National Institute of Health Pakistan Advisory on Wuhan Pneumonia

National Institute of Health Pakistan Advisory on Pneumonia outbreak due to novel coronavirus, in Wuhan City, Hubei Province, China.

A recent surge of pneumonia cases, associated with the novel coronavirus, has been reported in China. The Chines authorities have notified more than 200 confirmed human infections and cases have also been reported in Thailand, Japan, and South Korea. This situation has urged the neighbouring countries to enhance their surveillance and vigilance for response in case of detection. The NIH is accordingly monitoring the situation and will keep all stakeholders updated.

The objective of this advisory is to alert and sensitize the health staff at border posts as well as in healthcare institutions of Pakistan to stay vigilant about any suspected cases coming from affected areas for an early detection. The information about the illness is summarized below:

Infectious Agent

This pneumonia like illness is caused by a novel Coronavirus named by CDC-US, “2019-nCoV” of the family of Coronavirus.

Occurrence of Cases

According to the preliminary epidemiological investigation, most cases have either worked at or were handlers and frequent visitors to the Huanan Seafood and Meat wholesale Market.

Mode of Transmission

Recent evidences are highly suggestive that this is a zoonotic disease and primary causes of infections in human are through contact with infected animals, and animal products (needs to be confirmed). Substantial evidences are also suggestive of human to human transmission as secondary infections (confirmed by Chinese authorities).

Clinical Picture

Limited information is available to characterize the spectrum of clinical illness associated with 2019-nCoV. The observed clinical signs and symptoms of this illness include fever, cough, and difficulty breathing. Chest radio-graphs showing invasive pneumonic infiltrates in both lungs

The following should be suspected and investigated

  1. A person with severe acute respiratory infections (SARI) with history of fever and/or cough and/or difficulty breathing and with history of travel to Wuhan or any other affected area of China within last 15 days prior to symptom onset.
  2. Individual with acute respiratory illness of any degree of severity with any of the following exposures;
  3. Close physical contact with a suspected or confirmed case while the case was symptomatic, in affected areas of China.
  4. Direct contact with infected animals, seafood, meat or any other animal products in the markets of Wuhan City China, within 14 days before onset of illness.

Prevention & Treatment

No vaccine or specific treatment for 2019-nCoV infection is yet available. The patient care is mainly supportive.

Measures to be taken at all Health Facilities

Generally the same as for seasonal Influenza.

  • Ensure the standard precautions including hand and respiratory hygiene are being followed by using personal protective equipment (PPE).
  • Cover nose and mouth with a mask/tissue during examination of suspected persons.
  • Ensure hand hygiene after contact with respiratory secretions.
  • Clean and disinfect frequently touched surfaces and objects, such as doorknobs.

Laboratory Diagnosis and NIH Support

  • Sample from suspected pneumonia caused by new coronavirus case should be collected by trained technician with full preventive measures using appropriate PPEs.
  • Recommended samples for testing are nasopharyngeal and sputum samples.
  • Test on patient sample present an extreme bio-hazard risk and should only be conducted under maximum biological containment conditions.
  • For any further assistance in this context, the Field Epidemiology & Disease Surveillance Division (FE&DSD) (051 – 9255237 and Fax No. 051-9255575) may be contacted.

This advisory may please be widely distributed among all concerned and NIH may please be kept informed of the measures undertaken in respective areas of jurisdiction.

SOURCE: National Institute of Health Pakistan