By Pinaki Panigrahi* and Dhanada K Mishra*
The new type of corona virus infection reported in late December 2019 in Wuhan, China has now attracted world attention. Not just the threat of life, but the economy and stock markets around the world are getting battered. No one knows how this infection is going to spread and how bad will be the implications. But, one thing for sure, this virus has already infected many not showing any sign symptoms of disease and will infect many more in coming months.
This new coronavirus is similar to SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome), but, very little is now known about the virus, its epidemiology, and clinical outcomes. The current infection started as a cluster around a market where live animals are sold and half of the infected people worked in that setting. It is therefore safe to speculate that an animal/bird source exists. A recent report by Chen et al. in the medical journal Lancet has described 99 cases most of whom were middle aged males. The sign symptoms included respiratory illness including fever, cough, shortness of breath, chest pain, muscle ache, confusion, headache, and sore throat. Pneumonia is a hallmark and males with preexisting disease are more prone to disease.
Isolation of suspected patients in specialized hospital rooms is mandatory and treating health care personnel should wear protective measures to protect themselves and not transmit the virus to other patients. Treatment with antiviral drugs and supportive therapy has been useful and in the 99 cases, only 13 patients required non invasive ventilator mechanical ventilation for 4–22 days and four patients needed an invasive ventilator to assist ventilation for 3–20 days. 11% of patients died compared to reported 10% in SARS and about 35% in MERS.
Recommendations for the public to reduce exposure to and transmission of viral diseases including that with novel coronavirus (nCoV):
- If you have been to China or nearby Asian countries within the last 30 days, report to your nearest health authority even if you have no health issues
- If you know anyone else who has travelled to the above areas, ask him/her to report to health authorities
- Frequently clean hands by soap and water or using alcohol-based hand rub
- When coughing and sneezing cover mouth and nose with flexed elbow or tissue (discard tissue 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
- Do NOT cough into your hand. Whatever area the infected hand touches will become infected and the chain of spreading will continue. Cough into your folded elbow.
Guiding Principles: There is a need to take proactive measures than being reactive. Public health institutions and departments in the western world conduct regular surveillance and collect sentinel samples on a regular basis before overt cases are seen. These days, data analytics and citizen science is used to track out of ordinary drug sales or atypical case presentations in any geographic location. Laboratories are also set up in multiple strategic locations to conduct analysis swiftly. While these activities are done in the background and no one notices them, they form the backbone of a solid public health system. AIPH University works in Khorda and Sundergarh districts and has conducted surveillance of neonatal sepsis over the last 10 years. Results of these activities have been published in the world’s top journals including Lancet and Nature.
*The writer Pinaki Panigrahi works as Professor, Georgetown University Medical Center, USA / President, AIPH University and Dhanada K Mishra is Pro-Vice Chancellor, AIPH University.
DISCLAIMER: The views expressed in the article are solely those of the authors and do not in any way represent the views of Sambad English.