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More information on Novel Coronavirus Infection

24 January 2020

The number of confirmed cases of novel coronavirus (2019-nCoV) infection has increased to around 844 with 25 deaths. Most cases continue to be reported from Wuhan, China, but cases have now been reported from 25 provinces in China. Additionally a small numbers of cases, all with links to Wuhan, have been reported in South Korea, Japan, Thailand, USA, Hong Kong, Taiwan and Macau. The age range of confirmed cases is 15-89 years. To date there are no confirmed cases in Australia.

Fever has been the single consistent symptom, with other symptoms including cough (dry or productive), fatigue, chest discomfort, sore throat, difficulty breathing, headache and chest radiographs showing bilateral pneumonic infiltrations. The incubation period thought to be 4-14 days with an average of 7 days.

Suspected cases require BOTH epidemiological AND clinical criteria

Epidemiological criteria: at least one of the following

  • Travel to Wuhan City (Hubei Province, China) in the 14 days before the onset of illness.
  • Travel to an area with evidence of sustained human-to-human transmission, or a declared outbreak, within 14 days before onset of illness.
  • Close contact in the 14 days before illness onset with a case of 2019-nCoV.

See www.health.gov.au for up-to-date areas with sustained transmission and close contact definition.

Clinical criteria: at least one of the following

  • Fever or history of fever (≥38°C) and acute respiratory infection (sudden onset of respiratory infection with at least one of: shortness of breath, cough or sore throat).
  • Severe acute respiratory infection requiring admission to hospital with clinical or radiological evidence of pneumonia or acute respiratory distress syndrome (i.e. even if no evidence of fever).

Medical practitioners are advised to:

  • Be alert for patients of any age meeting the suspected case definition – noting that most returning travellers will have more common viral or bacterial respiratory infections.
  • Assess patients with suspected 2019-nCoV infection using transmission based precautions in addition to standard precautions
    • Put surgical mask on patient and ask to observe respiratory (cough) etiquette.
    • Social distancing i.e. move patient from general waiting area and use a single room, if available.
    • Staff examining patient to wear gloves, disposable gown, P2/N95 respirator mask (if available, if not available then wear a surgical mask) and eye protection.
    • Hand hygiene with alcohol hand rub, or if hands visibly soiled, soap and water.
    • Avoid aerosol generating procedures, if possible.
  • Contact the CDCB medical officer on 1300 232 272 (24/7) to discuss any suspected cases.
  • Consider laboratory testing
    • ONLY cases meeting the current case definition should be tested for 2019-nCoV.
    • Routine respiratory panel testing (which includes influenza) should always be requested if clinically indicated, as most patients with a respiratory illness will have a more common aetiology.
    • If, following discussion with the CDCB medical officer, your patient requires testing for 2019-nCoV then call your preferred laboratory to obtain details of the specimen and swab(s) required.
    • If you have access to the recommended PPE for collection of a respiratory specimen for suspected 2019-CoV, then do so in your surgery or emergency department. The required PPE consists of a P2/N95 respirator, gloves, disposable gown and eye protection. If you do not have this PPE discuss alternative options with the CDCB medical officer.
    • DO NOT send a patient with suspected 2019-CoV to a laboratory collection centre.
  • Except in urgent circumstances, only transfer patients with suspected 2019-nCoV to an emergency department after discussion with CDCB.

See

For all enquires please contact the CDCB on 1300 232 272 (24 hours/7 days)

Dr Louise Flood – Director, Communicable Disease Control Branch

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