In December 2019 a cluster of unusual pneumonia cases was reported from Hubei province in China, in and around the city of Wuhan. Scientists discovered that this respiratory disease is caused by a novel virus belonging to the coronavirus family and named it nCoV 2019. More than 95000 people from more than 85 countries have been infected and more than 3200 have died as of 5th March 2020. This viral disease has similarities with two previously reported epidemics of SARS (severe acute respiratory syndrome) in 2003 and MERS (middle-east respiratory disease) in 2014. World health organization (WHO) in early February 2020, has declared this epidemic as public health emergency of international concern (PHEIC)..
Question: How does this infection spread?
The virus spreads via droplets or fomites (inanimate objects touched by infected persons such as handkerchief or door knobs). The aerosol generated during coughing and sneezing is also infectious as the virus resides in the nasal or throat secretions of infected persons. People in close contact (within 6 feet of infected person) may get infected.
Question: What are the symptoms of coronavirus infection (COVID -19)?
In a study reported by CDC (centre for disease control) in China, more than 70000 persons with suspected COVID-19 were studied. Most people have fever and dry cough, muscle pains. Many also reported headaches, abdominal pain and diarrhea. Some of them with serious disease went on to have breathlessness and bloody phlegm. After the virus enters into body, the symptoms show up in 2-14 days (incubation period).
Question: How is coronavirus disease diagnosed?
There are only a few centres which can diagnose this disease. National Institute of virology (NIV) at Pune, Maharashtra is the nodal centre for diagnosis of COVID-19. Recently government of India has also opened up centres at 3-4 other places. A test called RT-PCR (real-time polymerase chain reaction) is used to diagnose this disease. Currently only people showing symptoms and, who have travel history to countries reporting COVID-19 infections or those with contact with diagnosed cases are eligible for testing. As of 5th March 2020, 30 positive cases have been reported from India.
Question: What is the treatment and/or prevention of this disease?
As of now, there is no definitive treatment for established coronavirus infections. We can only try to prevent it. Infected cases need to be isolated to prevent spread of infection. Most cases are mild and lead to clinical recovery on their own. Various drugs and therapeutic strategies have been tried for the serious patients but no firm conclusions can be drawn. Some new drugs (Remdesivir) previously used in other infection (ebolavirus disease) are into clinical trial for treatment of COVID-19. Other supportive treatments such as oxygen support, ventilation and nutrition can be offered to infected patients.
Question: What are the ways to prevent coronavirus infection?
Preventive measures that work for other respiratory viral infections also work for coronavirus infection (COVID-19).
Question: What are guidelines about use of mask in this epidemic?
Healthy persons need not wear mask at public places. Masks are to be used by persons sick with cough and cold and health-care workers. Proper use and disposal of mask is necessary to derive maximum benefit out of it.
Dr. Bharat Purandare is an Infectious Diseases Physician practicing in Pune. Article published based on inputs received from Dr. Purandare.