Background
Presently, almost every human in major cities across the world is aware of the coronavirus and its growing impact. Coronaviruses (CoVs) are considered to be a family of enveloped, single stranded, positive–stranded RNA viruses that are classified with the Nidovirales order.1 The coronavirus family consists of pathogens that come from a number of animal species and of humans. CoVs are known to lead to the development of a number of diseases in mammals and birds that can range from enteritis in cows and pig, upper respiratory disease in chickens, to the potentially lethal human respiratory infections.1 Most Americans became fully aware of the CoVs in 2002 in the form of the Severe Acute Respiratory Syndrome (SARS) outbreak in Guangdong Province of China. SARS-CoV was ultimately identified as the cause of the outbreak that lead to about 8,098 cases with 774 reported deaths.1 The elderly population experienced the highest mortality rate during this major outbreak. In the mist of the outbreak, viruses were isolated from exotic animals such as Himalayan Palm Civets and raccoon dogs.2 The larger belief during that time was that SARs came from bats since many possessed SARS related CoVs.
Incidence of Transmission and Prevention
The transmission of SARS-CoV was through direct contact with an individual that had been infected after the onset of the illness. The outbreak was able to be contained in the majority of cases in June 2003 through the practice of quarantine with the exception of some cases of inefficient transmission where one person was able to infect many people through the aerosolization of the virus. Over the years there have been other forms of the virus that have arisen such as the Middle East Respiratory Syndrome-CoV (MERS-CoV) in 2012 which lead to about 8,555 cases by 2014 and a fatality rate of nearly 40%. In the aftermath of these two devastating cases of CoVs there was not growing belief that another outbreak would be on the horizon due to the adoption of more preventative measures. While there is currently no anti-viral therapeutics that specifically combat the human coronaviruses, supportive treatment is an option.
Recent Coronavirus Outbreak
Most recently, a novel coronavirus was identified in Wuhan, China in which the death toll rose to 910 prompting attempts to evacuate citizens from the city. More than 40,000 people have been confirmed to have the CoV as of February 10, 2020 with the vast majority in mainland China.3 The World Health Organization is urging governments from across the world to take action in order to combat the virus. The confirmation of infection is based on a person having tested positive for the 2019 novel coronavirus.
For healthcare professionals it is important for patients to be educated on preventative measures that can be taken to combat the virus which include avoidance of cough or sneezing from an infected individual, close personal contact, or fecal contamination. The hallmark symptoms of CoV to be aware of include runny rose, headache, cough, sore throat, or fever and if there has been recent travel to Wuhan City to immediately notify their healthcare professional. While the immediate risk of the virus to the American public is expected to be low at this time, it is important for all to be mindful of how they can contribute to the growing threat.4 The recommendation from the CDC is for people to be vaccinated and to take actions to prevent the spread of germs.4
Management of Coronavirus and Future Direction
There are no specific treatment protocols for the illness caused by the human coronavirus and while most people with the condition will recover on their own, others with compromised immune systems or underlying conditions may not. There are very limited options for the prevention of coronavirus infections but vaccines (IBV, TGEV, and Canine CoV) have gained approval. However, these vaccines may not be utilized due to their diminished effectiveness and inability to induce better immunity.5 The best course of action to aid with the control of the human coronavirus is the ongoing public health surveillance system along with immediate diagnostic tests, when appropriate. Undoubtedly, the viruses will continue to emerge and change but a growing awareness of preventative measures and proper screening, and improved research to understand how coronavirus causes disease can lead to lower incidences and potential eradication.
UPDATE: Click here for the Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU).
References
- Fehr AR, Perlman S. Coronaviruses: an overview of their replication and pathogenesis. Methods Mol Biol. 2015;1282:1–23. doi:10.1007/978-1-4939-2438-7_1
- Guan Y, Zheng BJ, He YQ, Liu XL, Zhuang ZX, Cheung CL, Luo SW, Li PH, Zhang LJ, Guan YJ, Butt KM, Wong KL, Chan KW, Lim W, Shortridge KF, Yuen KY, Peiris JS, Poon LL Science. 2003 Oct 10; 302(5643):276-8.
- Coronavirus kills 97 people in one day, while cruise ship cases almost double. 2020. Retrieved from https://www.cnn.com/asia/live-news/coronavirus-outbreak-02-10-20-intl-hnk/index.html
- Center for Disease Control and Prevention. 2019 Novel Coronairus (2019-Ncov) situation summary. 2020. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/summary.html
- Saif LJ. Animal coronavirus vaccines: lessons for SARS. Dev Biol (Basel) 2004;119:129–140.
Abimbola Farinde, PhD, PharmD
Professor, Columbia Southern University, College of Business
Orange Beach, AL
Published on 2/10/2020