HIV can replicate in the T cells and turn them into factories to generate more copies to infect other cells.But Lu and Jiang did not observe any growth of the coronavirus after it entered the T-cells, suggesting that the virus and T-cells might end up dying together. The study gives rise to some new questions. For instance, the coronavirus can exist for weeks on some patients without causing any symptoms. How it interacted with the T cells in these patients remained unclear.Some critically ill patients also experienced cytokine storms, where the immune system overreacts and attacks healthy cells. But why and how the coronavirus triggers that remains poorly understood.


Ho Chi Minh city “live slowly” for 2 weeks

Afternoon 24.3 Steering Committee for prevention of disease Covid-19 held an emergency meeting under the chairmanship of Mr. Nguyen Thien Nhan, member of the Politburo, the Party Secretary of the city .HCM.

A pub (Tan Binh) know about the direction of the HCMC People's Committee should afternoon clearing discontinued business 24.3 (Photo: Independence)
A pub (Tan Binh) know about the direction of the HCMC People’s Committee should afternoon clearing discontinued business 24.3 (Photo: Independence)

Report at the meeting, Nguyen Tan Binh, Director of City Health Department , said that preventive war Covid-19 has entered into phase 2 with the European center. Experts predicted that Vietnam will have thousands of cancers.

Three risk of infection

Since the outbreak, there were 350,000 people on entry into Vietnam, including about 100,000 from the United States and Europe. Those who have gone through many local, exposed hundreds of Vietnam so when detecting an infected channel, looking for contacts with the risk of infection will be very hard. Three days, the health sector continuously detects positive cases across the country, including more than 14 days incubation shifts as case patients (BN) 100th in District 8.
Director of the Department of Health said the biggest risk was translated from the Tan Son Nhat airport, Noi Bai and domestic flights from the service area of the city. The second is the risk of infection in the community by many students and tourists to Vietnam before the forced isolation focus went to many places. The third source of transmission of the staff in direct contact with people from endemic areas, even with protective gear.
To prevent the risk of infection in the community, Mr. Binh suggested stop all vehicles, including buses, for taxis do not use air conditioning, always open the glass door open and the driver wearing a mask and hygiene after each passenger car.

The store is not really necessary, should be closed, the bars, the pub does not open the freezer, service personnel must wear a mask and regularly cleaning the table after your use, tourists do not practice Group loyalty than 10 people, keep a safe distance of 2 m, limited assembly. The hostel reception to quarantine people to relieve all students, students also stayed to limited sources of infection.

A bad begining makes a good ending

Mr. Nguyen Thien Nhan, member of the Politburo and Secretary of the HCM City Party, analyze some prevention lessons of Japan, Korea and the Steering Committee recommended prevention services Covid-19 of HCM research, deployment.
In particular, definitive stop source services from outside, have to handle the risk of infection when getting children of Vietnam from foreign countries, people wear masks when going out into the street, closed operations east people … Particularly religious activities, he’s religious Committee recommended the Department of Foreign Affairs to work with religious leaders in the city to respect the discussion.
Nhan stressed that the country had two weeks to determine whether the fight against Covid-19 and “if miss this golden opportunity and he can not be the fault history.” Therefore, the city must make drastic preventive measures, not to exceed 150 infected people to contribute to control of the country’s cases under 500 ca.
“As the number of cases grows, there are thousands of the new hospital site nor resolved well”, he’s worried.
Party Secretary of the proposal in the next 2 weeks, the people trying to “be harder to later better off”, if still living as normal, then the country will face difficulties. “Hair is not very long away from the cut. Do not buy shoes, clothes at home to keep themselves safe, “he’s shared and require TP to discuss technical solutions to reduce the people out of the way voluntarily to minimize the risk of infection in the community . In addition, the city needs to increase surveillance measures, detection and timely isolation cases roadblock close contact to squelch.
The same day, the MPC pause directing the activities of entertainment, restaurants, beer club; business establishments catering service with capacity of 30 persons or more; billiards club, gym, beauty establishments, hair salons, barber locality to end on 31.3.
He’s said the city will not stop all services and the health sector proposed guidelines styled restaurant is open, if the restaurant does not serve directly, but sellers are not brought there …


Arizona man dies, wife ill after taking drug touted as virus treatment: “Trump kept saying it was basically pretty much a cure”


A Phoenix-area man has died and his wife was in critical condition after the couple took chloroquine phosphate, CBS affiliate KPHO reported. The additive used to clean fish tanks that is also found in an anti-malaria medication that’s been touted by President Donald Trump as a treatment for COVID-19.

