By: Pro. Dr. Mohamed Shendy
Wuhan is the capital of Hubei and is the seventh-largest city in China, It is approximately 1,100 km (700 mi) south of Beijing, 800 km (500 mi) west of Shanghai, and 970 km (600 mi) north of Hong Kong.
In Wuhan, during December 2019, a cluster of cases displaying the symptoms of a “pneumonia of unknown cause” was linked to Huanan Seafood Wholesale Market, which had a thousand stalls selling fish, chickens, pheasants, bats, marmots, venomous snakes, spotted deer, and other wild animals.
In January 2020, the hypothesis was that this was a novel coronavirus from an animal source, In February 2020, the Chinese authorities have confirmed a highly pathogenic strain of the H5N1 bird flu in chickens in Hunan province.
Coronaviruses mainly circulate among other animals but have been known to evolve and infect humans as in the cases of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) together with four further coronaviruses that cause mild respiratory symptoms similar to the common cold, Transmission of coronaviruses is primarily thought to occur among close contacts via respiratory droplets generated by sneezing and coughing.
Of the first 41 confirmed cases of 2019-nCoV infection, two-thirds were found to have a link with the Huanan Seafood Wholesale Market, which also sold live animals. The virus spread to other Chinese provinces in early and mid-January 2020, helped by the Chinese New Year migration.
On 20 January, China reported a sharp rise in cases with nearly 140 new patients, including two people in Beijing and one in Shenzhen.
The virus was soon carried to other countries by international travellers: Thailand (13 January); Japan (15 January); South Korea (20 January); Taiwan and the United States (21 January); Hong Kong and Macau (22 January); Singapore (23 January); France, Nepal and Vietnam (24 January); Australia and Malaysia (25 January); Canada (26 January); Cambodia (27 January); Germany (28 January); Finland, Sri Lanka and the United Arab Emirates (29 January); India, Italy and Philippines (30 January); the United Kingdom, Russia, Sweden and Spain (31 January); Belgium (4 February).
Signs and symptoms:
Mild to severe symptoms, like fever, cough, shortness of breath, and diarrhea, the time from exposure to onset of symptoms is estimated at 2 to 10 days by the World Health Organization, and 2 to 14 days by the US Centers for Disease Control and Prevention (CDC).
Upper respiratory symptoms such as sneezing, a runny nose or sore throat are less frequent, Cases of severe infection can result in pneumonia, kidney failure, and death. Many of those who died had other conditions such as hypertension, diabetes, or cardiovascular disease that impaired their immune systems.
Several testing protocols, Testing uses real time reverse transcription-polymerase chain reaction (rRT-PCR), The test can be done on respiratory or blood samples.
Coronaviruses are spread through air droplets expelled when an infected individual coughs or sneezes within a range of about 6 feet (1.8 m), which can contaminate surfaces like door handles or railings.
There have been various estimates for the basic reproduction number (the average number of people an infected person is likely to infect), ranging from 2.13 to 3.11. The new coronavirus has been reportedly able to transmit down a chain of up to four people so far. This is similar to severe acute respiratory syndrome-related coronavirus (SARS-CoV).
Recommended measures to prevent infection depend on the likelihood of a person coming into contact with the disease. The US CDC recommends avoiding exposure.
A number of countries have advised against travel to either Mainland China, the province of Hubei, or just Wuhan. Other recommendations include frequent washing of hands with soap and water, not touching ones eyes, nose or mouth unless the hands are clean, and covering the mouth when one coughs.
People in high risk areas should take additional precautions even around people that are not displaying symptoms. There is no evidence that pets such as dogs and cats can be infected.
Hand washing is recommended as a preventive measure to prevent the spread of 2019-nCOV. The CDC recommends that individuals:
• “Wash hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.”
• “If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.”
Anyone experiencing respiratory symptoms should cover a cough or sneeze with a tissue, promptly discard it in the trash, and wash their hands. If a tissue is unavailable, individuals can cover their mouth or nose with a flexed elbow.
The WHO advises the following best practices for mask usage:
• Place mask carefully to cover mouth and nose and tie securely to minimise any gaps between the face and the mask; While in use, avoid touching the mask.
• Remove the mask by using appropriate technique (i.e. do not touch the front but remove the lace from behind).
• After removal or whenever you inadvertently touch a used mask, clean hands by using an alcohol-based hand rub or soap and water if visibly soiled.
• Replace masks with a new clean, dry mask as soon as they become damp/humid.
• Do not re-use single-use masks; Discard single-use masks after each use and dispose of them immediately upon removal.
By: Pro. Dr. Mohamed Shendy
Dr Mohamed Shindy: MD .ORL
Prof, ORL, Benha faculty of Medicine Benha University
Email: drshindi @yahoo.com