Corona virus

Coronavirus

What is 2019 Novel Coronavirus?

2019 Novel Coronavirus (2019-nCoV) is a new strain of coronavirus that has

not been previously detected in human. It is first identified in an outbreak of respiratory illness reported in December 2019 in Wuhan, China. Out of the first 41 people with pneumonia who were identified as having 2019-nCoV infection by 2 January 2020, two-thirds had been associated with Huanan Seafood Market, the largest wholesale market of live animal and seafood in Jiangshan District, Wuhan, Hubei province, China. According to The Wall Street Journal, among 585 animal specimens taken from the market, 33 showed evidence of 2019-nCoV.

Where does the 2019-nCoV come from?

Coronaviruses are known to circulate in animals and some of them have the capability of transmitting to people. However, the animal reservoir of the 2019-nCoV is still unknown. When the 2019-nCoV sequence is first available, some researchers found that it has a close relationship to relatives that were found in bats. A report on 23 January of a team led by a coronavirus specialist of the Wuhan Institute of Virology – Shi Zheng-Li – showed that the sequence of 2019-nCoV was 79.5% similar to SARS-CoV and had 96.2% similarity to a bat virus. That is why many scientists suspect there is one or more intermediary host pieces between 2019-nCoV and bats.

Early on, a research team led by Wei Ji, a microbiologist at Peking University Health Science Center School of Basic Medical Sciences in Beijing published a sequence analysis online on the Journal of Medical Virology on 22 January and pointed to snakes as “the most likely wildlife animal reservoir for the 2019-nCoV”. The researchers reported that codons of the 2019-nCoV had the most similarity to those used by two snakes which are the Chinese cobra and the many-banded krait and they noted that snakes were sold at the marketplace of live animals in Wuhan where the first cases were documented. Other scientists, however, pilloried it. According to some specialists, the evidence of the study is pretty weak and that coronavirus infections have been detected only in birds and mammals before, there is no proof that these viruses can infect other species so snakes would be a very unusual host. David Robertson, a virologist at the University of Glasgow, UK said that “Nothing supports snakes being involved”.

Nevertheless, doubts exist about the possibility that this “Novel Coronavirus” could have been artificially engineered and released deliberately or by accident, so that on February 4th the White House asked American scientists and medical researchers to investigate its origin. Infact, this Coronavirus holds some strange biochemical and genomic features in common with the HIV virus and, quite suspiciously, Wuhan is the home of the Wuhan Institute of Virology with a biosafety level 4 (BSL-4) laboratory which could be useful to develop both

vaccines and biologic weapons.

2. Transmission & Groups at risk

2.1 Transmission

How does this virus spread?

There are two types of transmitted: animals to people and between people, mainly among close contact. It was reported that many patients in the outbreak had some links to a market of living wild animal and seafood, indicating animalto-person spread. Meanwhile, it was reported that a growing number of patients have no exposure to the market, suggesting person-to-person spread. The 2019-nCoV transmit from people to people primarily through close contact with infected person, for example, in a healthcare center or household workplace, through droplets of saliva or discharge from the nose; through respiratory droplets generated when a person sneezes or coughs; through physically touching a surface that contaminated with the virus then touching

something like eyes, nose or mouth before washing hands.

There have been some reports that it is possible for 2019-nCoV to be transmitted by a person showing no symptoms, which is called asymptomatic person. According to The World Health Organization (WHO), it is possible with other coronaviruses such as MERS, but it is only happening in a very limited extent. Until now, there was some debate whether asymptomatic transmission of the coronavirus was possible. Even if asymptomatic people can spread the virus,

they may be less likely to than people who are sneezing and coughing — routes for the virus to jump from one person to another.

2.2 Group at risk

Who can catch this virus?

2019-nCoV can infect people of all ages who lives or travels in an area where the virus is circulating and people who in close contact with recent travelers from China. Especially those who work closely with wild animals such as workers at the market and those who are taking care of infected patients such as healthcare workers or family members appear to be more at risk.

People with pre-existing medical conditions (such as heart disease anddiabetes) and elderly are also at higher risk of getting severely ill with the virus.

On the other hand, a study published in January in the New England Journal of  Medicine also speculated that compared to adult, "children might be less likely to become infected or, if infected, may show milder symptoms".

3. Symptoms

How does the 2019-nCoV present?

There can be a range of symptoms from mild to severe, include fever and respiratory symptoms such as shortness of breath and coughing. There has been kidney failure, pneumonia and death in more severe cases.

