Update on Novel Coronavirus Infection
30 January 2020
The novel coronavirus (2019-nCoV) is now a controlled notifiable condition under the South Australian Public Health Act 2011. Doctors and diagnostic laboratories are required to notify the CDCB Medical Officer on call of any suspected cases on 1300 232 272 (24/7).
While most cases continue to be reported from Hubei Province, China, where the outbreak began, over 7,500 confirmed cases have been reported with over 170 deaths in mainland China, and the disease has now spread to all provinces of China. There have now been cases reported from more than a dozen other countries, including Australia, where 7 cases have been confirmed. There has not yet been a confirmed case in South Australia, and there is no evidence of local transmission in Australia at this stage.
The incubation period thought to be 2-14 days. The infectious period is currently unknown, but there is early evidence of transmission in the pre-symptomatic phase.
The information on this incident is constantly evolving.
The Australian Government has now recommended that:
- People (including healthcare workers) who have been in contact with any confirmed 2019-nCoV cases must be isolated in their home for 14 days following exposure.
- Returned travellers who have been in Hubei Province, China must be isolated in their home for 14 days after leaving Hubei Province, other than for seeking individual medical care.
Given the lower number of cases in China reported outside of Hubei province, isolation is not currently recommended for travellers from other parts of China or other countries. The development of cases outside of Hubei province is being closely monitored and this advice will be updated if necessary.
Medical practitioners are advised to:
- Consider 2019-nCoV in persons who have returned from mainland China or are contacts of a known case of 2019-nCoV, in the 14 days prior to illness onset, with fever or history of fever, or with respiratory symptoms such as cough, dyspnoea, or pneumonia.
- Assess patients with suspected 2019-nCoV infection using transmission based precautions in addition to standard precautions:
- Put a 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 long sleeved 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. If they cannot be avoided, use full airborne precautions including P2/N95 respirator mask and negative pressure room.
- Notify the CDCB medical officer on 1300 232 272 (24/7) to discuss any suspected cases.
- Consider laboratory testing
- Discuss testing with CDCB medical officer. If testing is recommended and you have the appropriate PPE (as above with P2/N95 respirator mask) in isolated room, collect a combined nasal / pharyngeal swab, preferably in viral transport medium. See specimen collection guide at https://www.sapathology.sa.gov.au/genericfiles/PUB-0712.pdf. Send specimens to SA Pathology.
- Do not send patients to pathology collection centres.
- Isolate any patient with suspected 2019-nCoV (either in a healthcare facility or at home).
For further information see SA Health www.sahealth.sa.gov.au/novelcoronavirus, the Australian Government Department of Health website at https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov and the World Health Organization website at https://www.who.int/health-topics/coronavirus
Dr Louise Flood – Director,
Communicable Disease Control Branch