|
|
| (40 intermediate revisions by 3 users not shown) |
| Line 9: |
Line 9: |
| | genus = '''''Coronavirus''''' | | | genus = '''''Coronavirus''''' |
| }} | | }} |
| {{SI}} | | {{Novel human coronavirus infection}} |
|
| |
|
| {{CMG}} | | {{CMG}}; {{AE}} {{ADI}} |
|
| |
|
| {{SK}} Human betacoronavirus 2c EMC/2012; Novel coronavirus | | {{SK}} Human betacoronavirus 2c EMC/2012; novel coronavirus |
| ==Overview==
| |
|
| |
|
| Novel human coronavirus is a new strain of coronavirus that has not been previously identified in humans. A previously unknown coronavirus was isolated from the sputum of a 60-year-old man who presented with acute pneumonia and subsequent renal failure with a fatal outcome in Saudi Arabia. A novel coronavirus (human betacoronavirus 2c EMC/2012) has caused a handful of infections in three countries in the Middle East. Although it does not seem to transmit between humans, it can cause severe disease and death, and scientists are watching closely for new cases | | ==[[Novel human coronavirus infection overview|Overview]]== |
|
| |
|
| ==Historical Perspective== | | ==[[Novel human coronavirus infection historical perspective|Historical Perspective]]== |
| The virus first emerged in the Middle East, and was discovered on September 2012 in a Qatari patient who had recently traveled to Saudi Arabia.<ref>{{cite news|last=Nebehay|first=Stephanie|title=WHO issues guidance on new virus, gears up for haj|url=http://in.reuters.com/article/2012/09/26/health-virus-idINL5E8KQ9GL20120926|accessdate=27 September 2012|newspaper=Reuters|date=26 September 2012}}</ref> He is being treated for the [[respiratory disease]], which has led to [[renal failure]].<ref>{{cite news|last=Falco|first=Miriam|title=New SARS-like virus poses medical mystery|url=http://thechart.blogs.cnn.com/2012/09/24/new-sars-like-virus-poses-medical-mystery/|accessdate=27 September 2012|newspaper=CNN|date=24 September 2012}}</ref> The first known case was a Saudi Arabian who died in early 2012. The [[World Health Organisation]] (WHO) announced that it is "engaged in further characterizing the novel coronavirus" and that it has "immediately alerted all its Member States about the virus and has been leading the coordination and providing guidance to health authorities and technical health agencies."<ref>{{cite web|title=Novel coronavirus infection|url=http://www.who.int/csr/don/2012_09_25/en/index.html|publisher=World Health Organisation|date=25 September 2012|accessdate=27 September 2012}}</ref> Virologist Ron Fouchier has speculated that the virus might originate from bats.<ref>{{cite news|last=Doucleff|first=Michaeleen|title=Holy Bat Virus! Genome Hints At Origin Of SARS-Like Virus|url=http://www.npr.org/blogs/health/2012/09/28/161944734/holy-bat-virus-genome-hints-at-origin-of-sars-like-virus|accessdate=29 September 2012|newspaper=NPR|date=28 September 2012}}</ref>
| |
|
| |
|
| Saudi Arabia's Ministry of Health was concerned that the virus might affect the October 2012 [[Hajj]], the Islamic pilgrimage to Mecca, as Muslims making the Hajj may have been infected.<ref>{{cite news|last=Moisse|first=Katie|title=Saudi Health Officials Brace for Hajj Pilgrimage to Mecca|url=http://abcnews.go.com/Health/Wellness/sars-virus-added-list-hajj-health-risks/story?id=17331279#.UGRAhhHLy5I|accessdate=27 September 2012|newspaper=ABC News|date=27 September 2012}}</ref>
| | ==[[Novel human coronavirus infection classification|Classification]]== |
|
| |
|
| Following the high-profile publicity of SARS outbreaks, there has been a renewed interest in coronaviruses in the field of [[virology]]. For many years, scientists knew only about the existence of two human coronaviruses (HCoV-229E and HCoV-OC43). The discovery of SARS-CoV added another human coronavirus to the list. By the end of 2004, three independent research labs reported the discovery of a fourth human coronavirus. It has been named NL63, NL or the New Haven coronavirus by the different research groups.<ref>{{cite journal | author=van der Hoek L, Pyrc K, Jebbink MF, ''et al.'' | title=Identification of a new human coronavirus | doi= 10.1038/nm1024 | journal=Nat Med | year=2004 | volume=10 | issue=4 | pages=368–73 }}</ref> The naming of this fourth coronavirus is still a controversial issue, because the three labs are still battling over who actually discovered the virus first and hence earns the right to name the virus. Early in 2005, a research team at the University of Hong Kong reported finding a fifth human coronavirus in two [[pneumonia]] patients, and subsequently named it [[HKU1]].
