Novel Coronavirus — It Hasn’t Gone Away

By Stan Deresinski, MD, FACP, FIDSA, Clinical Professor of Medicine, Stanford University, Hospital Epidemiologist, Sequoia Hospital, Redwood City, CA, Editor of Infectious Disease Alert.

Synopsis: Another case of novel coronavirus infection, for which person-to-person transmission has been demonstrated, has been reported.

Source: WHO. Novel coronavirus infection – update. http://www.who.int/csr/don/2013_03_12/en/index.html

In the January 2013 issue of Infectious Disease Alert the initial reports of a novel coronavirus were reviewed.¹ These included 5 cases (including 3 deaths) from Saudi Arabia, two cases from Qatar and two cases (both fatal) from Jordan. Unfortunately, this potentially lethal virus has not disappeared, as the SARS coronavirus appears to have done, and a 15th case has been reported.

On 12 March 2013, the WHO reported that they had been informed by the Ministry of Health in Saudi Arabia of a new confirmed case of infection with the novel coronavirus (nCoV). A 39-year-old man became ill on 24 February 2013 and died on 2 March, several days after hospitalization. While the epidemiological investigation is incomplete, no link to previously reported cases had been identified. This patient was the 15th known case of nCoV infection; 9 have died.

Commentary

No cases of nCoV infection have yet been reported in the U.S. but 3 cases within one family in the U.K. have been confirmed. The index family in that cluster had traveled to Pakistan and Saudi Arabia. Investigation indicated person-to-person transmission within the family.

The Centers for Disease Control and Prevention recommends reporting the following to your health department:^2,3

• A person with an acute respiratory infection, which may include fever and cough, AND
• Suspicion of pulmonary parenchymal disease (such as pneumonia or acute respiratory distress syndrome based on clinical or radiological evidence of consolidation, AND
• History of travel from the Arabian Peninsula or neighboring countries within 10 days, AND
• Not already explained by any other infection or etiology, including all clinically indicated tests for community-acquired pneumonia* according to local management guidelines, AND
• Persons who develop severe acute lower respiratory illness of known etiology within 10 days after traveling from the Arabian Peninsula or neighboring countries* but who do not respond to appropriate therapy, OR Persons who develop severe lower respiratory illness who are close contacts of a symptomatic traveler who developed fever and acute respiratory illness within 10 days of traveling from the Arabian Peninsula or neighboring countries.

References

1. Deresinski S. A New Human Coronavirus Causing SARS-Like Illness: WHO Casts Wide Net, no Definitive Human-to-Human Transmission. IDA 2013; 32:37-8
2. CDC. Update: Severe Respiratory Illness Associated with a Novel Coronavirus — Worldwide, 2012–2013 2013;62:194. Http://www.cdc.gov/mmwr/preview/mmwrhtml/mm62e0307a1.htm?s_cid=mm62e0307a1_e
3. CDC. Update, Case Definitions, and Guidance. http://www.cdc.gov/coronavirus/ncv/case-def.html