The tell-tale symptoms of the novel coronavirus are:

● fever

● cough

● shortness of breath

● sore throat

Right now, it is believed that symptoms may appear in 2 to 14 days, as the incubation period for the novel coronavirus has not yet been confirmed.There has been speculation about the virus spreading while the carrier (infected person) is not showing any symptoms, but that has not been confirmed as a scientific fact .

Out of all the cases that have been confirmed, up to 20% have been deemed to be severe. Complications that may arise as a result of being infected are pneumonia, sepsis (a life-threatening immune chain reaction triggered by the infection), septic shock (low blood pressure and abnormal cellular changes caused by sepsis), and acute respiratory distress syndrome (a severe lung condition characterized by fluid accumulation in the air sacs of the lungs). Due to the severity of the symptoms, a patient may require mechanical ventilation (aided breathing) until the infection is cleared. In a few instances (about 2% of the cases), the novel coronavirus led to the demise of the patient.

Guidelines for Prevention

The management and prevention of Coronavirus. Prevention remains a tricky affair for any viral and virus-based illness as it requires years and years of research and testing to finally achieve success in creating the most potent vaccine to ensure prevention from the said disease. In the case of Coronavirus, the best possible prevention is to avoid exposure to the virus. To date, no effective vaccine exists for 2019-nCoV infection.

• Keeping the hands clean as the first step in effective and efficient prevention. Washing hands with soap and water for at least 20-30 seconds is necessary.

• If there is no availability of water or soap, then any alcohol-based sanitizer must be used to keep the hands clean, especially after approaching any person suffering from any illness; it is better to sanitize the hands.

• Keeping the contact to the minimum, and that does not imply contact with another person only, but also it is better to avoid touching on one's eye, nose, mouth, or face without washing or sanitizing hands.

•In illnesses, where methods to complete cure are yet not known or the vaccines to prevent the attack of such viruses is still in the development phase, it is better to avoid all sorts and forms of contact with the sick person.

• Quarantining the sick person and the premises is always the best exercise. Also, people from infected area or suspected to having had any contacts with infected people, should be kept in quarantine at least for 14 days, tough the suspect exist, that a 24 days period could last from the infection to the appearing of the first symptoms .

• People suffering from eye redness (conjunctivitis), fever, cough, or flu facing difficulty in breathing must seek medical care sharing complete travel history with the doctor. • In case you are sick and exhibit symptoms of a disease or the symptoms of 2019-nCoV infection, then it is better to avoid public places and confine one's self to home.

• As in the case of flu or cough, it is advised to cover the nose and mouth to avoid any inadvertent spreading of germs.

• The best practice in the case mentioned above is to either use a tissue and dispose of it after the use. A cloth may also be used, but it must also be discarded to avoid contamination of people who might come in contact with the cloth.

• The use of the face mask is the wisest choice in diseases that are related to the respiratory system, and the virus is carried through the air.

• Cleaning the surroundings is a must as well. Thus to ensure prevention, the surfaces, and objects coming in frequent contact with the patient may also be cleaned and properly disinfected to ensure the protection of other people.

In addition to the preventive regime and avoidance of travel to affected areas, avoiding contact with animals alive or dead is also essential. Thus any visit to animal markets touching uncooked meat or produce from such animals must be avoided at all costs. Also, the consumption of raw or undercooked animal products is not advised and, therefore, should be avoided to ensure prevention.

Products such as raw meat, milk or animal organs should be handled with diligence and necessary caution so that uncooked foods are not contaminated. Two essential explanations are needed, first that the symptom of fever may not be existing in some patients, for example, very young patients or elderly and immunosuppressed patients on fever-lowering medications. Thus clinical judgment is required and advised to guide the testing of patients. Secondly, the

definition or explanation of the concept close contact discussed above: the approximately of 6 feet, sharing same room or ordinary care area, of a novel Coronavirus case for a more extended period and without recommended protective equipment such as masks, gowns, gloves, NIOSH-certified disposable N95 respirator, and eye protection are termed as close contact. Also, the act of caring for, attending to, and remaining in close vicinity of the patient. Lastly, thefact that a person comes in direct contact with infectious secretions of an infected person suffering from the disease.

Now some measures and guidelines for people having a recently in India.

·         You must avoid contact with other people and patients.

·          You should not travel while sick

·         .Covering face with tissue or cloth while sneezing or coughing.And wash hands as suggested above

·         .Stay at home

·         Follow the government Rules