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Public Alert

Public Alert
24 Jan 2020

 

GOVERNMENT OF INDIA

Ministry of Health & Family Welfare

National Institute of Public Health Training and Research, Mumbai

Novel coronavirus (nCov 2019-20) outbreak in China

Directives

1. Introduction:

On 31st December 2019 cluster of pneumonia was reported in Wuhan city, Hubei Provience of China. The cause of viral pneumonia was identified as a new type of coronavirus, which is different from any other human coronavirus discovered so far. As on 11th January 2020, 41 confirmed cases of nCov virus has been reported so far, of which one has died. Only travel reported cases have been reported (one each) in Thailand and Japan.

2. About Corona virus:

Corona virus are a large family of respiratory viruses that can cause diseases ranging from the common cold to Middle-East Respiratory Syndrome and the Severe Acute Respiratory Syndrome (SARS). The outbreak reported in the year 2003 due to SARS is also a corona virus, however the current virus is totally different genetically so it is given name as Novel Corona Virus. The source of this new corona virus is not yet known.

3. General Signs of Corona Virus:

nCov may present with mild, moderate or severe illness; the severe illness includes severe pneumonia, ARDS, sepsis and septic shock.

1. Sudden high grade Fever (> 38 * C)

2. Common cold

3. Difficulty in breathing

4. Pneumonia

5. Loose motion

4. Transmission:

Mode of transmission is unclear as of now. However considering the signs like sneezing, coughing, it is considered that the mode of transmission might be through Droplet.

From current available information, preliminary investigations suggest that there is no significant human-to-human transmission and no infections among health care workers have occurred.

5. Surveillance:

As per the World Health Organization risk assessment for global spread has been stated as low, however MoHFW, GOI has instructed to screen the travellers at the international airports at Mumbai, Delhi and Kolkata coming from China.

The following people should be investigated and tested for nCov infection by the health authorities in their jurisdiction Case definition for surveillance (WHO):

1. Severe acute respiratory infection (SARI) in a person, with history of fever and cough requiring admission to hospital, with no other etiology that fully explains the clinical presentation;

AND any of the following

a) a history of travel to or a person who lived in Wuhan, Hubei Provience China in the last 14 days prior to symptoms onset; or

b) The disease occurs in a health care worker who has been working in an environment where patients with severe acute respiratory infections are being cared for, without regard to place of residence or history of travel.

2. The person develop an unusual or unexpected clinical course, especially sudden deterioration despite appropriate treatment, without regard to place of residence or history of travel, even if another etiology has been identified that fully explains the clinical presentation.

3. A person with acute respiratory illness of any degree of severity who, within 14 days before onset of illness, had any of the following exposures:

a. Close physical contact with a confirmed case of nCov infection; or

b. A health facility in a country where hospital-associated nCov infections have been reported; or

c. Visiting or working in a live animal market in Wuhan, China

d. Direct contact with animals (if animal source is identified) in countries where the nCov is known to be circulating in animal populations or where human infections have occurred as a result of presumed zoonotic transmission.

6. Laboratory Diagnosis:

Any suspected case should be tested. Lower respiratory specimens likely have a higher diagnostic value than upper respiratory tract specimen for detecting 2019-nCov infection. WHO recommends that lower respiratory specimen such as sputum, endotracheal aspirate, or bronchoalveolar lavage be collected, if not possible then upper respiratory tract specimens such as nasopharyngeal aspirate or combined nasopharyngeal and oropharyngeal swabs should be collected.

Laboratory diagnosis facility for corona virus is available at National Institute of Virology, Pune, and Maharashtra. The guidelines for samples to be collected and procedure of collection is available at the institute website www.niv.co.in.

7. International Travellers: practice usual precautions:

1. Observe good personal hyegeine

2. Avoiding close contact with people suffering from acute respiratory infections

3. Frequent hand-washing with soap, especially after direct contact with ill people or their environment

4. Avoiding close contact with live or dead farm or wild animal

5. Avoid travel to farms, live animal markets or where animals are slaughtered

6. Practice cough etiquette-maintain distance, cover coughs and sneezes with disposable tissues or clothing and hand wash

Health practitioners and public health authorities should provide to travellers information to reduce the general risk of acute respiratory infections, via travel health clinic, travel agencies, conveyance operators and at point of entry

7.1 If you feel seek and have fever and cough:

1. Cover your mouth while coughing or sneezing

2. Don’t plan travel if sick

3. Seek medical attention promptly

7.2 If you feel seek on flight, while travelling back to India:

1. Inform the airline crew about illness

2. Seek mask from the airlines crew

3. Avoid close contact with family members or fellow passengers

4. Follow the directions of airline crew while disembarking

7.3 If you feel seek on flight or at the time of disembarkation:

1. Report to airport health authorities/immigration

2. Follow the directions of the airport health officer

7.4 If you feel seek with in a span of one month after return from China:

1. Report the illness to the nearest health facility and also inform the treating doctor regarding your travel history

7.5 International Traffic: No restrictions recommended, however as provided by the International Health Regulations (2005) (IHR), countries should ensure that:-

1. Routine measures, trained staff, appropriate space ad stockpile of adequate in place at points of entry for assessing and managing ill travellers detected before travel, on board conveyances and on arrival at point of entries

2. Procedures and means are in place for communicating information on ill travellers between conveyances and points of entry as well as between points of entry and national health authorities

3. Safe transportation of symptomatic travellers to hospitals or designated facilities for clinical management and treatment is organised

4. A functional public health emergencies contingency plan at points of entry in place to respond to public health events

8. Preventive measures for general public: at present there is very less possibility of nCov infection in our country, however following precautions may be taken by the people

1. Avoid close contact with the persons having respiratory infection

2. Cover your mouth with tissue paper/ handkerchief while coughing and sneezing

3. Frequent hand washing

4. Avoid touching your eyes, nose or mouth

5. Avoid crowed places

6. Do not shake or hug in greeting

7. Avoid raw and partially cooked non-vegetarian food

8. Don’t eat fruits and vegetables without washing

9. Get plenty of sleep

10. Drink plenty of water and eat nutritious food

11. Don’t take medicine without consulting a physician

Patients having following symptoms should seek medical attention:

1. Having breathing difficulty

2. Immunocompromised persons with history of travel from nCov infected countries

3. Undiagnosed acute respiratory illness with history of travel from nCov infected countries

9. Infection prevention and control at the Hospitals:

Infection control and prevention at the hospitals should be based on Universal Precautions measures. There should be provision of

1. Hand washing facility

2. Availability of personal protective equipments

3. Proper bio medical waste management

Hospitals also prepare well equipped isolation ward with ventilators for serious patients.

For further information about nCov kindly visit:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

https://mohfw.gov.in/diseasealerts/novel-corona-virus

 https://ncdc.gov.in/index4.php?lang=1&level=0&linkid=127&lid=432

https://arogya.maharashtra.gov.in/Site/Form/NewsAndEventDetails.aspx?ID=100660