Banner Health said Monday that the couple in their 60s got sick within half an hour of ingesting the additive. The man couldn’t be resuscitated when he arrived at a hospital, but the woman was able to throw up much of the chemical, Banner said.


“I saw it sitting on the back shelf and thought, ‘Hey, isn’t that the stuff they’re talking about on TV?'” the woman told NBC.

“Trump kept saying it was basically pretty much a cure,” she said, adding her advice for people would be, “Don’t take anything. Don’t believe anything. Don’t believe anything that the president says and his people … call your doctor.”

In light of the coronavirus pandemic, Banner Health is warning everyone to avoid self-medicating.


“Given the uncertainty around COVID-19, we understand that people are trying to find new ways to prevent or treat this virus, but self-medicating is not the way to do so,” said Dr. Daniel Brooks, Banner Poison and Drug Information Center medical director. “The last thing that we want right now is to inundate our emergency departments with patients who believe they found a vague and risky solution that could potentially jeopardize their health.”


At a news conference last week, Mr. Trump falsely stated  that the Food and Drug Administration had just approved the use of an anti-malaria medication called chloroquine to treat patients infected with coronavirus. Even after the FDA chief clarified that the drug still needs to be tested for that use, Mr. Trump overstated the drug’s potential upside in containing the virus.

On Friday, Dr. Anthony Fauci, the nation’s top infectious disease expert, called Mr. Trump’s assertions about hydroxychloroquine “anecdotal” and said there is no evidence that it is effective for COVID-19 patients. But the next day, Mr. Trump was still touting the drug on social media.

Chloroquine is obtained by prescription, and Banner Health is now urging medical providers against prescribing it to people who aren’t hospitalized. There are reports of people stockpiling the drug, and people with lupus, who need a version of the medication on a regular basis, say they are struggling to fill their long-standing prescriptions.

The difference between the fish tank cleaning additive that the couple took and the drug used to treat malaria is the way they are formulated.

The World Health Organization has launched a global clinical trial to study the potential effectiveness of a number of drugs to treat coronavirus, including hydroxychloroquine and chloroquine.

But Science magazine reports, “In guidance published on Friday, the US Society of Critical Care Medicine said that ‘there is insufficient evidence to issue a recommendation on the use of chloroquine or hydroxychloroquine in critically ill adults with COVID-19.'” It adds that hydroxychloroquine, in particular, can have side effects, in some cases affecting the heart, which could be a serious concern for vulnerable COVID-19 patients.

The man’s death came as the number of COVID-19 cases in Arizona spiked more than 50% in one day, from 152 on Sunday to 235 on Monday, according to the state Health Department.

Pima County reported its first coronavirus death: A woman in her 50s with an underlying health condition.

It marked the third COVID-19 death in Arizona. Two men, one in his 70s and one in his 50s, died previously from the disease. Both had underlying conditions.

Gov. Doug Ducey said he’s working on an “economic protection plan” to help people struggling with the loss of income, but he did not outline details. He said it will be released soon.

Ducey also answered questions about the role of the National Guard in Arizona, which the governor called upon last week. Ducey said the Guard is now involved only in shoring up the supply chain for grocery stores and food banks, but “they’re going to be flexible.”

He said he’d deploy the Guard as needed but sidestepped a question about whether the soldiers would be involved in law enforcement.

About 100 National Guard soldiers received briefings Monday from medical, legal, public affairs and others staff, Major Aaron Thacker said. All were given a basic medical screening to check for a fever, he said.

“They’re preparing for the mission,” Thacker said. “I’m anticipating in the next couple of days you’re going to see a large volume of guardsmen crossing across the state in order to support the needs of the food banks.”

The Guard expects to mobilize more than 700 people this week, but it wasn’t clear exactly when they would hit the streets, and many more could be expected.

Ducey anticipates the response to the virus will include up to 5,500 Arizona National Guard personnel, he wrote Friday in a letter to U.S. Defense Secretary Mark Esper requesting federal money and additional authority. That would represent the majority of the Guard’s 7,600 members. Ducey said the state needs immediate help in several areas including planning, consulting, logistics and supplies, testing and personnel movement.

People have tested positive in 11 of Arizona’s 15 counties, including 139 cases in Maricopa County, the state’s most populous.

For most people, the virus causes only mild or moderate symptoms, such as fever and cough. For some, older adults and people with health problems, it can cause more severe illness, including pneumonia.

The vast majority of people recover from the virus.


