2019-nCoV Novel Coronavirus Outbreak - Updated

Go to the profile of Julie Grishaw, ACNP
Jan 22, 2020

The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have identified an outbreak of pneumonia caused by a novel coronavirus in Wuhan, China.  The coronavirus is currently being termed “2019-nCoV”.  The outbreak was first reported on December 31, 2019.  This virus was first identified by the WHO as a novel coronavirus on January 9, 2020.  When this post was first written on January 11, 2020, 40 human cases had been identified with one mortality. At that time, there were no cases reported outside of China. This post is being updated as of January 22, 2020.  At this time, there have been 444 cases reported across six countries with 14 mortalities.  The first case in the United States was identified on January 20, 2020 in a patient that had recently traveled to Wuhan, China. The patient has been reported to be stable and undergoing treatment.

Coronaviruses comprise a large family of viruses and are a frequent cause of the common cold. Some cause less-severe disease, but more rarely, can cause severe disease as seen with the 2002 severe acute respiratory syndrome (SARS) and 2012 Middle East respiratory syndrome (MERS) outbreaks. The 2002 SARS epidemic, which originated in China, caused 8,300 illnesses and 785 mortalities.  A total of 1,879 cases of MERS have been reported with a 39% mortality rate.

The mode of transmission of coronaviruses is by respiratory aerosol, though the rates of human-to- human transmission varies between viruses. For example, the primary mode of transmission of MERS was camel-to-human transmission, with the rates of human-to-human transmission being very low. Initially, the likelihood of human-to-human transmission of 2019-nCoV was thought to be very low. The outbreak has a possible zoonotic origin, as it has been linked to a large seafood and animal market.  However, medical workers caring for patients in Wuhan city have become infected with the virus suggesting human-to-human transmission.  More information is being explored to determine the rates of human-to-human transmission, but safety precautions are currently being utilized to protect patients, providers, and the general public.

There is much to learn about the symptoms, severity, transmissibility and other features associated with 2019-nCoV. The CDC and WHO are actively investigating this outbreak and have taken many precautions to ensure continued public safety. CDC began entry screening of passengers on direct and connecting flights from Wuhan, China to the three main ports of entry in the United States on January 17, 2020. Entry screening will be expanded to airports in Atlanta and Chicago in the coming days.

The CDC has issued an updated interim Health Alert Notice (HAN) Advisory to inform state and local health departments and health care providers about this outbreak on January 17, 2020. The CDC has also deployed a team to support the ongoing investigation in the state of Washington in response to the first reported case of 2019-nCoV in the United States, including potentially tracing close contacts to determine if anyone else has become ill. The CDC has also developed a real time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) test that can diagnose 2019-nCoV. Currently, testing for this virus must take place at CDC, but in the coming days and weeks, CDC will share these tests with domestic and international partners through the agency’s International Reagent Resource.

Read more:

Review of Medical Microbiology & Immunology: A Guide to Clinical Infectious Diseases, 15e: Chapter 38: Respiratory Viruses

The Centers for Disease Control and Prevention: 2019 Novel Coronavirus (2019-nCoV), Wuhan, China

World Health Organization: WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China

Go to the profile of Julie Grishaw, ACNP

Julie Grishaw, ACNP

Senior Editor, McGraw-Hill Education

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