[volt-nuts] Fwd: Public Health Update: novel Corona virus update

Sat Oct 6 18:41:50 UTC 2012

   -------- Original Message --------
   Subject: Public Health Update: novel Corona virus update
      Date: Fri, 05 Oct 2012 06:37:53 -0700
      From: Frank James MD [1]<frankejamesmd at mac.com>
        To: San Juan Medical Providers [2]<medical at sanjuandem.net>
   Much is still unknown and this virus does not appear to be easily
   transmitted from person to person. I found this summary of what we know
   so far and will pass it along incase your patients ask about it or in
   the unlikely event that this becomes a more important issue. Millions
   of people travel to Mecca this time of year and if it were more easily
   transmissible there would be potential for further spread.
   Frank
   Frank James MD
   Health Office
   San Juan County

   Novel Coronavirus in UK and Saudi Arabia
   By Amesh A. Adalja, MD, FACP
   Since the deadly outbreak of SARS and the discovery of its etiological
   agent, the SARS Coronavirus (SARS-CoV), there has been a heightened
   awareness that coronaviruses cause severe transmissible disease, a far
   cry from the common cold they were exclusively linked to in the past.
   From 2003 to 2011, 2 new human coronaviruses have been discovered, both
   of which caused mild illness.^1 However, in 2012, a third new human
   coronavirus (HCoV) was discovered and was sequenced at Erasmus Medical
   Center (EMC) in the Netherlands. The new virus, designated HCoV-EMC, is
   responsible for 2 severe cases in England and Saudi Arabia, 1 of which
   was fatal.^2

      Genus Coronaviruses That Infect Humans
      The Coronavirus genus contains several viruses that are known to infect
      humans. The first human coronavirus, HCoV-229E, was isolated in 1965,
      followed soon after by the isolation of HCoV-OC43. The eventual
      discovery of other coronaviruses that infect other animal species led
      to the division of the animal and human coronavirus into 3 groups
      (1-3). These groups have subsequently been split into
      subgroups.^1 HCoV-EMC is in the 2c group, where it clusters with 2
      coronaviruses of bats. The classification of human coronaviruses is
      summarized below.^1,2

   Group Viral strains
    1b   HCoV-NL63
    2a   HCoV-OC43, HCoV-HKU1
    2b   SARS-CoV
    2c   HCoV-EMC

      HCoV-EMC Cases
      Thus far, 2 cases of HCoV-EMC infection have been confirmed. The first
      case, which was fatal, occurred in June in a 60-year-old man in Saudi
      Arabia; the second case occurred in a 49-year-old Qatari man who
      traveled to Saudi Arabia and is currently being treated in England.
      From early case descriptions, it appears pneumonia is the primary
      manifestation of the disease. The WHO has published a case definition
      (Figure 1). It appears that the disease has an incubation period of up
      to 10 days and that it is not easily transmitted between humans,
      although full airborne isolation is recommended. As with all
      coronaviruses, no specific treatment is available.^2
      Figure 1: WHO Case Definition for People to Be Investigated for
      Infection^3

     * A person with an acute respiratory infection, which may include
       fever (a 0/00YEN 38ADEGC, 100.4ADEGF) and cough; AND
     * suspicion of pulmonary parenchymal disease (eg, pneumonia or Acute
       Respiratory Distress Syndrome [ARDS]) based on clinical or
       radiological evidence of consolidation; AND
     * travel to or residence in an area where infection with novel
       coronavirus has recently been reported or where transmission could
       have occurred; AND
     * not already explained by any other infection or aetiology,
       including all clinically indicated tests for community-acquired
       pneumonia according to local management guidelines.

      Diagnostic Tests
      Confirmatory testing is via nucleic acid amplification, which is
      available at reference labs; standard coronavirus primers may be able
      to detect the virus. Samples are to be handled in a BSL-3 setting.
      Many Questions Remain
      The detection of the new coronavirus raises many questions that will
      likely be answered in the months to come, including:
        * Are there asymptomatic cases? Will serosurveys be performed?
        * Given that human-to-human transmission appears difficult for the
          virus, what is the common exposure between the 2 cases? Is it
          animal related?
        * As with SARS, does the possibility exist of superspreaders who are
          able to transmit the virus between humans?
        * Are there prior unexplained cases that can be attributed to this
          virus?

      References
       1. McIntosh K, Perlman S. Coronaviruses, including Severe Acute
          Respiratory Syndrome (SARS)-associated coronavirus. In: Mandell GL,
          Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's
          Principles and Practice of Infectious Diseases. 7th ed.
          Philadelphia, PA: Churchill Livingstone; 2010.
       2. UK Health Protection Agency. Novel coronavirus,
          2012.[3]http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/P
          age/1317136202637. Accessed October 2, 2012.
       3. World Health Organization. Revised interim case definition--novel
          coronavirus.[4]http://www.who.int/csr/disease/coronavirus_infection
          s/case_definition/en/index.html. Accessed October 2, 2012.

References

   1. mailto:frankejamesmd at mac.com
   2. mailto:medical at sanjuandem.net
   3. http://r20.rs6.net/tn.jsp?e=001DtzIOsQQCDvgLae818E89ncYGnlAFkpfQ5MWVqmSJIYSuBL4QLo8SOSxtutQJ3XYnS_JQP2ReCKY8LqyQKg2i1TZ0wsPByelX6ZRv6Q5fgWYl8-aD7ZxZt6VBb0jv8fQH1LN1uJTOr-Urv7CIbLoKLg7p8qSsTdLZkHMbM6zBwkKnyJlfMkrgB6GwkC5W_73Ku2whJmW4mE=
   4. http://r20.rs6.net/tn.jsp?e=001DtzIOsQQCDvRn-WB0hYHEu1FmHat1m91bNcJgClrFFd58utGs7oI-ODKspQvJNbPID5TxBbXXQezghaqZxCqAQXh4_vuTbQKtaSLC4Xe4H9SFPcLFjI2SEek8Auq3AzhkoGO39MJD4a2rBRFN_hHqkwYUW6ZqJRm0haThy0giM99U5GZt3XtqdxMZHPYVsYvzjtrGL4hJRI=
-------------- next part --------------
_______________________________________________
Medical mailing list
Medical at sanjuandem.net
http://sanjuandem.net/mailman/listinfo/medical_sanjuandem.net