Dr. Cara Christ, Arizona’s top health official, said the state is preparing for surging demand on hospitals. She said possibilities include building three field hospitals and re-opening shuttered medical centers, and using a former basketball arena to house patients leaving the hospital but not yet well enough to go home.

Ducey issued an executive order outlining “essential services” that can continue to operate if the state or any local government issues an order for people to stay home. The essential services include health care, food suppliers, gas stations, banks, hardware stores, laundromats, home repair and infrastructure.

Ducey said he’s preparing for the future but there’s no need currently for a stay-at-home order like those issued in several U.S. cities and states, including California and New York.

“Arizona is not there yet,” Ducey said. “We’re not at the same stage as other states.”



Scientists Identify 69 Drugs to Test Against the Coronavirus

Two dozen of the medicines are already under investigation. Also on the list: chloroquine, a drug used to treat malaria.


A worker checking the production of chloroquine phosphate in China last month. There has been “anecdotal evidence” that chloroquine, a drug used to treat malaria, might work against the coronavirus.


Nearly 70 drugs and experimental compounds may be effective in treating the coronavirus, a team of researchers reported on Sunday night.

Some of the medications are already used to treat other diseases, and repurposing them to treat Covid-19, the illness caused by the coronavirus, may be faster than trying to invent a new antiviral from scratch, the scientists said.

The list of drug candidates appeared in a study published on the web site bioRxiv. The researchers have submitted the paper to a journal for publication.

To come up with the list, hundreds of researchers embarked on an unusual study of the genes of the coronavirus, also called SARS-CoV-2.
To infect a lung cell, the coronavirus must insert its genes, co-opting the cell’s own genetic machinery. The cell begins to produce viral proteins, which are used to produce millions of new viruses.

Each of those viral proteins must be able to latch onto the necessary human proteins for the process to work.
In the new study, the scientists investigated 26 of the coronavirus’s 29 genes, which direct production of the viral proteins. The researchers found 332 human proteins targeted by the coronavirus.

Some viral proteins seemed to target just one human protein; other viral proteins are capable of targeting a dozen human cellular proteins.

The researchers sought drugs that also latch onto the human proteins that the coronavirus seems to need to enter and replicate in human cells. The team eventually identified 24 drugs approved by the Food and Drug Administration to treat such seemingly unrelated diseases as cancer, Parkinson’s disease and hypertension.
On the list were such unexpected candidates as haloperidol, used to treat schizophrenia, and metformin, taken by people with Type 2 diabetes.

The investigators also found candidates among compounds that are now in clinical trials or that are the subject of early research. Intriguingly, some of the possible treatments are drugs used to attack parasites.

And the list includes antibiotics that kill bacteria by gumming up the cellular machinery they use to build proteins. But some of those drugs also attach to human proteins. The new study raises the possibility that this side effect might turn out to be an antiviral treatment.

One drug on the list, chloroquine, kills the single-celled parasite that causes malaria. Scientists have long known that it can also attach to a human cellular protein called the sigma-1 receptor. And that receptor is also the target of the virus.

Chloroquine has been much in the news this past week, thanks to speculation about its use against the coronavirus — some of which was repeated by President Trump at a news briefing at the White House on Friday.

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, followed the president’s remarks with a warning that there was only “anecdotal evidence” that chloroquine might work.
Only well-run trials could establish whether chloroquine was safe and effective against the coronavirus, Dr. Fauci said.

On Wednesday, the World Health Organization announced it would begin a trial on chloroquine, among other drugs.

And on Sunday, Gov. Andrew M. Cuomo of New York announced that the state had obtained large amount of chloroquine and the antibiotic azithromycin to start its own drug trial.

Nevan Krogan, a biologist at the University of California, San Francisco, who led the new study, warned that chloroquine might have many toxic side effects, because the drug appears to target many human cellular proteins.

“You need to be careful,” he said. “We need more data at every level.”

Dr. Krogan’s collaborators at the Icahn School of Medicine at Mount Sinai in New York and the Pasteur Institute in Paris have started testing 22 of the other compounds on the list against live coronavirus grown in their laboratories.

On Sunday night, they were still awaiting the first results.


How AI Helped Predict the Coronavirus Outbreak Before It Happened

Coronavirus has been all over the news for the last couple weeks. A dedicated hospital sprang up in just eight days, the stock market took a hit, Chinese New Year celebrations were spoiled, and travel restrictions are in effect.

But let’s rewind a bit; some crucial events took place before we got to this point.

