As of last night, over 31,000 people worldwide have been reported as infected with 2019-nCoV coronavirus of which 638 have died. So far, all but two of the fatalities have been in mainland China with the others being in the Philippines and Hong Kong.
Of increasing significance in the management of the outbreak is, that like both SARS and MERS (see previous insights) the initial animal to human transmission has become human to human. We are also seeing more cases occur of people becoming infected outside of China, with, for example, the third reported case in the UK (a person from Brighton) looks to have contracted the disease in Singapore.
Over 24 countries have reported cases of the disease, of which Europe accounts for 9 of them (Belgium, Italy, Russia, Germany, France, Spain, Finland, Sweden and the UK) as reported by the BBC. Asia remains the focus for travel however with the government being anyone arriving in the UK from a total of 9 countries and territories to check for symptoms, these include:
- Republic of Korea;
- Hong Kong; and
- As well as mainland China
The advice is for anyone who has travelled back from these locations over the past 14 days and is displaying any symptoms, should stay indoors and call the NHS 111 service.
The Coronavirus family typically cause cold/flu-like illnesses and this is a new variant of the disease, as were SARS and MERS. Symptoms associated with 2019-nCoV appear to start with a fever, followed by a dry cough and then, after a week, leads to shortness of breath, with some patients needing hospitalisation. Early estimates indicate approximately one-in-five cases are thought to be severe, although the infection rarely seems to cause a runny nose or sneezing.
The Department of Health said they should do so "even if symptoms are mild” going on to confirm "These countries have been identified because of the volume of air travel from affected areas, understanding of other travel routes and a number of reported cases. This list will be kept under review."
More generally one of the other focuses of the World Health Organisation (WHO) has been to “strengthen global diagnostic capacity for 2019-nCoV detection to improve surveillance, early detection, track and manage the spread of the disease.” At the end of January, a three-pronged approach was adopted covering:
1) Developing a network of specialised referral laboratories (with expertise in the detection of coronaviruses) to support national labs managing cases of the disease.
2) To strengthening a countries capacity for detection so that any diagnostic tests needed can be performed rapidly.
3) Ensuring the ready availability of test and assay kits for the 2019-nCoV virus.
To date, 15 international laboratories have been identified to provide reference testing for the virus and 250,000 tests made available and shipped to over 159 laboratories across all WHO regions.
One of their other considerations is to give the disease a proper name. Most news reports are using the “Coronavirus” name, but this is the name of the family (Coronaviridae) the disease belongs to. The tags WN-CoV (Wuhan novel coronavirus) and 2019-nCoV (2019 (after the year it was first seen) novel coronavirus are not the easiest names to use either.
The problem can be however that a name, if not properly considered, can have unintended consequences, e.g.
- the “swine flu” epidemic saw pigs being slaughtered despite the spread of the disease being between humans, not pigs.
- The use of regions i.e. “China flu” for the current epidemic which in turn has seen some people wrongly associate and fear catching the disease from any Chinese person.
A name, which has already been submitted for approval by the International Committee on Taxonomy of Viruses (ICTV) – the committee responsible for such tasks - should be known shortly. Following published guidelines, however, it is unlikely to contain any:
- Geographical locations
- People's names
- The name of an animal or a kind of food
- References to a particular culture or industry
But will be short and descriptive - such as SARS (Severe Acute Respiratory Syndrome).