New coronavirus prompts concern
No human-to-human transmission
When a coronavirus recently caused two cases of severe respiratory illness in Saudi Arabia and Qatar, it was hard not to think of the challenging and deadly experience with another coronavirus — Severe Acute Respiratory Syndrome, or SARS.
SARS emerged in China in 2003 and eventually led to 774 deaths in 26 countries. In all, more than 1,700 health care workers were known to be infected with SARS, or about one-fifth of all cases.1
As a “lesson learned,” the Centers for Disease Control and Prevention noted: “Healthcare facilities were disproportionately affected by SARS-CoV, and healthcare workers were among the first and most severely affected groups in every large outbreak reported.”
A SARS Commission in Ontario criticized the lack of a safety culture in Canadian hospitals and emphasized the “precautionary principle” — that facilities should take “reasonable action to reduce risk” to health care workers even if there is still scientific uncertainty.
So when a novel coronavirus emerged this year, it immediately received global attention. The first known patient was a 60-year-old man from Saudi Arabia, who died in June. A 49-year-old man from Qatar was hospitalized in September with pulmonary and renal failure. There have been no cases of person-to-person or health care-associated transmission.2
In Ontario hospitals, the information produced some alerts, says Gabor Lantos, MD, P.Eng, MBA, president of Occupational Health Management Services in Toronto and a consultant to hospitals.
Hospitals still struggle with issues such as respirator fit-testing, says Lantos, but preparedness has improved. “The awareness is definitely higher than it was 10 years ago, at all levels,” he says.
Although this coronavirus is a reminder of SARS, it is distinct from the virus that spread quickly in hospitals in Asia and Canada. “There are still only two cases so it doesn’t seem that it’s very communicable,” says Lantos. “When we had SARS, we had one index case, and within days we had people coming down with it.”
Lantos notes that “anybody presenting with a fever of 101 and coughing should be appropriately isolated, to the best available means,” until they have been fully evaluated. For respiratory hygiene, the CDC recommends providing a mask to the coughing patient, if possible, and separating the individual from other patients. Health care workers should wear a mask when in close contact with a coughing patient, CDC says.
The World Health Organization offers this definition for a “patient under investigation” for the new coronavirus:
- A person with an acute respiratory infection, which may include fever (≥ 38°C, 100.4°F) and cough; AND
- suspicion of pulmonary parenchymal disease (e.g. 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 etiology, including all clinically indicated tests for community-acquired pneumonia according to local management guidelines.
According to the CDC, anyone who develops an acute respiratory illness within 10 days of returning from Saudi Arabia or Qatar (beyond just passing through an airport) should consult a physician and mention the recent travel. Cases of patients who meet the WHO criteria should be reported immediately to CDC through state and local health departments.
Testing for this virus must occur through CDC. “[W]idely available diagnostic tests for coronaviruses are not suitable for detecting this new virus,” CDC says.
Based on its tests, CDC determined that this coronavirus is similar to coronaviruses found in bats but not to any coronavirus previously found in humans. “Treatment is supportive because no specific therapy has been shown to be effective,” CDC says.
[Editor’s note: More information on the novel coronavirus is available at www.cdc.gov/coronavirus/ncv/.]
References
- Chan-Yeung M. Severe Acute Respiratory Syndrome (SARS) and healthcare workers. Int J Occup Environ Health 2004; 10:421-427.
- Centers for Disease Control and Prevention. Severe respiratory illness associated with a novel coronavirus — Saudi Arabia and Qatar, 2012. MMWR 2012; 61:820.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content