| | ==[[Novel human coronavirus infection pathophysiology|Pathophysiology]]== |
|
| |
|
| ==Classification== | | ==[[Novel human coronavirus infection causes|Causes]]== |
| ===Human Coronaviruses===
| |
|
| |
|
| *HCoV-229E
| | ==[[Novel human coronavirus infection differential diagnosis|Differentiating Novel Human Coronavirus Infection from other Diseases]]== |
| *HCoV-OC43
| |
| *SARS-CoV
| |
| *NL63/NL/New Haven coronavirus
| |
| *HKU1-CoV
| |
| *HCoV-EMC
| |
| *Novel Coronavirus 2012
| |
| ==Pathophysiology==
| |
| ===Transmission===
| |
| * The cases occurring in the same family raises the possibility of limited human-to-human transmission. Alternatively, it is possible that the infected family members were exposed to the same source of infection, for example, in a household or workplace.
| |
| * There is currently no direct evidence that the human cases were exposed through direct contact with animals.
| |
| * The route taken by this coronavirus to infect humans is still not clear. It could, for example, be carried by intermediate animal hosts, or in foodstuffs contaminated by the faeces of bats or other infected animals.
| |
|
| |
|
| ===Cytopathic Effects=== | | ==[[Novel human coronavirus infection epidemiology and demographics|Epidemiology and Demographics]]== |
| The [[virus]] replicated readily in cell culture, producing cytopathic effects of rounding, detachment, and syncytium formation. The virus represents a novel betacoronavirus species. The closest known relatives are bat coronaviruses HKU4 and HKU5. <ref name="pmid23075143">{{cite journal |author=Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA |title=Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia |journal=[[The New England Journal of Medicine]] |volume=367 |issue=19 |pages=1814–20 |year=2012 |month=November |pmid=23075143 |doi=10.1056/NEJMoa1211721 |url=http://www.nejm.org/doi/abs/10.1056/NEJMoa1211721?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed |accessdate=2012-12-29}}</ref>
| |
|
| |
|
| This coronavirus seems to differ from the [[SARS virus]] in some important ways. [[SARS virus]] binds to the ACE-2 receptor on human cells deep in the lungs, it causes serious disease in the [[lower respiratory tract]] but is relatively difficult to contract and is not easily spread by [[coughing]] or [[sneezing]]. The researchers have determined that the new coronavirus does not bind to the ACE-2 receptor, but declined to elaborate on which receptor it does use. But ruling out the ACE-2 receptor has immediate practical implications all the reagents and therapeutic strategies developed for the SARS virus will be of little use.<ref name="urlClusters of coronavirus cases put scientists on alert : Nature News & Comment">{{cite web |url=http://www.nature.com/news/clusters-of-coronavirus-cases-put-scientists-on-alert-1.12006 |title=Clusters of coronavirus cases put scientists on alert : Nature News & Comment |format= |work= |accessdate=2012-12-29}}</ref>
| | ==[[Novel human coronavirus infection risk factors|Risk Factors]]== |
| | ==[[Novel human coronavirus infection screening|Screening]]== |
|
| |
|
| The same team of researchers also found that cells from bats, pigs and humans can all be infected in the lab with the coronavirus. This suggests that it can spread among mammals and that it might jump readily between mammal species.
| | ==[[Novel human coronavirus infection natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| | |
| ===Genetics===
| |
| The partial genetic sequences of a virus isolated from bats match the [[coronavirus]] found in [[humans]].
| |
| | |
| ==Differentiating Novel Human Coronavirus Infection from other Diseases==
| |
| WHO recognizes that the emergence of a new coronavirus capable of causing severe disease raises concerns because of experience with [[SARS]]. Although this novel coronavirus is distantly related to the [[SARS]] CoV, they are different. Based on current information, it does not appear to transmit easily between people, unlike the [[SARS|SARS virus]].
| |
| | |
| ==Epidemiology and Demographics==
| |
| As of November 30, 2012, nine laboratory confirmed cases have been reported to WHO - five from Saudi Arabia, two from Qatar, and two from Jordan. The onset of illness was between April - November 2012. Among the nine cases, five were fatal. Based on available information, the clinical picture consists of febrile illness and pneumonia.<ref name="urlCDC - Coronavirus - Case Definitions and Guidance Novel Coronavirus">{{cite web |url=http://www.cdc.gov/coronavirus/ncv/case-def.html#guidance |title=CDC - Coronavirus - Case Definitions and Guidance Novel Coronavirus |format= |work= |accessdate=2012-12-28}}</ref>
| |
| | |
| Five cases were associated with two clusters. The first cluster of two cases, both fatal, occurred near Amman, Jordan, in April 2012. Stored samples from these two cases tested positive retrospectively for the novel coronavirus. This cluster was temporally associated with cases of illness among workers in a hospital. A second cluster occurred in October, 2012, in Saudi Arabia. Of the four individuals in the household, three were laboratory confirmed cases, two of them died.
