Not just mortality, transmission, too, a cause for concern

PT Jyothi Datta Mumbai | Updated on February 10, 2020

People wearing protective face masks commute on a train in Shanghai, on Monday . The death toll from the novel coronavirus surged past 900 in mainland China even as the World Health Organization said the outbreak appeared to be stabilising   -  NOEL CELIS

Experts call for sentinel surveillance to trace those who may have slipped past screening points

As the death toll linked to the coronavirus outbreak inches past 900 globally, there is an underlying fear that this could escalate and take more lives across countries.

And feeding this fear are reports that more number of people have died from the virus in a limited span of time than from SARS (Severe Acute Respiratory Syndrome) over a longer period.

Experts clarify that the “mortality rate” (the percentage of those who died among those infected) from Coronavirus was lower than SARS or Ebola. Health systems must be on high alert as rapid transmission of the virus is as much of a concern, they point out.

Dr G Arunkumar, Director with the Manipal Institute of Virology (under MAHE) told BusinessLine that the novel coronavirus had a fatality of 1 one or 2 per cent of the total number of people infected. In comparison, the fatality of SARS was about 10 per cent; MERS 60 per cent; Avian flu 50-60 per cent; Nipah 90 per cent and Ebola between 40 and 60 per cent, said Dr Kumar who played a key role in detecting and controlling the first outbreak of the Nipah virus in Kerala.

The worrying aspect of the nCoronavirus is its “transmissibility” — the increasing concern of transmission between humans, he said. Rapid transmission puts pressure on a country’s health system as quarantine and medical management of the infected can overwhelm healthcare resources, he added.

The other variable is that present projections are based on information from China and there could be a possibility that some of the infections may have gone undetected at the hospitals or laboratories that are already working at full capacity, says a virologist. Presently, over 40,000 people are reported to be infected, most of them in China.

Symptoms, source

The coronavirus family causes illnesses ranging from common cold to the more severe Middle East Respiratory Syndrome (MERS) and SARS. And the common signs of infection vary from respiratory symptoms, fever, cough, shortness of breath and breathing difficulties to severe pneumonia, kidney failure and death.

‘Tip of the iceberg’

While there are many theories on how the new virus appeared in humans, the sea food market at Wuhan in Hubei province that handled meat from captive wild and live animals is largely believed to be the source of this zoonotic virus that was transmitted from animals to humans.

The virus is reported to have an incubation period of 14 days, after which the symptoms start showing up. If, during this period, a person with the virus manages to slip through screening at the airport, he or she could pass the infection to an elderly person or one with compromised immunity, says Dr Kumar.

Countries need to be alert against spread of the virus in the community, he said, urging the government to take three or four sentinel hospitals and investigate all cases of pneumonia there.

Expert warning for sentinel surveillance assumes significance against the backdrop of the World Health Organisation Chief Tedros Adhanom Ghebreyesus’ recent caution. The spread of the coronavirus in countries outside China could be the “tip of the iceberg”, he said, as cases were being reported in people who had not travelled to China, the epicentre of the outbreak.

A WHO team was also headed to China on Monday to help tackle the spread of the virus.

Published on February 11, 2020

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