×

Novel Corona Virus Infection from China- Vigilance and not panic is the Mantra!

Posted By

IMAlive, Posted on January 30th, 2020

Novel Corona Virus Infection from China By Dr  Abdul Ghafur

Author: Dr. Abdul Ghafur, Consultant and Adjunct Professor in Infectious Diseases, Apollo Hospital, Chennai. @draghafur

On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown cause, detected in Wuhan City of China. A novel coronavirus (2019-nCoV) was identified as the causative agent by Chinese authorities on 7 January.  Most of the reported early cases in Wuhan worked at or were frequent visitors to a  Seafood Wholesale Market. As per the latest statistics, more than 7500 cases of nCoV have been detected and more than 170 patients have died. More than 70 cases are now reported outside China.

Coronaviruses are one of the largest RNA viruses.  The name "coronavirus" originates from the Latin word corona, meaning crown or halo, resembling the halo/ring surrounding the sun and refers to the characteristic appearance of virions under electron microscopy. Coronaviruses were first described in the 1960s from the nasal cavities of patients with the common cold. Coronaviruses are believed to cause a significant percentage of all common colds, throat congestion and cough in human adults and children.

Coronaviruses usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. Most people get infected with these viruses at some point in their lives. These illnesses usually only last for a short amount of time. Symptoms may include running nose, throat pain, headache, cough, fever, a general feeling of being unwell, though coronavirus can sometimes cause lower-respiratory tract illnesses, such as pneumonia or bronchitis. Severe infection can cause pneumonia followed by respiratory distress in the form of acute respiratory distress syndrome(ARDS) and needs hospitalization and intensive care. Mechanical ventilation might be required for such individuals. In very severe cases it can result in significant widespread infection with multiple organ system involvement and dysfunction. This is more common in people with cardiopulmonary disease, diabetes, chronic kidney disease, chronic liver diseases, people with weakened immune systems, infants, and older adults.

Between 2012 and 2018, more than 2000 laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection were reported to WHO, 83% of whom were reported by the Kingdom of Saudi Arabia. More than 750 individuals had died of MERS-CoV.

Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. The illness spread to more than two dozen countries. More than 7000 people were infected and more than 700 died. The most recent human cases of SARS-CoV infection were reported in China in April 2004.

Most cases of Wuhan nCo-V cases are mild to moderate compared to SARS or MERS-CoV. The mortality of the nCo-V infection is less than 3%( SARS 10-20%, MERS-CoV 50%). Any person who develops signs or symptoms of running nose, sore throat, cough, fever and or breathing difficulty within a period of 14 days after returning from a region where documented outbreak or cases have been reported is at high risk for getting the infection. He /she should be actively screened for it.

Testing involves taking upper respiratory tract (like nasopharyngeal, throat swab) samples or lower respiratory tract (sputum or tracheal secretions or bronchial wash) samples for specific coronavirus PCR testing. Growing virus in culture is difficult and maybe done so only in referral laboratories.

Treatment is mainly supportive care. No specific anti-viral medication is available to date for coronavirus, though the effectiveness of lopinavir-ritonavir combination against nCoV is being investigated. The therapy mainly consists of ensuring adequate oxygenation, treating superadded bacterial respiratory infections if any and monitoring and maintaining the function of other organ systems.

Triage of suspected patients is necessary for proper management. Those with mild upper respiratory disease and no other concurrent medical comorbidities can be treated on an outpatient basis, though they should be clearly advised to seek immediate medical care in case of worsening of symptoms at home. Those with mild pneumonia features should be admitted to nonintensive care units and supportive therapy should be given. Close observation and immediate shifting to intensive care facilities should be done for any clinical worsening. For patients with moderate to severe pneumonia or respiratory distress or sepsis with multiorgan involvement, intensive care unit management is mandatory from the beginning.

Those who are diagnosed or suspected to have coronaviruses infection should be asked to wear a surgical mask and be evaluated in a private room with the door closed. Patients should cover nose and mouth during coughing or sneezing with a tissue or flexed elbow for preventing the spread of infection to others. Hand hygiene with alcohol-based hand rubs, else soap and water should be performed after contact with respiratory secretions. Healthcare personnel entering the room should use contact and droplet precautions. Long-sleeved fluid-repellant disposable gown, nonsterile surgical gloves, medical (or surgical masks) must be worn while entering rooms. While performing aerosol-generating procedures, N95 mask and eye protection with goggles and face shield must be worn.

