2020 Pneumonia outbreak in Wuhan China
OriginsCoronaviruses (CoV) are a broad family of viruses named
after the crown-like spikes on their surface. They typically
cause mild to moderate upper respiratory tract disease
in humans, but can also cause more severe infections
such as pneumonia and other lower respiratory tract
infections. Mild illness caused by CoV includes the
common cold and influenza-like illness. Severe illness
caused by CoV includes Severe Acute Respiratory
Syndrome (SARS) CoV, Middle East Respiratory Syndrome
(MERS)-CoV, and some pneumonias. There are some
coronaviruses that can be transmitted from animals to
people. Both the SARS-CoV and MERS-CoV are believed
to have originated in animals and were transmitted to
people, causing infection.
In Jan 2020 a novel CoV was identified in 200+ people
in Wuhan China, most of whom had contact with the
same seafood market in Wuhan. If the virus is zoonotic
as is believed (meaning an animal reservoir with animal
to human transmission), it does not appear to be easily
transmittable to people, or transmittable from person to
person based on the study of the outbreak. The market
where the outbreak occurred sells seafood, chickens, bats,
cats, marmots, and other wild animals. It is not known
which animal(s) are likely the cause of the outbreak.
So far the people infected have had pneumonia, but
otherwise mild symptoms with only a few deaths, with
10-20% of those infected requiring hospitalization for
more severe forms of the disease. For comparison, SARSCoV
had a mortality rate of 9.6% (9.6% of those people
infected died from the disease) and MERS-CoV has a
mortality rate of 34.5%. Until the virus causing this illness is formally named, we will refer to it in this document as the Wuhan Coronavirus.
Diagnosis
Our understanding of the incubation period (time from
exposure to development of symptoms) for the Wuhan
Coronavirus and comorbidities that may affect patient
risk are in the early stages. The one patient that died
had extensive comorbidities, so as with other diseases,
patient comorbidities are likely to make the infection
more severe.
For other CoV, the incubation period is 2-5 days for the
development of symptoms, suggesting people exposed
to CoV will rapidly present symptoms of infection. If a
person does not develop symptoms approximately 7
days after a potential exposure, they are unlikely to have
been infected. This knowledge will evolve over time.
The symptoms likely to present early in the illness are
often seen in patients with more commonly occurring
diseases, such as the common cold, and influenzalike
illness, or even other CoV infections. Diagnosis
and treatment should only be performed by a trained
physician who can rule out other potential diseases.
Symptoms of CoV infection include:
• Sudden onset fever/high fever
• Cough
• Headache
• Stuffy/runny nose
• Sore throat
• Muscle and joint pain, body aches, and fatigue
Method of Transmission/Contagiousness
The primary site for preventing the spread of the Wuhan
Coronavirus is unknown at this point. If the virus has an
animal host, which seems most likely, the housing where
the animals are kept will be the primary point to control
the virus’s spread. If person to person transmission
is possible, it will likely only occur where there is close
personal contact. Casual contact in the public is unlikely
to result in transmission. Both SARS-CoV and MERSCoV
are spread by droplet transmission. In droplet
transmission, infected droplets of liquid are discharged
from the infected person (such as by coughing and
sneezing) and only travel up to 1 meter before rapidly
settling onto surfaces. The droplets are not carried in air
currents over a larger area, minimizing the risk of ongoing
transmission.
When the method of transmission for a pathogen is
not well understood, the CDC and WHO recommend
additional caution for healthcare workers when in close
contact or when treating symptomatic patients.
Prevention
Assuming primarily an animal reservoir with some
potential for animal to human transmission, the following
recommendations apply to a business that handles living
or dead animals.
1. Protective Equipment: Workers that handle living
or dead animals should use protective clothing, gloves,
and masks when handling feed, water, feces, or in close
contact with the animals. They should wash clothing after
contact with animals and change clothing each day.
2. Hand Hygiene: Workers that handle living or dead
animals should perform frequent hand hygiene through
the day, especially when entering and leaving animal
housing areas. Hand hygiene should be performed after
sneezing or coughing. Workers should avoid touching
their face, mouth, eyes, and nose, especially when around
animals. 3. Surface Disinfection: As CoV are easily killed on
environmental surfaces with healthcare disinfectants
(being enveloped viruses), standard cleaning and
disinfection practices are effective and critical in
preventing the spread of CoV, including the Wuhan
Coronavirus.
References and useful websites
Much of the information used in the development of this
blog was taken from the sites listed below.
We stock Diversey disinfectants to help prevent viruses including the Coronavirus here.
Diversey have created a guide surrounding this topic and its prevention. To download this guide please click here.
https://emergency.cdc.gov/han/HAN00424.asp
https://www.cdc.gov/coronavirus/index.html
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