Preparing for 2019 Novel Coronavirus Cases

This article was last reviewed on February 7, 2020.

Coronaviruses are named for the crown-like spikes on their surfaces. Seven coronaviruses are known to infect humans. Most cause mild to moderate respiratory symptoms and are among the viruses associated with causing the common cold. But the 2019-nCoV, MERS (Middle East respiratory syndrome), and SARS (severe acute respiratory syndrome) coronaviruses can cause more severe symptoms, leading to pneumonia and death.

The number of cases in Australia is low, with all thought to have been acquired in China.  This number may rise, but the Australian Public Health response has been rapid and has included self-quarantine of returned travellers and testing of symptomatic returned travellers or those who have been in contact with a person who has been confirmed to be infected with 2019-nCoV.  Currently the virus is not known to be spreading in the community.

The situation is evolving quickly, and the Department of Health continues to closely monitor the outbreak. (For the most recent information, visit the Department of Health Coronavirus updates).
Since December 2019, the virus has sickened thousands and killed hundreds of people in China. Over 200 cases have also been reported in at least two dozen other countries. Due to concerns about the virus spreading to resource-limited countries, the World Health Organization (WHO) declared a global health emergency on January 30, 2020.

Because 2019-nCoV is a novel virus, everyone is potentially susceptible to infection.  The World Health Organization has said that has thus far older people and people with pre-existing medical conditions such as diabetes and heart disease appear to be at more risk of developing severe disease (such as pneumonia and difficulty breathing) from the 2019-nCoV.  However, as with other respiratory viruses, it can cause mild symptoms including runny nose, sore throat, cough and fever. Unlike seasonal influenza, which can also cause serious illness and death, there is no vaccine or specific treatment for 2019-nCoV yet.
Like MERS and SARS, the 2019-nCov appears to have initially spread from animals to humans, but there is now clear evidence that it can spread from person-to-person through coughing, sneezing, and contact with contaminated surfaces.  This spread is usually after close contact with an infected person such as in a household or health care centre.

People infected with 2019-nCoV may have no symptoms at first but may be contagious while asymptomatic. The incubation period is the time between initial infection and becoming ill, and it is thought to be between 1-12.5 days after infection, with the median time to people becoming symptomatic around 5-6 days after exposure.

The first 2019-nCoV cases reported in December 2019 were traced to Wuhan, the capital of Hubei Province in China, a major transportation hub with 11 million people. China's Bureau of Disease Prevention says the virus is "highly infectious." To contain the virus, China's government has banned travel to and from Wuhan and the surrounding region during the country's busiest transportation season around the Lunar New Year, a major holiday.

The Chinese government had identified the unique genetic sequence of the virus from early cases and made it publicly available.

In Australia, diagnostic testing for the 2019-nCoV is available as a molecular test on a sample if the person is showing signs of illness.  The sample may be a swab collected from the throat or nose, or a sputum sample.  There is no blood test available yet, but blood samples may be collected to look for another infection, to check on the person’s other blood parameters.  Some sample may be stored to look for antibodies to the virus if a test becomes available in the near future.

Any samples that test positive for 2019-nCoV at a laboratory will be sent to a regional reference laboratory for confirmatory testing. The Department of Health has issued lab and biosafety guidelines for collecting, handling, and processing respiratory samples from patients with suspected 2019-nCoV infection.

Travel and healthcare precautions

Australia has in place mechanisms for border control, isolation of people who are unwell, surveillance and case tracing.  “Level 4 – do not travel” advice has been issued by the Department of Foreign Affairs and Trading for travel to mainland China.  A 14 day isolation period after leaving mainland China is currently required for people in Australia who travelled to Hubei, or who transited through mainland China on or after the 1st of February 2020.  The isolation requirement applies to those who have been in close contact with a confirmed case of 2019-nCoV.

Anyone who has travelled to China in the last 14 days and feels sick with fever, cough, or has difficulty breathing should seek immediate medical care but is advised to call ahead and notify providers of their recent travel and symptoms.

Healthcare providers should ask patients with fever and respiratory symptoms to wear masks and describe recent travel. If patients have been to China, medical staff should call their local Public Health Unit immediately.

More information:
Australian Government Dept. of Health Coronavirus updates
WHO coronavirus information (including video)
WHO Q&A about coronavirus

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