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Overview of 2019 novel coronavirus (2019-nCoV)

  • 来源:未知
  • 作者:bmjchina
  • 日期:2020-01-23
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Introduction

The 2019 novel coronavirus (2019-nCoV), also known as nCoV or Wuhan novel coronavirus (there is no internationally agreed name as yet), has been identified during an outbreak of pneumonia in Wuhan City, Hubei Province, China. Investigations to learn more about the novel coronavirus, its origin, and how it affects humans are ongoing, and the situation is evolving rapidly.
Preliminary investigations suggested that the virus did not transmit readily between people; however, based on the latest information available, the World Health Organization (WHO) has said that there is evidence of limited human-to-human transmission. China’s National Health Commission has confirmed cases of human transmission, with health care workers currently among the infected.
中彩网 There are increasing concerns about the virus spreading with hundreds of millions of people travelling across China for the Lunar New Year this week. WHO will convene an emergency committee to ascertain whether the outbreak constitutes a public health emergency of international concern on the 22nd January, 2020. Currently, the risk to other countries is thought to be low; however, the situation is under constant review.

Epidemiology

On the 31st December, 2019, WHO was informed of 44 cases of pneumonia of unknown microbial aetiology associated with Wuhan City, Hubei Province, China. Most of the patients in the outbreak reported a link to a large seafood and live animal market (Huanan South China Seafood Market), which has been closed since the 1st January, 2020 for environmental sanitation and disinfection.
On the 9th January 2020, WHO announced that a novel coronavirus that has not previously been identified in humans had been detected in samples taken from patients in Wuhan City. Laboratory tests ruled out SARS-CoV, MERS-CoV, influenza, avian influenza, and other common respiratory pathogens.
中彩网 As of the 20th January, WHO have confirmed 282 cases with 12 patients in critical condition. The majority of cases are in Wuhan City; however, cases have also been confirmed in Beijing, Shanghai, and the Guangdong province. Six deaths have been reported, all from Wuhan City. Travel-related cases have been reported in Thailand, Japan, the Republic of Korea, Taiwan, Macau, and the US. The first travel-related case in the US was confirmed on the 21st January in Washington state. The patient recently returned from Wuhan City. The situation is evolving rapidly and the latest case counts may be higher. News reports put the case count at 461 with 9 deaths as of the 22nd January.

Etiology

Coronaviruses are a large family of viruses, some of which cause illness in people (e.g., common cold, severe acute respiratory syndrome [SARS], Middle East respiratory syndrome [MERS]), and others that circulate among animals such as bats and camels. Rarely, animal coronaviruses can spread to humans, and then spread between people as was the case with MERS and SARS.
Most, but not all, patients in the outbreak in Wuhan City have reported a link to Huanan South China Seafood Market, which suggests a zoonotic origin of the virus. The animal reservoir is unknown at this point.
The full genome of the virus has been published in GenBank.

Diagnosis

Diagnosis should be suspected in patients with signs and symptoms of pneumonia who report a travel history to an affected location, or who report direct contact with a person with confirmed or suspected novel coronavirus infection in the 14 days prior to symptom onset. Suspected cases should be reported to the relevant local health authorities.
Fever and cough are the most common presenting symptoms. Some patients may also have difficulty breathing. Chest x-rays may show bilateral lung infiltrates. Other symptoms of coronavirus infection include shortness of breath, breathing difficulties, and other respiratory symptoms, as well as sore throat, nasal congestion, malaise, headache, and myalgia. Patients may also present with sepsis or septic shock.
WHO have published an interim case definition for human infection with novel coronavirus.
WHO have published interim guidance for laboratory testing to confirm diagnosis.

Management

There is no evidence to recommend any specific treatment for suspected or confirmed novel coronavirus infection. Management should follow recommendations for other severe acute respiratory infections and include appropriate infection control measures (standard, droplet, airborne, and contact precautions; eye protection), managing sepsis if present, supportive therapies (e.g., oxygen, fluid management, empirical antibiotics, intubation, mechanical ventilation), and close monitoring.
WHO have published interim guidance on the management of patients with novel coronavirus infection.  
WHO have published interim guidance on the management of patients with mild infection at home and contacts.  

Prevention

There is no vaccine available.
WHO have published interim guidance on infection control and prevention during health care.  
WHO does not currently recommend any trade or travel restrictions on China. They advise international travellers to practice usual precautions while travelling in or from affected areas, including: avoiding close contact with people suffering acute respiratory infections; frequent hand washing, especially after contact with people who are ill or their environment; practicing appropriate cough etiquette; and avoiding close contact with live or dead farm or wild animals.
The US Centers for Disease Control and Prevention (CDC) recommend that travellers practice usual precautions.  
A number of countries, including Singapore, Hong Kong, Thailand, Malaysia, South Korea, Australia, and the US (San Francisco, New York, Los Angeles) are actively screening incoming travellers from China for signs and symptoms of infection.

Other guidelines

 

 

Resources




Related conditions


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中彩网 Highly pathogenic avian influenza (HPAI) A H5N1 virus originates in poultry and wild birds can be transmitted to humans, with rare cases of infection transmitted between humans.


中彩网 Geographically focused in China and associated with exposure to infected poultry. Five annual epidemic waves of human cases occurred from 2013 to 2017. Case clusters of limited human-to-human transmission have been described, but there is no evidence of sustained transmission.


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Contributors
Authors: Editorial Team

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