[Analytics] Novel coronavirus: Why this ‘mysterious’ virus from China has triggered a health scare

The outbreak of a new ‘mysterious’ virus in China that has infected at least 62 people in the country and claimed two lives so far has concerned health officials the world over. All 62 cases were reported in Wuhan, a major city in China’s Hubei Province. The virus, named 2019-novel coronavirus (2019-nCoV), is a new variant of coronaviruses and this is the first time it has been reported to have infected humans. Mukesh Rawat specially for the India Today.

Scientists in China and elsewhere are brainstorming to find effective measures to identify the virus’ source and contain its impact. Cases of 2019-novel coronavirus infections have also been reported in Thailand (two cases) and Japan (one case) among people returning from Wuhan.

Several Asian countries, including India, have issued health advisories in the wake of the 2019-nCoV outbreak in China.

On January 17, three major airports in the US–Los Angeles, New York and San Francisco–started screening people arriving from Wuhan.

The World Health Organisation (WHO) has said the infection may spread to other places, and has issued interim guidelines based on the limited information available about 2019-novel coronavirus. It has however not called for any trade or travel restrictions at present.

A total of 41 cases were reported in Wuhan till January 3 and for nearly a fortnight no fresh case was officially reported. However, on January 18, Wuhan Municipal Health Commission issued a statement saying four fresh cases have been reported. A day later, the commission realised another statement informing 17 fresh cases, taking the overall count in Wuhan to 62.

WHAT IS 2019-NOVEL CORONAVIRUS?

The 2019-nCoV is a new strain of cornoviruses and has not been previously seen in humans. Cornoviruses form a large family of viruses and the illness they cause can range from common cold to more severe diseases such as the Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

These viruses are zoonotic, which means they are transmitted between animals and people.

While the exact source of 2019-nCoV is yet to be identified, other strains of coronoviruses have previously been seen to be transmitted from civet cats to humans (in the case of SARS-CoV) and from dromedary camels to humans (in the case of MERS-CoV). These aren’t the only form of coronaviruses. There are many that circulate among animals but have not yet infected humans.

The WHO has said so far there is no clear evidence of any human-to-human transmission of this virus, but health officials in China have cautioned that its possibility cannot be denied completely.

WHAT CAN 2019-nCoV DO?

Since this is the first time 2019-nCoV is reported to have infected humans, there is limited information on the exact range of illness the virus can cause. Its effects can range from cough and fever to kidney failure and even death.

The WHO has listed the following common signs observed in people infected by 2019-nCoV:

• Fever
• Cough
• Shortness of breath and breathing difficulties
• Pneumonia
• Severe acute respiratory syndrome
• Kidney failure
• Death

To contain the virus infection, health officials in China have isolated the infected patients who are being treated at various medical institutions in Wuhan.

WHERE DID THE OUTBREAK START?

On December 8, 2019, a patient in Wuhan city reportedly complained of pneumonia-like symptoms and sought medical help at a local hospital. Within days, many others reported similar problems, prompting health officials to launch an investigation.

On December 31, health officials in China informed the WHO’s country office about these pneumonia cases emanating from unknown causes in Wuhan.

Taking note of the matter and the limited information available, the WHO issued interim guidelines for all countries. On January 7, Chinese authorities said they had identified 2019-nCoV as the cause of the pneumonia. However, experts are yet to identify the source of 2019-nCoV i.e. the animal from which it transmitted to humans.

On January 12, in a statement the WHO said national health officials in China have reported 41 confirmed cases with this new type of pneumonia. Of these 41 patients, seven were severely ill.

In China, health officials have identified 763 people, including health care workers, who had close contacts with the infected patients. They were kept under observation for symptoms of 2019-nCoV and 644 of them have been discharged, while the rest are being treated.

The exact source of the 2019 novel coronavirus remains to be traced but health officials in Wuhan have identified that most patients had either worked at or visited the Huanan Seafood Wholesale Market in the city. The market has been shut down since January 1.

Meanwhile, officials in Wuhan have also identified a woman who may have contracted the virus from her husband, suggesting possibility of human-to-human transmission.

