The World Health Organization is considering declaring a newly identified coronavirus a global threat. This comes as the death toll from the current outbreak in China has risen to 17, with nearly 500 people infected with the respiratory illness.
The disease first appeared in Wuhan, China, in late December and authorities are now shutting down outbound transportation in the area, just as billions prepare to travel for the massive annual Spring Festival holiday season.
Cases have been reported in large portions of China, as well as in Macau, Thailand, Japan and South Korea. The first U.S. case of coronavirus was diagnosed this week in Washington state.
Dr. William Petri is the Wade Hampton Frost Professor of Medicine and vice chair for research in the University of Virginia’s Department of Medicine and a professor of infectious diseases and international health.
He spoke with UVA Today about the coronavirus outbreak, how it spreads, his expectation that the death toll will continue to rise and how people can protect themselves.
Q. Can you describe the disease?
A. Coronaviruses are a common cause of the common cold. So probably about one out of every eight times you have a common cold, it is due to a coronavirus. But they also have the ability to cross species barriers and go, for example, from bats into people. And in some of those instances, we’ve had very, very severe coronavirus infections, much worse than the common cold. An example of that is the SARS epidemic in China several years ago and something that is still ongoing called the Middle East Respiratory Syndrome, or MERS.
This is a new, novel coronavirus that’s just been identified in Wuhan, China, by the Chinese public health authorities. And the virus has been sequenced. We know that it’s in the beta family of the coronaviruses, which are most often found in bats. And so that could potentially explain how the epidemic started in a seafood market in Wuhan, if a bat was carrying the virus and urinated or exhaled. Surfaces that are contaminated with coronavirus could spread the infection to people.
What’s happened since the initial outbreak in the seafood market, which was mid-December, is that there’s now person-to-person transmission. That is through droplets, so someone coughing on someone else; as well as through what we call fomites, which means that basically there’s a surface or something that is contaminated with the virus, and then you touch that surface and you can infect yourself.
Q. How was it discovered?
A. Through a severe case of acute respiratory infection in Wuhan. Clinicians were able to identify the novel virus by amplifying and sequencing its genome. Not every novel coronavirus infection is severe. But this patient had had pneumonia, and there was no other known cause of pneumonia that explained why the patient was so ill. That’s how the search was set forward to identify the novel coronavirus.
Q. What are the symptoms?
A. In the most common situation, is it’s going be fever, sort of an acute respiratory infection, symptoms you would get with the common cold. And so, you might have a cough and a runny nose. In the more severe cases, you get pneumonia. That would be manifest as shortness of breath, because parts of the lungs are now filled up with virus and the inflammatory response to that virus, so your air exchange isn’t as good. So, you get short of breath. Fever, chills. You can also get what’s called pleurisy, where it actually hurts to take a deep breath.
Q. If you get pneumonia, should you be concerned that you have this new coronavirus?
A. Right now, all of the cases of novel coronavirus can be epidemiologically linked back to Wuhan, China, so if you’ve not recently been in Wuhan and if you’ve not been exposed to somebody with a novel coronavirus, you really should not be concerned about it right now.
Q. How is coronavirus treated?
A. There is no specific antiviral treatment. There’s nothing like Tamiflu for influenza. So it’s supportive therapy right now. With the severe cases, that could include giving supplemental oxygen, since the air exchange in the lungs can be compromised. We could be giving intravenous fluids if someone is so sick that they’re getting dehydrated. This would only be for the most severe cases. There seem to be many, many more mild cases of this infection.
Q. Do you expect the death toll to rise?
A. Yes, that would make sense. Most of the deaths have been in people who are compromised to some extent – [such as] people with chronic obstructive pulmonary disease or congestive heart failure. The average, healthy person that’s getting this is not at risk of succumbing to it. That’s what we understand today.
Q. How contagious is coronavirus and how does it spread?
A. As the epidemic has evolved, it’s gone from cases where the patient was directly linked to the seafood market in Wuhan and moved to human-to-human transmission, including health care workers who were caring for patients with the novel coronavirus. We don’t know yet how infectious it is. If I have influenza, I’m going to, on average, spread it to two to four other people. But that number has not been defined yet for the novel coronavirus.
Q. What can people do to protect themselves?
A. Frequent handwashing makes really, really good sense, because as you’re handling doorknobs and furniture and things, those could be contaminated with a common cold virus. Hand sanitizers, too. The coronaviruses are very easy to destroy because they are RNA viruses, versus DNA viruses, so any kind of soap or antiseptic would work to sterilize a surface or your hands from coronaviruses.