Novel coronavirus: What GPs need to know

Amanda Lyons

17/01/2020 1:16:27 PM

A new virus from the same family as SARS and MERS has emerged in China, with further cases confirmed in Japan and Thailand.

People in Tokyo wearing protective masks
A case of the virus has been confirmed in Japan, with a man treated for pneumonia testing positive for coronavirus. (Image: AAP)

Researchers have identified the virus as a member of the coronavirus family.
‘Coronaviruses are very common viruses found worldwide in humans and animals,’ Dr Penny Burns, a GP with a special interest in travel medicine, told newsGP.
‘They cause respiratory disease, including common colds. Most people will contract at least one of the common human coronaviruses during their life, usually during childhood.
‘Coronaviruses, however, are also responsible for MERS [Middle East Respiratory Syndrome] and SARS [Severe Acute Respiratory Syndrome].’
The new virus is pneumonia-like, manifesting with symptoms such as fever, difficulty breathing and invasive lesions of the lungs. Believed to be transmitted to humans from animals, it first emerged in the central Chinese city of Wuhan in mid-December, where it has been linked to a seafood market which also sold live chickens, bats and other mammals.
Dozens of people, most of them workers at the market, have been hospitalised and quarantined, some in critical condition, although many have since been released.
But there is certainly reason to be vigilant: while the new virus is milder than its SARS counterpart, two deaths have been recorded. There have also been cases confirmed in Thailand and Japan in people who had travelled through or from Wuhan.
However, neither traveller had visited the market from which the disease first emerged, raising the possibility the disease is more widely spread through the city than first thought.
And while there has so far been little evidence the disease can spread from person to person, the possibility has now emerged the disease may have transmitted between members of a family.
Dr Burns has advice for practitioners in helping to identify patients who may be most at risk.
‘GPs have a crucial frontline role to play in surveillance for early presentations of this condition,’ she said.
‘A suspected case must have epidemiological evidence – as in, have travelled to Wuhan City in the 14 days before illness onset – as well as fever and respiratory signs and symptoms.
‘Most at risk are travellers to Wuhan City, particularly areas around the Wuhan South China Seafood City Market, also called the South China Seafood Wholesale Market and the Hua Nan Seafood Market.
‘Possible sources at the market include seafood and chickens, as well as wild animals such as bats –so those who have had contact with living or dead animals, animal markets, or contact with people unwell with fever and respiratory symptoms are particularly at risk.’

The people most at risk of the the new virus are those who have travelled to Wuhan, China, where it was first identified.
Dr Burns also has advice for patients who are travelling to the area in which the virus has been identified.
‘Travellers, particularly to that region of China, need to practice good respiratory and personal hygiene and avoid people with fever and respiratory symptoms,’ she said.
‘They could take N95, or P2, masks with them. They also need to be aware of and avoid living or dead animals, animal markets, and contact with sick people. 
‘If they start to feel unwell with these symptoms they need to avoid contact with others and seek medical attention.’
Although gene sequencing has found the new coronavirus to be at least 70% similar in genetic makeup to SARS, authorities so far believe it is unlikely it will cause a situation as serious as the SARS outbreak in 2002, which emerged in southern China and spread worldwide, resulting in 774 deaths in 37 countries.
However, health authorities have emphasised the importance of monitoring the situation and continuing to investigate the disease.
‘We should always be concerned about novel organisms and monitor them closely until we understand their characteristics and therefore their risk to human health,’ Dr Burns said.  
Although the outbreak has come ahead of the Chinese New Year holiday, during which millions of people travel to and across China to visit their families, the World Health Organization is not currently recommending any travel or trade restrictions.
‘Travellers to other areas of China are not considered at risk but this could change,’ Dr Burns said.
‘This is an emerging and rapidly changing situation as the characteristics of the virus are being understood.’ 
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A.Prof Christopher David Hogan   18/01/2020 8:35:18 AM

Well, here we go again. I remember that the SARS patient zero in Australia was a sick, tired traveller who just wanted to go home- to rural Australia. An astute rural doctor saved us that time. We will all need to be alert again.
The bushfires have shown the uttery critical role of General Practitioners in their communities & the government is slowly starting to remember that. Here's hoping that General Practice is properly supported & re-integrated into the health care system as an equal partner in combating all our health challenges- for all our sakes.

Dr Wai Mun Tsang   22/01/2020 8:00:12 PM

Professor KY Yuen, professor of infectious diseases, University of Hong Kong, said in the news yesterday that a confirmed case had infected fourteen medical staff in China. It CAN be transmitted from humans to humans.