Target Health Blog

Coronavirus - 2019-nCoV

February 3, 2020


2019-20 Wuhan coronavirus outbreak - Symptoms of 2019-nCoV (Wuhan coronavirus). There are reports that it may spread even without symptoms.
Graphic credit: by Mikael Haggstrom, M.D.- Author info- Reusing images [Category:Mikael Haggstrom/{cat} - Own work, CC0; Wikipedia Commons

A new coronavirus, designated 1) ___,  was first identified in Wuhan, Hubei province, China, after people developed pneumonia without a clear cause and for which existing vaccines or treatments were not effective. The virus has shown evidence of human-to-human transmission and its transmission rate appeared to escalate in mid-January 2020, with several countries across Europe, North America and the Asia-Pacific region reporting cases. The incubation period (time from exposure to developing symptoms) of the virus is between 2) ___ days and it remains contagious during this time. Symptoms include fever, coughing, and breathing difficulties, and it can be fatal.

In response to the virus spreading, cities equaling over 40 million people including 3) ___ and 15 cities in the surrounding Hubei province were placed on lockdown, involving the termination of all urban public transport and outward transport by train, air and long-distance buses.

4) ___ are named for the spikes that protrude from their membranes, which resemble the sun's corona. They can infect both animals and people, and can cause illnesses of the respiratory tract, ranging from the common cold to dangerous conditions like Severe Acute Respiratory Syndrome, or SARS, which sickened thousands of people around the world - and killed nearly 800 - during an outbreak in 2003.

No drugs have been approved for any coronavirus diseases, including the Wuhan coronavirus, though an antiviral medication called remdesivir appears to be effective in animals. Chinese officials are experimenting with at least one other H.I.V. drug to treat the infection. Animals are the most likely primary source of the outbreak, but it is still not clear which animals. Past outbreaks of similar illnesses, including SARS, also are believed to have emerged from live animal markets. The coronavirus that causes MERS is transmitted to humans by camels.

Chinese scientists were able to isolate a strain of the new coronavirus quickly, with the genetic sequence being made available for laboratories across the world to independently develop 5) ___ tests that can confirm infection in a person. Of the first 41 people confirmed by real-time PCR and next-generation sequencing to have been infected, two-thirds were found to have a link with the Huanan Seafood Wholesale Market. The immediate hypothesis was that this was a novel coronavirus from an animal source (zoonosis).

Coronaviruses mainly circulate among 6) ___, 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. All coronaviruses known to infect humans have been shown to spread from human to human. In 2002 an outbreak of SARS that started in China resulted in more than 700 deaths worldwide. The virus originated in horseshoe bats, then passed to humans via civets from live animal markets and with the help of a few super-spreaders and international air travel, reached as far as Canada and the United States. The last case of SARS occurred in 7) ___.

Phylogenetic studies of 2019-nCoV examine the evolutionary history of the virus and its relationships with other organisms. The seventh member of the family of coronaviruses that can infect humans, 2019-nCoV has been reported to have a genome sequence 75% to 80% identical to the SARS-CoV and to have more similarities to several bat coronaviruses. At least five genomes of the novel coronavirus have been isolated and reported. These show that the virus is genetically distinct from other known coronaviruses such as Severe acute respiratory syndrome-related coronavirus (SARS-CoV) and Middle East respiratory syndrome-related coronavirus (MERS-CoV). Like SARS-CoV, it is a member of Beta-CoV lineage B.

Reported symptoms have included 8) ___ in 90% of cases, fatigue and a dry cough in 80%, and shortness of breath in 20%, with respiratory distress in 15%. The virus is transmissible from human to human via droplet when breathing or coughing or via contacts.The first 59 suspected cases at the end of December 2019 and early January 2020 were admitted to Jinyintan Hospital, which was specially designated to isolate them. 41 of the 59 were confirmed with the 2019-nCoV infection. Of these 41 cases, there was one group of family members, 30 (73%) were men and the average age was 49 years. Almost a third (32%) had an underlying medical condition including eight with diabetes, six with high blood pressure and six with heart disease. Two-thirds had a history of exposure to the 9) ___ ____ _____ Market.

10) ___ has received praise and thanks for their efforts and transparency. At a Sunday mass at St. Peter's Square on 26 January 2020, Pope Francis praised “the great commitment by the Chinese community that has already been put in place to combat the epidemic“ and commencing a closing prayer for “the people who are sick because of the virus that has spread through China“.

ANSWERS: 1) 2019-nCoV; 2) 2 and 10; 3) Wuhan; 4) Coronaviruses; 5) PCR; 6) animals; 7) 2004; 8) fever; 9) Huanan Seafood Wholesale; 10) China

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