The authors report on the findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong, after visiting Wuhan, plus an additional family member who did not travel to Wuhan. Of six family members who travelled to Wuhan, five were identified as having been infected with the 2019 novel coronavirus (2019-nCoV). In addition, one family member, who did not travel to Wuhan, became infected after several days of contact with four of the family members. None of the family members had contact with Wuhan markets or animals, although two had visited a Wuhan hospital. Five members, aged 36-66 years, presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3-6 days following exposure. They presented to a hospital 6-10 days following symptom onset. They, and one asymptomatic child (aged 10 years), had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia and increased C-reactive protein and lactate dehydrogenase levels. Five of the patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface spike protein of the 2019-nCoV. Phylogenetics demonstrated that this was a novel coronavirus and is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. Therefore these findings are consistent with person-to-person transmission of 2019-nCoV.
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