Please follow recommendations from the Union Health Ministry and respective states regarding triage, sample collection, and testing policies.

Humanity is always at war with deadly microbes. Microbes also have the right to emerge, survive and thrive in this universe. The final outcome will depend on which team devises more intelligent strategies and outsmart the other.

Be vigilant and do not panic!

 

As per the latest statistics, more than 7500 cases of nCoV have been detected and more than 170 patients have died. More than 70 cases are now reported outside China.

Whoops, looks like something went wrong.

(1/1) ErrorException

file_put_contents(/home/imalive/public_html/storage/framework/sessions/oS6LLHtnYGEOsBOFLZQ8ZCE5427bC2vtoIvUKjNF): failed to open stream: Disk quota exceeded

in Filesystem.php line 122
at HandleExceptions->handleError(2, 'file_put_contents(/home/imalive/public_html/storage/framework/sessions/oS6LLHtnYGEOsBOFLZQ8ZCE5427bC2vtoIvUKjNF): failed to open stream: Disk quota exceeded', '/home/imalive/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php', 122, array('path' => '/home/imalive/public_html/storage/framework/sessions/oS6LLHtnYGEOsBOFLZQ8ZCE5427bC2vtoIvUKjNF', 'contents' => 'a:3:{s:6:"_token";s:40:"FH6ilVui5nizhhiYefeshfEvBJ87y7bB3I9DV10H";s:9:"_previous";a:1:{s:3:"url";s:105:"http://www.imalive.in/infectious-diseases/1012/novel-corona-virus-infection-from-china-by-dr-abdul-ghafur";}s:6:"_flash";a:2:{s:3:"old";a:0:{}s:3:"new";a:0:{}}}', 'lock' => true))
at file_put_contents('/home/imalive/public_html/storage/framework/sessions/oS6LLHtnYGEOsBOFLZQ8ZCE5427bC2vtoIvUKjNF', 'a:3:{s:6:"_token";s:40:"FH6ilVui5nizhhiYefeshfEvBJ87y7bB3I9DV10H";s:9:"_previous";a:1:{s:3:"url";s:105:"http://www.imalive.in/infectious-diseases/1012/novel-corona-virus-infection-from-china-by-dr-abdul-ghafur";}s:6:"_flash";a:2:{s:3:"old";a:0:{}s:3:"new";a:0:{}}}', 2)in Filesystem.php line 122
at Filesystem->put('/home/imalive/public_html/storage/framework/sessions/oS6LLHtnYGEOsBOFLZQ8ZCE5427bC2vtoIvUKjNF', 'a:3:{s:6:"_token";s:40:"FH6ilVui5nizhhiYefeshfEvBJ87y7bB3I9DV10H";s:9:"_previous";a:1:{s:3:"url";s:105:"http://www.imalive.in/infectious-diseases/1012/novel-corona-virus-infection-from-china-by-dr-abdul-ghafur";}s:6:"_flash";a:2:{s:3:"old";a:0:{}s:3:"new";a:0:{}}}', true)in FileSessionHandler.php line 83
at FileSessionHandler->write('oS6LLHtnYGEOsBOFLZQ8ZCE5427bC2vtoIvUKjNF', 'a:3:{s:6:"_token";s:40:"FH6ilVui5nizhhiYefeshfEvBJ87y7bB3I9DV10H";s:9:"_previous";a:1:{s:3:"url";s:105:"http://www.imalive.in/infectious-diseases/1012/novel-corona-virus-infection-from-china-by-dr-abdul-ghafur";}s:6:"_flash";a:2:{s:3:"old";a:0:{}s:3:"new";a:0:{}}}')in Store.php line 129
at Store->save()in StartSession.php line 88
at StartSession->terminate(object(Request), object(Response))in Kernel.php line 218
at Kernel->terminateMiddleware(object(Request), object(Response))in Kernel.php line 189
at Kernel->terminate(object(Request), object(Response))in index.php line 58
at require_once('/home/imalive/public_html/public/index.php')in index.php line 21