Written by Clay Smith
A novel coronavirus is spreading in China and now beyond. It is now more deadly than SARS. It presents as a flu-like illness. Ask about travel to China in patients with fever and cough.
Why does this matter?
This is a new viral threat that we as frontline clinicians need to know. This is a basic overview from JAMA and has information on rudimentary screening. We will go in depth with tomorrow’s post by Nicole McCoin.
Why did you just sneeze?
In December 31, 2019, Beijing notified the WHO of a cluster of unusual pneumonia cases in Wuhan, the largest city in the Hubei province in China. It was determined to be a novel coronavirus, now dubbed COVID-19. Since the number of cases is changing every day, the best place to go is the CDC website to get the latest information. Estimates are that it is doubling every 6.4 days. Incubation is 5.2 days but as long as 14 days. Clinically, it manifests as an influenza-like illness. For now, the best way to suspect it is a travel history to China, Hubei province. If they have the travel history, fever, and cough, place a mask on the patient; place them in respiratory isolation; and wear an N-95 mask yourself. It seems to be rare in children. Most cases are mild. Those hospitalized have infiltrates on CXR and ground glass opacities on CT. About one-third develop ARDS. No antivirals are known to work. To prevent spread, “basic public health measures such as staying home when ill, handwashing, and respiratory etiquette including covering the mouth and nose during sneezing and coughing,” are recommended.
Del Rio C, Malani PN. 2019 Novel Coronavirus-Important Information for Clinicians [published online ahead of print, 2020 Feb 5]. JAMA. 2020;10.1001/jama.2020.1490. doi:10.1001/jama.2020.1490
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