Dr.Prem Nair, Director, Amrita Institute of Medical Sciences and Research Centre, Kochi, and Dr.T S Dipu, Asst. Prof.Infectious Diseases, AIMS, Kochi
The current outbreak of respiratory tract infections happening around the world is caused by a virus called Novel corona virus (2019-nCoV). Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. Seven types are known to infect humans. Most cause mild illness of common cold (229E, NL63, OC43, HKU1). Some can produce life threatening severe diseases such as Middle East respiratory syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).
What is (new)Novel Corona virus?
2019-nCoV was first identified in Wuhan, Hubei Province, China following evaluation of an outbreak of rapidly progressive viral pneumonia. Early on, many of the patients in the outbreak in Wuhan, China reportedly had some link to a large seafood and animal market suggesting animal-to-person spread at the onset. The growing number of affected people indicate a possible human spread, occurring mainly via the respiratory droplet and among close contacts (about 1 metre). This possibly occurs primarily via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. These droplets then come in contact with exposed areas like mouth or nostrils of people who are nearby or possibly be inhaled into the lungs.
When to suspect corona virus infection?
Any person with a positive travel history to China or any person in close contact with a lab confirmed case of 2019-nCoV in 14 days prior to the onset of illness and presenting with symptoms of fever, shortness of breath, sore throat, cough or severe acute respiratory infection.
How is 2019-nCoV diagnosed?
Anyone who has positive travel history / contact with lab confirmed case with fever/ cough/ sore throat/ shortness of breath/ severe acute respiratory infection has to undergo physical examination and diagnostic tests. Other symptoms include weakness or fatigue, muscle pains, headache and rarely loose stools. Clinical examination can show low oxygen saturation, low blood pressures, fever, increased rate of breathing. Severe infections can be progressive with involvement of other organs like kidneys, heart or can have secondary bacterial infections and sock.
Diagnostic tests are done from respiratory secretions like sputum, nasal swab, throat swab and bronchoalveolar lavage (in patients on ventilator) and blood samples. Lung tissue can be tested after post mortem examination in suspected cases. Samples have to be transported in viral transport media to the ICMR-Virology Lab after informing state and district health authorities. Meanwhile the patient has to be evaluated for other possible causes of pneumonia.
Can we treat novel corona viral infections?
Treatment is mainly supportive. The patient has to be isolated and appropriate samples should be sent for diagnostic tests. Supplemental oxygen, medications for symptomatic relief along with regular medications for community acquired pneumonia should be started. Antiviral medications for 2019-nCoV have not been discovered till date. If respiratory failure occurs, ventilatory support is warranted. Close contacts of the patient have to be maintained under surveillance.
Can we prevent Coronavirus infection?
No vaccinations are available for prevention. However, the following steps have to be followed to decrease the risk of transmission.
Avoid non essential travel to the affected areas, especially to China.
Drink plenty of water and avoid smoking.
Frequent hand washing with soap and water or use alcohol based sanitiser.
Use personal protection devices while caring for a suspected patient.
Maintain close surveillance of the patient and close contacts.
Is there a helpline number where one could receive 24-hour information?
Avoid self-prescription and always reach out for help to health care worker if there is any doubt .
(DISHA Helpline 0471 2552056, or 1056 toll-free within Kerala)