What is the novel coronavirus?
The World Health Organization (WHO) describe coronaviruses as a large family of viruses that can cause illness ranging from the common cold to more severe diseases like Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The 2019 novel coronavirus, or “2019-nCoV”, is a new strain that has not been identified in humans before.
Outbreak summary: where, when and possible source
On 31 December 2019, the WHO was informed of several cases of viral pneumonia of unknown cause detected in Wuhan City, China. The European Centre for Disease Prevention and Control (ECDC) reports that 2019-nCoV patients exhibited symptoms such as fever and dyspnoea. According to the ECDC, most cases of 2019-nCoV had an epidemiological link to Wuhan’s South China Seafood City market, which is a wholesale market for seafood and live animals.
Since the outbreak, cases of 2019-nCoV have been reported elsewhere in China and in 14 other countries worldwide, including in the regions of Asia, Europe, North America and Australia. ERS recommends consulting the WHO's situation reports for the latest updates on confirmed case numbers and 2019-nCoV deaths, and for information on the geographic spread of 2019-nCoV.
How is the virus transmitted?
The WHO reports that human-to-human transmission is occurring with a preliminary R0 estimate of 1.4-2.5.
Current estimates of the incubation period of the virus range from 2–10 days, but more information about the mode of transmission is needed to confirm this. Experts are also still unclear whether transmission can occur from asymptomatic individuals or during the incubation period.
The WHO offers standard recommendations to prevent the spread of coronavirus, including regular hand washing, covering the mouth and nose when coughing and sneezing, and thoroughly cooking meat and eggs. Where possible, WHO advises avoiding close contact with persons showing symptoms of respiratory illness, including coughing and sneezing.
What is the risk of cases in the European region?
The first laboratory confirmed cases of 2019-nCoV in Europe were reported by French health authorities on 24 January 2020. The authorities confirmed three known cases of the virus in France, which the ECDC says are not unexpected based on recent developments.
On 28 January 2020, it was reported that German health authorities confirmed the first case of 2019-nCoV in the country, caused by human-to-human transmission. The patient had not visited China, but is believed to have caught the virus due to contact with a colleague who had recently traveled to Wuhan.
The ECDC recommends that the risk of:
- Infection for EU/EEA citizens residing in or visiting Wuhan is moderate
- Case importation into EU/EEA countries is moderate
- Cases in the EU resulting in secondary cases within the EU/EEA is low
In the EU, PREPARE has reached out to clinical sites and diagnostic labs to ensure that they are ready, and researchers are currently developing a clinical protocol that can be implemented swiftly in the event that cases of 2019-nCoV are reported in the region. Read the full PREPARE report for more information on its outbreak response mode and next steps.
Advice for healthcare professionals
The WHO reports that common signs of coronavirus infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. As with SARS and MERS, when dealing with suspected 2019-nCoV cases, health professionals should follow CDC airborne precautions and wear respiratory masks (N95 or higher) during intubation and when entering a negative pressure room.
The WHO has published interim clinical care guidance for hospitalised patients and for mildly ill patients at home, covering:
- Early recognition of patients with SARI associated with 2019-nCoV infection
- Immediate implementation of appropriate IPC measures
- Early supportive therapy and monitoring
- Collection of specimens for laboratory diagnosis
- Management of hypoxemic respiratory failure and ARDS
- Specific anti-Novel-CoV treatments and clinical research
The ECDC has developed guidelines to support EU and EEA Member States in the testing of individuals for 2019-nCoV, which covers the epidemiological and clinical criteria that should prompt laboratory testing of suspected cases of 2019-nCoV. The criteria include:
| Epidemiological criteria | Clinical criteria |
|---|---|
| Any person with travel-history to Wuhan City, China in the 14 days before the onset of illness | Any person with clinical symptoms compatible with severe acute respiratory infection seeking healthcare or admitted to hospital with clinical or radiological evidence of pneumonia |
| (or) Any person being in close contact with a laboratory-confirmed case of 2019-nCoV in the 14 days before the onset of illness | (or) Any person with fever or recent history of fever (>=38°C) and acute respiratory infection (sudden onset of respiratory infection with one or more of the following symptoms: shortness of breath, cough or sore throat) |
The ECDC also advise that infection with 2019-nCoV should be immediately reported to the Early Warning and Response System (EWRS) in accordance with Decision No 1082/2013 on serious cross-border threats to health and to the IHR system in accordance with the International Health Regulations 2005 (IHR).
Further information:
Last updated: 29 January, 2020
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