Novel Corona Virus (2019-nC0V)

dr-gc-khilnani

WHO Declares International Health Emergency

Dr. G. C. Khilnani, New Delhi

What is Corona Virus?

Corona virus is a common microorganism which causes infections of upper respiratory tract and Pneumonia. These are enveloped RNA viruses which are distributed among human, animals as well as birds. Two serious corona viruses have been SARS-CoV and MERS-CoV which were responsible for severe respiratory disease outbreaks.

On December 31, 2019 China reported a cluster of cases of Pneumonia from Wuhan associated with seafood. This was later diagnosed to be associated with novelCorona virus, 2019-nCoV which falls into genus Betacoronavirus which is found in human, bats and other wild animals.

As on 13th. Feb., 2020, total 46550 confirmed cases reported from china to be infected with 2019-CoV including 17 healthcare worker. Other than China, so far 24 countries have reported 395 cases of Novel Corona Virus including INDIA.

Total deaths because of this dreaded infection raised to 1017 in China & one death reported from Philippines.

How to Suspect Corona Virus Infection?

Patients may vary from being asymptomatic (Without fever, cough etc) to being seriously ill requiring ICU care

    Usual symptoms are:

  • Fever
  • Cough
  • Running nose
  • Sore throat
  • Shortness of breath

The incubation period is between 2-14 days.

Spread of Infection

  • Corona virus is common in different species of animal. Sometimes these animal viruses spread to humans.
  • Most spread is from person to person from close contact (about 6 feet). Person to person spread occur via respiratory droplets which are produced when an infected person coughs or sneezes.
  • It is unclear whether infection can spread via fomite i.e. when a person touches a surface (for example Chair, Table, door handle etc) that has virus on it.
  • Though it is thought that virus spreads when a person is most symptomatic but with 2019-nCoV, there are report of spread even when infected person is asymptomatic.

 

How to prevent Spread (transmission)?

  • Clean your hand with running water and soap when visibly dirty
  • Clean your hands with alcohol-based hand rubs/soap when not visibly dirty.
  • Avoid close contact with person who has fever or cough.
  • If you have flu-like symptoms such fever, cough, running nose or sore throat; seek medical help early.
  • While coughing or sneezing cover your face.
  • The consumption of raw and under-cooked animal products should be avoided
  • Avoid travel if you are unwell
  • Avoid travelling to areas with outbreaks
  • Share your travel history with healthcare provider

Diagnosis

Three specimens including serum, Respiratory secretions (broncho-alveolar lavage, sputum, tracheal aspirate) and upper respiratory secretions (Nasal or throat swab) should be sent for evaluation. Additional samples like urine and stools may also be safely stored for testing later. Samples should be stored at 2-8 degrees centigrade. These samples should be subjected to RT-PCR assays.

Treatment and Prevention

There is no specific treatment (Antiviral drug) for this virus infection. Therefore there is only supportive treatment can be offered. Also there is no vaccination is available for prevention.

 

My Take of Subject

Like SARS and EBOLA outbreak in the past, this is another outbreak with Corona virus which is a big public threat to mankind. If not controlled by public health measures this virus infection may become truly `VIRAL’.  One of the major difficulty is long and uncertain incubation period (2-14 days) during which time a person may spread the infection. It is important to keep track of all the contacts and keep them under surveillance. Health care providers are particularly at high risk and all the personal protective equipment must be used while looking after even potential cases. Equally important is to have widespread availability of facility of diagnosis (rtPCR).

 

Dr.(Prof) G.C.Khilnani                                                                                            14.02.2020

Member Governing Body, Indian Chest Society

Chairman,

PSRI Institute of Pulmonary, Critical care and Sleep Medicine

New-Delhi