The Wuhan Municipal Health Commission said the woman’s husband used to work at the seafood market and he was the one who fell ill first. The woman has declined having any exposure to the market.

“It’s possible that the husband brought home food from the market that then infected his wife,” a health official was quoted as saying by the Associated Press, adding that since the wife didn’t exhibit symptoms until days after her husband, it’s also possible that he infected her.

THE DEATHS

Two people have died so far due to 2019-nCoV infection and both of them were in Wuhan. The latest death, 69-year-old Xiong Moumou, was reported on January 15.

According to a statement issued by health officials in Wuhan, Xiong Moumou fell ill on December 31; his condition deteriorated on January 4 and he was admitted to the Wuhan Jinyintan Hospital.

At the time of being hospitalised, Xiong had abnormal renal function, severe damage to multiple organ functions, severe myocarditis, among other symptoms. The statement suggests he was also a tuberculosis patient.

CASES OUTSIDE CHINA

Two confirmed cases have been reported in Thailand and one in Japan so far. The three patients had recently returned from Wuhan and are being treated.

The patient in Japan, a man, had travelled to Wuhan in late December and developed fever on January 3 when he was still in Wuhan. WHO says as per information received from Japan, the man didn’t visit the Huanan Seafood Wholesale Market (to which most cases have been linked) or any other live animal market in Wuhan. He has also denied having close contact with any person suffering from pneumonia.

He returned to Japan on January 6 and tested negative for influenza. When his condition didn’t improve, he visited a local hospital on January 10 and a chest x-ray revealed abnormal infiltrates. Following this, he was admitted and on January 14, the doctor attending him notified his case to a local public health authority as an unidentified serious infectious illness’.

When his samples were collected and tested by the National Institute of Infectious Diseases, very small amount of 2019-nCoV RNA were identified.

In Thailand, the first confirmed case of 2019-nCoV infection was identified on January 13 (a 61-year-old woman) and the second case on January 17 (a 74-year-old woman). They had both returned from China.

As a precautionary measure, Thai authorities have started screening passengers at airports and close to 13,600 passengers have been screened since January 3

PRECAUTIONS YOU MUST TAKE

Wuhan is a major city in China which is also a hub of international and domestic travels. Experts haven’t been able to identify the source of the 2019-nCoV infection and much remains to be known about how exactly this infection transmits between humans and animals, and whether human-to-human transmissions are also possible.

Assessing the available information, WHO has said at present there is no need for countries to call for travel and trade restrictions on China on account of the 2019-nCoV outbreak.

However, it has issued an advisory aimed at reducing the risk among those travelling from or to the affected region.

As per WHO you should:

• Avoid close contact with people suffering from acute respiratory infections
• Wash hands frequently, especially if there is a direct contact will ill people or exposure to their environment
• Avoid close contact with live or dead farm and wild animals
• If you have symptoms of acute respiratory infection, you should practice cough etiquette (maintain distance, cover cough and sneezes with disposable tissues or clothing and wash hands).
• If you are visiting a live animal market, a wet market or any animal product market, practice general hygiene like regular hand washing with soap and potable water after touching animals and animal products.
• Avoid touching eyes, nose or mouth with hands and avoid any contact with sick animals or spoiled animal products.
• Avoid consuming raw or undercooked animal products and handle raw meat and milk with care.

With festivities of the Chinese New Year approaching, there is a heightened risk of 2019-nCoV infection spreading because in the coming weeks people (especially non-natives of Wuhan) will be travelling home for vacations. China’s Transport Ministry has estimated that nearly 3 billion trips will be made during the festivities which triggers the world biggest annual human migration.

Officials have said extra precautions will be taken this year due to the novel coronavirus outbreak in Wuhan.

Transport hubs will strengthen disinfection, monitoring and prevention measures, Wang Yang, the Chinese Ministry of Transport’s chief engineer, was quoted as saying by the Associated Press. The emergence of the epidemic may cause panic among people, especially in areas where people are concentrated during the Spring Festival travel period, Wang said.

The WHO too has said that the annual human migration for these festivities can increase the risk of 2019-nCoV cases being reported from elsewhere.

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