By Kirk Frady
Regional Health Command Europe
SEMBACH KASERNE, Germany – The Centers for Disease Control and Prevention, the Military Health System and the U.S. Army Public Health Center are closely monitoring developments around the recent outbreak of respiratory illness caused by a novel coronavirus first identified in Wuhan, Hubei Province, China.
Common human coronaviruses usually cause mild to moderate upper respiratory tract illnesses, like the common cold. Most people get infected with these type viruses at some point in their lives. These illnesses usually only last for a short amount of time. Symptoms may include:
•A general feeling of being unwell
Human coronaviruses can sometimes cause lower-respiratory tract illnesses, such as pneumonia. This is more common in people with cardiopulmonary disease, people with weakened immune systems, infants and older adults.
As with most viruses, human coronaviruses are most commonly spread from an infected person to others by the following means:
•Through the air by coughing and sneezing.
•Close personal contact, such as touching or shaking hands.
•Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands.
According to the CDC, there are currently no vaccines available to protect against human coronavirus infection. However, there are simple steps that can be taken to protect yourself and others. To reduce your risk of infection, or transmitting the virus to others, public health officials recommend the following steps:
•Wash your hands often with soap and water for at least 20 seconds.
•Avoid touching your eyes, nose, or mouth with unwashed hands.
•Avoid close contact with people who are sick.
•Stay home while you are sick.
There are currently no specific treatments for illnesses caused by human coronaviruses. Most people with common human coronavirus illness will recover on their own. Medications for pain and fever can help relieve symptoms. If you are mildly ill, drink plenty of fluids, stay home, and rest. If you have flu-like symptoms and have recently travelled to China, or been in direct contact with a person known to be infected with the virus, seek medical care. Your health care provider will order appropriate tests, if needed, and determine if additional precautions should be taken.
Translation by the USAG Stuttgart Public Affairs Office of a news article from Spiegel Magazine, dated Jan. 28:
The first infection in Germany of the coronavirus was confirmed yesterday.
A man from Starnberg (State of Bavaria) was infected, according to a spokesman of the Bavarian Ministry of Health. This was confirmed in Munich late Monday evening. In a press release the POC of Health Ministry stated that the patient was “clinically in good condition”. The man is under medical supervision and in isolation. His close relatives were informed about possible symptoms, hygiene measures and transmission risks.
It was also stated in the press release that the “Task Force Infectious Diseases Department” of the State Office for Health and Food Safety (LGL), as well as the Robert Koch Institute consider the risk of transmission and infecting others to be low.
The Ministry of Health and the LGL cancelled the Tuesday scheduled Press conference in Munich.
Worldwide, more than 4500 infections with the new virus “2019-nCoV” was confirmed. According to current information from the Chinese Government, the death toll in the country rose to at least 106.
Coronavirus: What providers, patients should know
With news of the contagious and potentially deadly illness known as novel coronavirus grabbing headlines worldwide, military health officials say that an informed, common sense approach minimizes the chances of getting sick.
Many forms of coronavirus exist among both humans and animals, but this new strain’s lethality has triggered considerable alarm. Believed to have originated at an animal market in Wuhan City, China, novel coronavirus has sickened hundreds and killed at least four. It has since spread to other parts of Asia. The first case of novel coronavirus in the U.S. was reported Jan. 22 in Washington State.
Anyone contracting a respiratory illness shouldn’t assume it’s novel coronavirus; it is far more likely to be a more common malady.
“For example, right now in the U.S., influenza, with 35 million cases last season, is far more commonplace than novel coronavirus,” said U.S. Public Health Service Commissioned Corps Dr. (Lt. Cmdr.) David Shih, a preventive medicine physician and epidemiologist with the Clinical Support Division, Defense Health Agency. He added that those experiencing symptoms of respiratory illness – like coughing, sneezing, shortness of breath, and fever – should avoid contact with others and making them sick, Shih said.
“Don’t think you’re being super dedicated by showing up to work when ill,” Shih said. “Likewise, if you’re a duty supervisor, please don’t compel your workers to show up when they’re sick. In the short run, you might get a bit of a productivity boost. In the long run, that person could transmit a respiratory illness to co-workers, and pretty soon you lose way more productivity because your entire office is sick.”
Shih understands that service members stationed in areas of strategic importance and elevated states of readiness are not necessarily in the position to call in sick. In such instances, sick personnel still can take steps to practice effective cough hygiene and use whatever hygienic services they can find to avert hindering readiness by making their battle buddies sick. Frequent thorough hand washing, for instance, is a cornerstone of respiratory disease prevention.
“You may not have plumbing for washing hands, but hand sanitizer can become your best friend and keep you healthy,” Shih said.
Regarding novel coronavirus, Shih recommends following Centers for Disease Control and Prevention travel notices. First, avoid all non-essential travel to Wuhan, China, the outbreak’s epicenter. Second, patients who traveled to China in the past 14 days with fever, cough, or difficulty breathing, should seek medical care right away (calling the doctor’s office or emergency room in advance to report travel and symptoms) and otherwise avoid contact with others and travel while sick.
CDC also has guidance for health care professionals, who should evaluate patients with fever and respiratory illness by taking a careful travel history to identify patients under investigation, or PUIs, who include those with fever, lower respiratory illness symptoms, and travel history to Wuhan, China, within 14 days prior to symptom onset. PUIs should wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed, ideally an airborne infection isolation room if available. Workers caring for PUIs should wear gloves, gowns, masks, eye protection, and respiratory protection. Perhaps most importantly, care providers who believe they may be treating a novel coronavirus patient should immediately notify infection control and public health authorities (the installation preventive medicine or public health department at military treatment facilities).
Because novel coronavirus is new (as its name suggests), there is as yet no immunization nor specific treatment. Care providers are instead treating the symptoms – acetaminophen to reduce fever, lozenges and other treatments to soothe sore throats, and, for severe cases, ventilators to help patients breathe.
“Lacking specific treatment,” Shih said, “we must be extra vigilant about basic prevention measures: frequent hand washing, effective cough and sneeze hygiene, avoiding sick individuals, and self-isolating when sick.”