Novel Coronavirus (2019-nCoV) on the move. 600+ sick. 1 in USA.

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The Centers for Disease Control and Prevention (CDC) yesterday (1/22) confirmed the first case of 2019 Novel Coronavirus (2019-nCoV) in the United States in the state of Washington. The patient recently returned from Wuhan, China, where an outbreak of pneumonia caused by this novel coronavirus has been ongoing since December 2019. While originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening. It’s unclear how easily this virus is spreading between people.

The U.S. began screening for the new virus at airports in New York, San Francisco and Los Angeles on Jan. 17. The Washington state patient entered the United States before the screening system was implemented and before any of his symptoms developed. There are plans to expand screenings to airports in Chicago and Atlanta.

China quarantines three cities to prevent spread of Novel Coronavirus (2019-nCoV)

The head of a Chinese government expert team said Monday that human-to-human transmission has been confirmed in an outbreak of a new coronavirus (viral pneumonia) epidemic. It is usually transmitted from animal to human but it appears to been passed from human-to-human in this outbreak as many victims have never been near animals. A wildlife market seafood and live-animal market in the Chinese city of Wuhan, which includes snakes, has been pinpointed as Ground Zero for this epidemic. The Wuhan virus is from the same family of coronaviruses as SARS, or Severe Acute Respiratory Syndrome, which killed over 800 people worldwide in an outbreak toward the end of 2002.

January 25, 2020, marks the first day of the Lunar New Year. If you, or a friend/neighbour, plan to travel to Asia during the Lunar New Year to visit friends or relatives or to participate in festivities, take some simple precautions to stay safe and healthy. (Note that North Korea has shut its borders to tourists in fear of this new virus.) Taking a flight? Remember – international connections, including from China, can be made at most major US airports.

The Center for Diseases and Control has said this is an emerging, rapidly evolving situation and it will provide updated information as it becomes available. Currently the threat level is I – meaning basic precautions should be taken. This is a rapidly evolving situation. CDC will continue to update the public as circumstances warrant.

Investigations are ongoing to learn more, but some degree of person-to-person spread of Corona virus (2019-nCoV) is occurring. It’s important to note that person-to-person spread can happen on a continuum. Some viruses are highly contagious (like measles), while other viruses are less so. It’s not clear yet how easily 2019-nCoV spreads from person-to-person. It’s important to know this in order to better assess the risk posed by this virus. While CDC considers this is a serious public health concern, based on current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time. Nevertheless, CDC is taking proactive preparedness precautions.

CDC is closely monitoring an outbreak of respiratory illness caused by a novel (new) coronavirus (termed “2019-nCoV”) that was first detected in Wuhan City, Hubei Province, China and which continues to expand. Chinese health officials have reported hundreds of infections with 2019-nCoV in China, including outside of Hubei Province. They have quarantined Wuhan, Huanggang and Ezhou. A number of countries, including the United States, have been actively screening incoming travelers from Wuhan and human infections with 2019-nCoV have been confirmed in TaiwanThailand,external icon Japanexternal icon, and South Koreaexternal icon. The United States announced their first infection with 2019-nCoV detected in a traveler returning from Wuhan on January 21, 2020.

The World Health Organization announced at a separate press conference on Wednesday (1/22) that it had decided not to declare a world emergency regarding the outbreak, but I just heard that they have now elevated it to emergency status. This call is made by determining whether an outbreak constitutes an international public health emergency and how it can be managed. Such declarations are typically made for epidemics of severe diseases that threaten to cross borders and require an internationally coordinated response. 

People in China are lining up to buy protective masks as it is feared the virus can be spread in saliva.

People who travel back to China to visit friends or relatives are at higher risk for some diseases. Their risk is higher because they generally stay longer than tourists, eat local food in people’s homes, and may not take the same precautions that tourists do.

The CDC began entry screening of passengers on direct and connecting flights from Wuhan China to the three main ports of entry in the United States on January 17, 2020.

On Tuesday the Center for Disease Control reported the first confirmed case of the virus in the United States. A man from Washington State contracted the virus while on a visit to Wuhan. Other cases have been reported in Japan, South Korea, Taiwan and Thailand.

What is the current situation?

Coronaviruses are a large family of viruses. There are several known human coronaviruses that usually only cause mild respiratory disease, such as the common cold. However, at least twice previously, coronaviruses have emerged to infect people and cause severe disease, such as has been seen with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).The cases in the Wuhan pneumonia outbreak have tested negative for both SARS and MERS.

Chinese health officials have reported more than 40 cases of pneumonia; several patients had severe illness, and 2 people have died. Cases were identified between December 8, 2019, and January 8, 2020. Both patients who died were older adults and one of the two patients had known serious underlying medical conditions.

Chinese health officials have monitored several hundred close contacts, including health care workers, for illness and found no additional cases. Some patients in the outbreak reportedly have not had exposure to animal markets, suggesting that some limited person-to-person spread may be occurring. All the characteristics of this virus and how it may affect people are still unclear.

In response to this outbreak, several countries and territories in the region are reported to have implemented health screening of travelers arriving from Wuhan. Some cases have been exported to other countries in the region.

On arrival to the United States, travelers from Wuhan may undergo health screening, including having their temperature taken and filling out a symptom questionnaire. Travelers with symptoms (fever, cough, or difficulty breathing) will have an additional health assessment.

Symptoms

Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. 

Standard recommendations to prevent infection spread include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.

Based on currently available information, the World Health Organization does not recommend any restriction of travel or trade. Countries are encouraged to continue strengthening their preparedness for health emergencies.

How to protect yourself from getting infected

WHO’s standard recommendations for the general public to reduce exposure to and transmission of a range of illnesses are as follows, which include hand and respiratory hygiene, and safe food practices:

  • Frequently clean hands by using alcohol-based hand rub or soap and water;
  • When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands;
  • Avoid close contact with anyone who has fever and cough;
  • If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider;
  • When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals;
  • The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.

What can travelers do to protect themselves and others?

Travelers to Wuhan, China should

  • Avoid animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat).
  • Avoid contact with sick people.
  • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.

If you traveled to Wuhan and feel sick with fever, cough, or difficulty breathing, you should

  • Stay home. Except for seeking medical care, avoid contact with others.
  • Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms.
  • Not travel while sick. 
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
  • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.

Clinician Information

Health care providers should obtain a detailed travel history for patients with fever and acute respiratory illness. For patients who traveled to Wuhan on or after December 1, 2019, and had onset of illness within 2 weeks of leaving, consider the novel coronavirus outbreak in China and notify infection control personnel and your local health department immediately.

Although the transmission dynamics have yet to be determined, CDC recommends a cautious approach to interacting with patients under investigation. Ask such patients to wear a surgical mask as soon as they are identified. Conduct their evaluation in a private room with the door closed, ideally an airborne infection isolation room, if available. Personnel entering the room should use standard precautions, contact precautions, and airborne precautions and use eye protection (goggles or a face shield). For additional infection control guidance, visit CDC’s Infection Control webpage.