Coronaviurs: An Update

I initially wrote this blog on January 21, 2020. At that time we had just learned that the Centers for Disease Control (CDC) had announced that they would be checking passengers arriving to three airports in the US from Wuhan, China for symptoms of this new virus that has caused several infections and a couple of deaths in China.

Since that time we have learned a lot about this novel coronavirus.

According to the WHO, there are 60,329 cases of coronaviurs worldwide as of 2/13/20.

So what do we know about this virus at this point?

Coronaviruses in general can infect humans and animals. The novel coronaviurs now has an official name: 2019-nCoV. This virus has now been confirmed to be the cause of upper respiratory infections that started in Wuhan, a city in the Hubei Province of China.

This virus has rapidly spread, resulting in an epidemic throughout China, with cases reported globally including in the US.

We are learning more about this virus everyday and our understanding of this novel coronavirus is evolving.

Where is the virus now?

The first confirmed cases were from Wuhan, a city in the Hubei province of China in late 2019. Since that time, there have been more than 40,000 confirmed cases in China. The count is rising daily. The Chinese have built a hospital specifically to deal with the viral infection.

More and more cases have also been reported globally. These include Asia and Europe, as well as Australia, the United States and Canada. It is important to note that these are mainly among travelers returning from China.

How does the virus spread? How do human infections occur?

Our understanding of how this virus spreads is incomplete.

Initial investigations in Wuhan, China identified an initial association with a seafood market where most of those infected had worked or visited. This market was known to sell live rabbits, snakes and other animals.

This market has been closed for disinfection.

Despite aggressive measures by the Chinese government to contain this virus, the outbreak spread through China and then cases were identified globally.

Most recent cases had no contact with this market, and cases have been identified among health care workers and other contacts of patients with 2019-nCoV infection.

Human-to-human transmission has been confirmed in China and other countries including the US.

Whether asymptomatic people with known or high risk for exposure to 2019-nCoV can transmit the virus to others remains unknown at this time.

Incubation period for the virus

The period between exposure and the appearance of the first symptoms of 2019-nCoV is thought to be within 14 days.

Clinically, a lung infection (pneumonia) appears to be the most frequent manifestation of infection, characterized by fever, cough, shortness of breath, and infiltrates on chest imaging.

It is unknown how many of those infected have no symptoms or just a mild infection. We do know that about 20 percent of patients have been very sick to this viral infection with a mortality rate that is less than 2 percent of all reported cases.

Most of those who succumbed to the disease had other medical problems.

Diagnosis

Early recognition and immediate isolation are of paramount importance to help minimize the spread of the virus till we learn more about it.

Treatment

There is no known cure for this viral infection. Treatment of those known to be infected includes ensuring appropriate infection control and supportive care.

Clinical guidance can be found on the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) websites.

Prevention

On January 30, 2020, the WHO declared the 2019-nCoV outbreak a international public health emergency.

In China, health officials announced travel restrictions within and a halt of air and rail traffic out of Wuhan and other surrounding areas.

In the United States, the CDC recommends that all nonessential travel to China be avoided.

US citizens returning from the Hubei Province are undergoing a 14-day quarantine, while those returning from other parts of China are undergoing screening for signs of illness on arrival as long as there is no known high-risk exposure.

Foreign nationals who have been in China in the prior 14 days are temporarily suspended from entry to the US. This is situation is evolving.

Clearly we have much to learn about this novel virus. There are scientists working on a vaccine, but it will take some time before this vaccine is available. While there is some panic over how quickly this virus has spread globally, it is reassuring to know that the case fatality rate is very low. We still have much to learn.

Please remember that medical information provided by us must be considered an educational service only. This blog should not be relied upon as medical judgement and does not replace your physician’s independent judgement. This is NOT medical advice. Please seek the advice of your physician.