The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passengers Data on Evacuation Flights
by
Hiroshi Nishiura 1,2,*
, Tetsuro Kobayashi 1, Yichi Yang 1, Katsuma Hayashi 1, Takeshi Miyama 3, Ryo Kinoshita 1, Natalie M. Linton 1, Sung-mok Jung 1, Baoyin Yuan 1, Ayako Suzuki 1 and Andrei R. Akhmetzhanov 1
Hiroshi Nishiura 1,2,*, Tetsuro Kobayashi 1, Yichi Yang 1, Katsuma Hayashi 1, Takeshi Miyama 3, Ryo Kinoshita 1, Natalie M. Linton 1, Sung-mok Jung 1, Baoyin Yuan 1, Ayako Suzuki 1 and Andrei R. Akhmetzhanov 1
1
Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo-shi, Hokkaido 060-8638, Japan
2
Core Research for Evolutionary Science and Technology, Japan Science and Technology Agency, Honcho 4-1-8, Kawaguchi, Saitama 332-0012, Japan
3
Osaka Institute of Public Health, Nakamichi 1-3-69, Higashinari, Osaka 537-0025, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(2), 419; https://doi.org/10.3390/jcm9020419
Received: 2 February 2020 / Accepted: 3 February 2020 / Published: 4 February 2020
(This article belongs to the Special Issue Real Time Clinical and Epidemiological Investigations on Novel Coronavirus)
From 29 to 31 January 2020, a total of 565 Japanese citizens were evacuated from Wuhan, China on three chartered flights. All passengers were screened upon arrival in Japan for symptoms consistent with novel coronavirus (2019-nCoV) infection and tested for presence of the virus. Assuming that the mean detection window of the virus can be informed by the mean serial interval (estimated at 7.5 days), the ascertainment rate of infection was estimated at 9.2% (95% confidence interval: 5.0, 20.0). This indicates that the incidence of infection in Wuhan can be estimated at 20,767 infected individuals, including those with asymptomatic and mildly symptomatic infections. The infection fatality risk (IFR)—the actual risk of death among all infected individuals—is therefore 0.3% to 0.6%, which may be comparable to Asian influenza pandemic of 1957–1958.
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Keywords:
epidemiology; ascertainment; diagnosis; travel; importation; statistical inference
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
MDPI and ACS Style
Nishiura, H.; Kobayashi, T.; Yang, Y.; Hayashi, K.; Miyama, T.; Kinoshita, R.; Linton, N.M.; Jung, S.-M.; Yuan, B.; Suzuki, A.; Akhmetzhanov, A.R. The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passengers Data on Evacuation Flights. J. Clin. Med. 2020, 9, 419.
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