| |
| | |
| ===United States===
| |
| * There are no reports of anyone in United States getting infected and sick with the novel coronavirus. Risk of getting infected with this virus is estimated to be low.
| |
| * WHO and CDC have not issued any travel alerts for countries in the Arabian Peninsula or neighboring countries. Your risk of getting infected with the novel coronavirus while in these countries is estimated to be low.
| |
| ==Natural History, Complications and Prognosis==
| |
| ===Complications===
| |
| * [[Pericarditis]] <ref name="urlWHO | Background and summary of novel coronavirus infection – as of 21 December 2012">{{cite web |url=http://www.who.int/csr/disease/coronavirus_infections/update_20121221/en/index.html |title=WHO | Background and summary of novel coronavirus infection – as of 21 December 2012 |format= |work= |accessdate=2012-12-29}}</ref>
| |
| * [[Renal failure]]
| |
| * [[DIC]]
| |
| * Severe [[respiratory failure]]
| |
|
| |
|
| ==Diagnosis== | | ==Diagnosis== |
| ===History and Symptoms===
| |
| In confirmed cases of illness in humans, common [[symptoms]] have been acute, serious respiratory illness with [[fever]], [[cough]], [[shortness of breath]], and breathing difficulties. Based on current clinical experience, the infection generally presents as [[pneumonia]]. It has caused [[kidney failure]] and [[death]] in some cases. It is important to note that the current understanding of the illness caused by this infection is based on a limited number of cases and may change as more information becomes available.
| |
|
| |
|
| ===Physical Examination===
| | [[Novel human coronavirus infection case definitions|Case Definitions]] | [[Novel human coronavirus infection history and symptoms|History and Symptoms]] | [[Novel human coronavirus infection physical examination|Physical Examination]] | [[Novel human coronavirus infection laboratory findings|Laboratory Findings]] | [[Novel human coronavirus infection chest x ray|Chest X Ray]] | [[Novel human coronavirus infection other imaging findings|Other Imaging Findings]] | [[Novel human coronavirus infection other diagnostic studies|Other Diagnostic Studies]] |
| ====Vital Signs====
| |
| * Temperature: [[Fever]]
| |
| ====Throat====
| |
| * [[Cough]]
| |
| ====Lungs====
| |
| * [[Shortness of breath]]
| |
|
| |
|
| ===Laboratory Findings=== | | ==Treatment== |
| Lab tests ([[polymerase chain reaction]] or [[PCR]]) for the novel coronavirus are available at CDC and other international labs. Otherwise, these tests are not routinely available.
| |
|
| |
|
| ===Other Diagnostic Studies===
| | [[Novel human coronavirus infection medical therapy|Medical Therapy]] | [[Novel human coronavirus infection primary prevention|Primary Prevention]] | [[Novel human coronavirus infection secondary prevention|Secondary Prevention]] | [[Novel human coronavirus infection cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Novel human coronavirus infection future or investigational therapies|Future or Investigational Therapies]] |
| The United Kingdom's [[Health Protection Agency]] is working on the genetic sequence of the virus, based on the sequence obtained from the Qatari case.<ref>{{cite news|title=How threatening is the new coronavirus?|url=http://www.bbc.co.uk/news/health-19699677|accessdate=27 September 2012|newspaper=BBC|date=24 September 2012}}</ref>
| |
|
| |
|
| ==Treatment== | | ==Case Studies== |
| ===Medical Therapy===
| | [[Novel human coronavirus infection case study one|Case #1]] |
| There are no specific treatments for illnesses caused by the novel coronavirus. Medical care is supportive and to help relieve symptoms.
| | ==Related Chapters== |
| ===Prevention=== | | * [[SARS]] |
| * There is no [[vaccine]] currently available. | | * [[Coronavirus]] |
|
| |
|
| ==External Links== | | ==External Links== |
| Line 98: |
Line 53: |
| * [http://www.cdc.gov/coronavirus/ncv/index.html CDC Fact Sheet] | | * [http://www.cdc.gov/coronavirus/ncv/index.html CDC Fact Sheet] |
|
| |
|
| ==Related Chapters==
| |
| * [[SARS]]
| |
| * [[Coronavirus]]
| |
|
| |
|
| ==References==
| |
| {{reflist|2}}
| |
| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |
| | [[category:disease]] |
| | |
| | [[category:virology]] |
