‘Novel coronavirus’ or 2019 nCoV: What we know so far

The Department of Health (DOH) on Tuesday, January 21, confirmed that it is investigating a case of “non-specific pancoronavirus” found in a 5-year-old Chinese boy in Cebu City.

Health officials have ruled out MERS-CoV, which causes Middle East respiratory syndrome or MERS and SARS-CoV, which causes severe acute respiratory syndrome or SARS. This means that the samples from the child, which are currently being tested in Australia, could be one of the 5 other existing coronaviruses that are known to infect humans, including the 2019 novel coronavirus (nCoV), which started in Wuhan, China and has infected over 200 people.

The World Health Organization (WHO) is set to hold an emergency meeting to discuss this novel virus that has since been found not just in China but in Thailand, Japan, and South Korea as well. The WHO said the mode of transmission for the virus is still being determined, though a Beijing government expert said it could be contagious between humans.

Here’s what we know so far:

When did it start?

The first cases of nCoV were revealed by Chinese state media on December 31, after 44 people from the Chinese city of Wuhan were confirmed to be infected. Initial reports referred to the disease as “mystery viral pneumonia,” as infected people exhibited flu-like symptoms like persistent coughing, fever, shortness of breath, and difficulty in breathing.

Where did it come from?

The infections started in the Chinese city of Wuhan, a city of 11 million. It is the capital of China’s Hubei province and also serves as a major transport hub in the country. There are fears that the virus might spread as many people travel across the country during the Chinese New Year. Officials in Wuhan have put in place strict screening measures of people traveling out of the city, with medics even taking passengers’ temperatures before planes are allowed to fly out.

So far, cases have been confirmed in Shanghai and Beijing. The virus has also reached South Korea, Japan, and Thailand, with cases confirmed in people with history of travel to Wuhan.

Health officials in China have said that the virus probably originated in animals and was transmitted to humans by contact with animals at a live market, but such suspicion has yet to be confirmed. Chinese officials in China have also said that the virus can spread from person to person, but the WHO has yet to make a similar pronouncement.

How is it related to SARS and MERS?

The pneumonia-like disease caused by the 2019 nCoV is similar to SARS and MERS in that nCoV, like MERS-CoV and SARS-CoV, is also a coronavirus. Coronaviruses are a large group of viruses that can cause a range of diseases in humans and animals – diseases as simple as the common cold to diseases like MERS and SARS.

MERS is a viral respiratory disease that was first identified in Saudi Arabia in 2012. By the end of 2015, 483 deaths and a total of 1,180 cases were reported in the Middle East. MERS symptoms include fever, cough, and shortness of breath. Pneumonia may also be present, but not always.

Though it remains unknown where exactly the virus came from, health officials have said that the virus might have come from camels, which is common in the Horn of Africa and the Middle East.

SARS is another viral respiratory disease which originated in Guangdong province, southern China in 2003. A SARS epidemic spread to 26 countries in 2003, resulting in a total of 8,000 cases and over 800 deaths in China and Hong Kong. Transmitted by human-to-human contact, it is characterized by the following flu-like symptoms: fever, headache, diarrhea, shivering, cry cough, and shortness of breath.

The virus is believed to have come from bats and spread to other animals. Unlike MERS that was found to infect mostly older men with chronic conditions, SARS was found to infect both health and unhealthy individuals.

It is not yet known whether the 2019 disease infecting over 200 in China is caused by a more severe kind of coronavirus like MERS and SARS, but the WHO has emphasized that 3 of the 4 who have died due to the new virus had pre-existing illnesses. Like MERS and SARS, though, the disease emerging from the 2019 nCoV cannot be treated through vaccination. Control of the disease is done through close monitoring, symptom management, and rest.

How severe is it?

The 5-year-old boy in which the 2019 nCoV was found is recovering, according to DOH. He remains under observation in a hospital in Cebu City, still experiencing cough but no longer feverish.

WHO’s country representative to the Philippines, Rabindra Abeyasinghe, said in a January 21 press briefing that “it is too early to say this is a severe disease.” Abeyasinghe reiterated that the 3 people who have died due to the virus were proven to have pre-existing illnesses.

“We still need to understand better the mode of transmission and what needs to be done specifically for management,” he added. WHO recommends the use of tried and tested guidelines used for MERS-CoV and SARS-CoV. “We are advocating following those same precautions until we have clearer information that will help us form more specific guidelines,” Abeyasinghe added.

For now, DOH and WHO are reminding people to practice proper hygiene, as transmission may be from contacts with animals or other humans. They have also advised the public to practice frequent handwashing and avoid unprotected contact with farm or wild animals.

Proper cough etiquette is to be observed as well: maintaining distance and covering your nose and mouth with tissue, a towel, or the crook of your elbow. DOH and WHO are also calling on people to ensure that food is well-cooked while the potential source of the virus is still being identified.

What is the government doing?

The health department’s Bureau of Quarantine (BOQ) is on high alert, especially with travelers from Wuhan and China manifesting fever or signs of respiratory infection. The BOQ is set to meet with airlines to remind them of measures to observe in light of the scare. They will ensure that airlines have universal protective kits on board and remind them of protocols in handling cases on board and reporting cases to authorities on the ground.

DOH also said that health workers are also expected to be more vigilant when in contact with patients with acute respiratory infection, especially those with travel history to China.

Health Secretary Francisco Duque III said the Philippines’ “detection capability is still evolving.” The Research Institute for Tropical Medicine (RITM), DOH’s main research arm for prevention and control of infectious and tropical diseases, has yet to determine whether the virus found in the 5-year-old boy in Cebu was MERS-CoV or SARS-CoV.

Duque said RITM would have to acquire samples of the new coronavirus from China to be able to test whether samples found here are indeed the same.

“WHO is in constant coordination with the Chinese health ministry as to when the available primer (DNA sample of nCoV that will serve as basis for determining other samples of nCoV) will be given to countries so it will serve as the basis for our own testing and treatment,” Duque said. – Rappler.com

Sources: World Health Organization, Centers for Disease Control and Prevention, Department of Health