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The new China coronavirus

Development of a diagnostic test

China was extraordinarily efficient and open in identifying the virus, a new strain of coronavirus, within just over a week. Chinese scientists sequenced the virus’s genetic code and, within days, shared that information with the world.

This allowed researchers from Germany to rapidly develop and openly share a suite of specific nucleic acid tests that sensitively identify the virus by detecting small amounts of its ribonucleic acid (or RNA, similar to DNA). Researchers in Hong Kong and from the Chinese Centre for Disease Control then published their own different tests.

The new Wuhan coronavirus at first seemed to cause less severe disease than the SARS coronavirus, which is now extinct after its single dramatic outbreak in 2002-4.

MERS was less severe than either, unless the patient was already burdened with underlying disease. MERS continues to transmit from camels to humans, but it’s relatively easy to avoid infection and vaccines are in development.

Because it was such an early stage of discovery and characterisation of the new Wuhan virus, it was very difficult to compare it to other viruses or to draw any strong conclusions about how it transmits, and its impact on humans.

How does it spread?

We don’t know where the new virus came from originally. We think it originated in animals, but testing so far has not confirmed a specific animal host. Analysis of the genome suggests it has only recently emerged in humans. So which host were humans exposed to? And how was it transmitted to humans? Once we know where it came from we can track down and remove the source of the virus.

Some evidence suggests it can also spread between people. We don’t yet know how, but we can make some guesses.

It seems to be a respiratory virus, given the disease primarily involves the lungs, so it’s likely to spread through the same routes as colds and flu: sneezes and coughs propelling droplets into the air or onto hands that then touch other surfaces, or by touching our eyes, nose or mouth after contact with contaminated surfaces.

We also don’t know how easily it spreads. Initially it seemed to require prolonged and close contact, making it harder to catch in day-to-day life. However, there are more recent indications that it spreads more easily between people.

What we know and don’t know

Up to January 22, 17 deaths had tragically occurred from 582 cases (about 3%). Scientists said this is lower than the proportion who die from influenza-associated pneumonia, which one study estimated to be 10%. It’s a crude comparison, but one we can at least mull over for now.

The number of virus cases is likely to be an underestimate, but we don’t know by how much.

So far, we know the new Wuhan coronavirus causes pneumonia and therefore places an extra burden on hospitals. It’s transmitting from human to human, but may also still be transmitting from animal to humans. And it can be tested for by professional laboratories.

For now, health authorities are ensuring we are prepared and watching the situation while we await further details.

The Centres for Disease Control and Prevention (CDC) in the USA on Jan.22 issued a travellers health advisory in which it indicated that the outbreak in in China was at Level 2, the second highest which encourages travellers to “practice enhanced precautions”.

According to WHO, countries should screen entry from areas with infections and encourage suspected cases among travellers to seek medical attention. Countries should ensure they have appropriate trained staff, space, screening equipment, and safe transportation of symptomatic travellers to hospitals or designated facilities for clinical assessment and treatment.

People are advised to apply measures often used to reduce the general risk of acute respiratory infections. These include avoiding close contact with people suffering from the infection, hand-washing frequently, avoiding close contact with live or dead farm or wild animals, practice proper cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).

You can protect yourself in the same way as you would against other respiratory illness: by being vigilant about hand-washing and practising good cough and sneeze etiquette, which means coughing or sneezing into your flexed elbow or into a tissue, and washing your hands.

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