A little under two weeks before the World Health Organization (WHO) alerted the public of the coronavirus outbreak, a Canadian artificial intelligence company was already sounding the alarm. BlueDot uses AI-powered algorithms to analyze information from a multitude of sources to identify disease outbreaks and forecast how they may spread. On December 31st 2019, the company sent out a warning to its customers to avoid Wuhan, where the virus originated. The WHO didn’t send out a similar public notice until January 9th, 2020.

The story of BlueDot’s early warning is the latest example of how AI can improve our identification of and response to new virus outbreaks.

Predictions Are Bad News

Global pandemic or relatively minor scare? The jury is still out on the coronavirus. However, the math points to signs that the worst is yet to come.

Scientists are still working to determine how infectious the virus is. Initial analysis suggests it may be somewhere between influenza and polio on the virus reproduction number scale, which indicates how many new cases one case leads to.

UK and US-based researchers have published a preliminary paper estimating that the confirmed infected people in Wuhan only represent five percent of those who are actually infected. If the models are correct, 190,000 people in Wuhan will be infected by now, major Chinese cities are on the cusp of large-scale outbreaks, and the virus will continue to spread to other countries.

Finding the Start

The spread of a given virus is partly linked to how long it remains undetected. Identifying a new virus is the first step towards mobilizing a response and, in time, creating a vaccine. Warning at-risk populations as quickly as possible also helps with limiting the spread.

These are among the reasons why BlueDot’s achievement is important in and of itself. Furthermore, it illustrates how AIs can sift through vast troves of data to identify ongoing virus outbreaks.

BlueDot uses natural language processing and machine learning to scour a variety of information sources, including chomping through 100,000 news reports in 65 languages a day. Data is compared with flight records to help predict virus outbreak patterns. Once the automated data sifting is completed, epidemiologists check that the findings make sense from a scientific standpoint, and reports are sent to BlueDot’s customers, which include governments, businesses, and public health organizations.

AI for Virus Detection and Prevention

Other companies, such as Metabiota, are also using data-driven approaches to track the spread of the likes of the coronavirus.

Researchers have trained neural networks to predict the spread of infectious diseases in real time. Others are using AI algorithms to identify how preventive measures can have the greatest effect. AI is also being used to create new drugs, which we may well see repeated for the coronavirus.

If the work of scientists Barbara Han and David Redding comes to fruition, AI and machine learning may even help us predict where virus outbreaks are likely to strike – before they do.

The Uncertainty Factor

One of AI’s core strengths when working on identifying and limiting the effects of virus outbreaks is its incredibly insistent nature. AIs never tire, can sift through enormous amounts of data, and identify possible correlations and causations that humans can’t.

However, there are limits to AI’s ability to both identify virus outbreaks and predict how they will spread. Perhaps the best-known example comes from the neighboring field of big data analytics. At its launch, Google Flu Trends was heralded as a great leap forward in relation to identifying and estimating the spread of the flu—until it underestimated the 2013 flu season by a whopping 140 percent and was quietly put to rest.

Poor data quality was identified as one of the main reasons Google Flu Trends failed. Unreliable or faulty data can wreak havoc on the prediction power of AIs.

In our increasingly interconnected world, tracking the movements of potentially infected individuals (by car, trains, buses, or planes) is just one vector surrounded by a lot of uncertainty.

The fact that BlueDot was able to correctly identify the coronavirus, in part due to its AI technology, illustrates that smart computer systems can be incredibly useful in helping us navigate these uncertainties.

Importantly, though, this isn’t the same as AI being at a point where it unerringly does so on its own—which is why BlueDot employs human experts to validate the AI’s findings.


How has coronavirus affected China’s and the world’s economy compared to SARS outbreak?

The deadly coronavirus, which was first reported in the Chinese city of Wuhan in December, is sending ripples across the global business community as numerous firms close their doors and employees stay home in an effort to contain the outbreak from spreading.

As the number of people infected and the death toll continue to rise, multinational businesses from supply chains to automakers to tourism and the film industry are beginning to feel the impact.

A man wearing a face mask waits for his food at an empty restaurant in Beijing.

Airlines have canceled 25,000 flights to and within China after ticket sales collapsed, according to travel data provider OAG. General Motors Co. and other automakers are telling employees to limit travel to China, their biggest market.

The Chinese gambling enclave of Macau announced on Tuesday that it was closing casinos for two weeks as a precaution. The territory is a big moneymaker for U.S. casino operators Wynn Resorts Ltd. and Las Vegas Sands Corp.

