Coronavirus

4 months ago
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Basic information about the novel Coronarvirus, currently in China.

Coronaviruses (CoV)
A large family of viruses that cause illness ranging from the common cold to more severe respiratory diseases.

A new novel virus identified from humans 29th December 2019, 2019-nCoV

Human respiratory viral infections
Cold often caused by rhinovirus
Influenza (flu) caused by influenza virus

Coronaviruses virion
CoV is a single stranded RNA
Protein envelope (protein shell or capsid)
Crown shaped virions
Less than 100 nm

Coronaviruses are zoonotic
MERS Middle East Respiratory Syndrome, 2012
SARS Severe Acute Respiratory Syndrome, 2003
Novel previously unidentified in humans, 2019 – nCoV

Clinical features
Fever 98%
Cough 76%
Myalgia or fatigue 44%
Sputum production 28%
Headache 8%
Haemoptysis 5%
Diarrhoea 3%
Dyspnoea 55%

Severe acute respiratory infection – pneumonia
Acute respiratory distress syndrome
Radiology

Median duration from illness onset to dyspnoea 8·0 days
Median time from onset of symptoms to first hospital admission 7·0 days
Time from onset of symptoms to mechanical ventilation was 10·5 days
Leucopenia less than 4 × 109/L 25%
Lymphopenia less than 1·0 × 109/L 63%

Transmission
Direct from animals, vectors
Human to human
Droplet, nasal or mouth mucosa, eyes
Coughs and sneezes spread diseases – over 2 metres
Catch it – bin it – kill it
Surfaces – hands – mucous membranes
Virus contained in an envelope, so virus can stay dormant for 5 days
Fomites
Closed environments, less likely outside

Sometimes people with mild or no symptoms can be carriers

Contagious for a few (2-5-14) days of incubation period, feeling well but still contagious.

Protection
1. Stay home, avoid planes, buses, trains, busy areas
2. No visitors avoid close contact with symptomatic people or potential carriers
3. Wear a quality medical mask
4. Wrap around glasses
5. Gloves and meticulous hand hygiene, don’t touch eyes, nose mouth
6. Don’t trust hand sanitizers
7. Avoid hospitals

Same infectiousness as SARS, lower mortality (SARS) 10% v 3%

2 to 3 people get new infection for every infected case

Treatment
Supportive
Keep warm
Hydration
Eat if hungry
No specific coronavirus antiviral drugs
Oxygen for hypoxaemia
3% mortality
No vaccine as yet