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Source: Government of Victoria 3

What is the issue?

A novel coronavirus (2019-nCoV) outbreak has been identified associated with Wuhan City, Hubei Province, China. As of January 23, 2020, local, provincial, and national health commissions in China have reported approximately 600 cases and 18 deaths. Confirmed cases have been identified in China, Thailand, Japan, South Korea and the USA. All but two of the confirmed cases have a history of travel to Wuhan. At this time there is no clear evidence of sustained transmission. There is evidence of limited human-to-human transmission in Wuhan.

The 2019 novel coronavirus (2019-nCoV) identified in this outbreak has not previously been identified in people. Coronaviruses are a large and diverse family of viruses that include viruses that are known to cause illness of variable severity in humans, including the common cold, severe acute respiratory syndrome (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV). They are also found in animals such as camels and bats.

Who is at risk?

Novel coronavirus (2019-nCoV) should be considered in patients with fever and respiratory symptoms who have travelled to Wuhan, China in 14 days before they became unwell. The virus should also be considered in patients who have had close contact with a healthcare facility in a China in the 14 days prior to illness onset.

Symptoms and transmission

Reported symptoms include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. Sore throat and headache have also been reported.

The following case definitions are now in place in Victoria:

Confirmed case

A person tested for 2019-nCoV at the Victorian Infectious Diseases Reference Laboratory and found to have 2019-nCoV infection.

Suspected case

Both clinical and epidemiological criteria need to be met for a person to be classified as a suspected case.

Clinical criteria:

Fever or history of fever AND acute respiratory infection (shortness of breath or cough or sore throat)
OR
Severe acute respiratory infection without fever requiring hospitalisation

AND

Epidemiological criteria:

A history of being in Wuhan city in the 14 days prior to symptom onset
OR
Close contact within 14 days of symptom onset with any of the following:

  • a confirmed or suspected case of 2019-nCoV;
  • a healthcare facility in China (where limited hospital-associated infections have been reported).

This case definition information may change as further information emerges.
Currently there have been no confirmed cases of 2019-nCoV in Australia.

Recommendations

Clinicians are asked to be alert for patients of any age presenting with respiratory symptoms who meet the suspected case definition above. Please ensure that patients presenting with pneumonia to triage are being asked about travel specific to Wuhan, China.
If you have a patient who meets the suspected case definition above:

  • Place a surgical mask on the patient;
  • Undertake an assessment in a private room with the door closed if negative pressure ventilation is not available;
  • Apply droplet and contact precautions (single-use face mask, eye protection, gown and gloves). If available, Airborne Precautions can be applied as well by wearing a P2 respirator (N95 mask) instead of a single use face mask during any assessment.
  • Notify the Department of Health and Human Services immediately on 1300 651 160, who will assist with conducting a public health risk assessment and short epidemiological questionnaire for suspected cases;
  • Undertake testing in your hospital for alternative causes as soon as possible, in particular for respiratory viruses using multiplex PCR if available.
  • After discussion with the Department, you may be advised to take:
    • upper respiratory samples (combined nose and throat swabs, or nasopharyngeal swabs)
    • lower respiratory samples lower respiratory tract sample if the lower tract is involved (bronchoalveolar lavage, tracheal aspirate, pleural fluid, sputum)
    • whole blood.
  • These samples are to be forward for novel coronavirus testing at the Victorian Infectious Diseases Reference Laboratory.

If you traveled to Wuhan and feel sick, you should:

  • Avoid contact with others, except for seeking medical care
  • Don’t travel while sick.
  • Seek medical care right away. Before you go to a doctor’s office or emergency department, call ahead and tell the doctor about your recent travel and your symptoms.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.

Department of Foreign Affairs and Trade have updated a Smartraveller travel advisory for Wuhan to level 3 – reconsider need to travel.

More information

Clinical information

Information for health services and general practitioners – Novel Coronavirus

WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China

Consumer information

Information for the public – Novel Coronavirus

WHO Coronavirus

Smartraveller – China

Contacts

For more information please contact the Communicable Disease Prevention and Control section at the Department of Health and Human Services on 1300 651 160 (24 hours).

MIL OSI News