Hyundai Motors, meanwhile, said it is suspending production in South Korea due to disruptions in the supply of parts as a result of the outbreak. It said it is seeking alternative suppliers in other regions.

The coronavirus has drawn comparisons to the Severe Acute Respiratory Syndrome (SARS) outbreak of 2002-2003. SARS emerged in the southern Chinese province of Guangdong before spreading around the world, infecting more than 8,000 people and killing nearly 800 in 26 countries.

A woman runs past an Apple logo colored red in Beijing, China.

At the time, China had just gained access to global markets, having only recently joined the World Trade Organization (WTO). The country had an abundant supply of low-wage workers who made low-cost goods like T-shirts and shoes for customers around the world.

Though the SARS outbreak did have some effect on the global economy, growth rebounded relatively quickly, and the overall impact was limited.

But today, international companies increasingly rely on China, the world’s No. 2 economy, as a major buyer of food, cars, movie tickets, and other goods. That reliance has left companies more exposed than ever to the pain of its latest abrupt slump.

Forecasters predict that even if China recovers quickly, the worldwide impact could be bigger than SARS. That is because China now accounts for more than 16 percent of global economic activity – more than triple its share in 2003, according to the International Monetary Fund.

Many manufacturers have yet to feel the impact because factories closed for up to three weeks ahead of the Lunar New Year holiday. But forecasters say delays in reopening will quickly depress demand for imported components and materials such as copper and steel.



Hong Kong confirms first death, a 39-year-old man

  • City suffers first fatality related to deadly virus originating in Wuhan, the second outside mainland China
  • Coronavirus patient, from Whampoa Garden, succumbs to heart failure on Tuesday morning
A patient at Princess Margaret Hospital has become the first in Hong Kong to succumb to an illness related to the coronavirus. Photo: Bloomberg
A patient at Princess Margaret Hospital has become the first in Hong Kong to succumb to an illness related to the coronavirus. Photo: Bloomberg

Hong Kong has confirmed two more cases of the deadly new coronavirus, just hours after a 39-year-old man became the first to die in the city after being infected.

Health officials said there was no obvious source of infection for the two most recent cases but it was suspected it had been transmitted locally. It took the total number of cases in the city to 17.

Dr Chuang Shuk-kwan, head of the Centre for Health Protection’s communicable disease branch, said so far four confirmed cases presented “no obvious source of infection”, and warned of the possibility of outbreaks in the community.

“It is highly probably the four cases were infected locally, so there could be invisible chains of infection happening within communities,” Chuang said. “We do not rule out a large spread [of the virus] in the future.”

She urged people to maintain good personal hygiene and wash their hands frequently, and said some reports had shown the virus could linger on door handles.

The Department of Health said neither patient had any recent travel history to mainland China nor family members who had crossed the border.

The first of the new cases concerned a woman, 64, who went to work at a clothing store in Jordan, Kowloon while displaying symptoms on January 23.

The department said they were not sure how many people had been in contact with the female patient, as she was in a deteriorating state and on a ventilator.

The other, a 60 year-old male retiree, visited four private clinics before he was taken to hospital and later tested positive for the virus.

Earlier on Tuesday morning, a man being treated for the virus at Princess Margaret Hospital in Kwai Chung, died after his condition deteriorated. He had suffered sudden heart failure, according to medical sources.

The Whampoa Garden resident was previously identified as Hong Kong’s 13th confirmed case of the novel coronavirus originating in Wuhan. His death is the second fatality linked with the outbreak that has been reported outside mainland China.

He had been to Wuhan, the provincial capital of Hubei, on January 21 and returned to Hong Kong two days later via the Guangzhou-Shenzhen-Hong Kong Express Rail Link, before developing a fever on January 31.

The man was admitted to Queen Elizabeth Hospital in Yau Ma Tei on the same day, where he was confirmed to be infected before his transfer to an isolation ward at Princess Margaret Hospital.

He had underlying health issues, according to information previously disclosed by the Centre for Health Protection.
The deceased man had lived in block 1, site 11 of Whampoa Garden in Hung Hom with his mother, the government had revealed earlier.

She was confirmed on February 2 as Hong Kong’s 15th case, but did not have a recent history of travel. The 72-year-old was believed to have caught the virus from close contact with her son, health officials said earlier.

The Hospital Authority confirmed at about 10.30am on Tuesday the man had died in Princess Margaret Hospital after his condition deteriorated.

Health authorities have confirmed 15 cases of the coronavirus in Hong Kong. More than 20,600 people have been been infected across the world with the death toll in its hundreds.