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Table of Contents
PERSPECTIVE
Year : 2020  |  Volume : 13  |  Issue : 3  |  Page : 97-98

Novel coronavirus (2019-nCoV) update: What we know and what is unknown


Emergency Centre for Transboundary Animal Diseases, Food and Agriculture Organization of the United Nations (FAO-ECTAD), Dar es Salaam, 14111, United Republic of Tanzania; Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort 0110, South Africa

Date of Submission04-Feb-2020
Date of Decision04-Feb-2020
Date of Acceptance04-Feb-2020
Date of Web Publication05-Feb-2020

Correspondence Address:
Folorunso Oludayo Fasina
Emergency Centre for Transboundary Animal Diseases, Food and Agriculture Organization of the United Nations (FAO-ECTAD), Dar es Salaam, 14111, United Republic of Tanzania; Department of Veterinary Tropical Diseases, University of Pretoria, Onderstepoort 0110, South Africa

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1995-7645.277795

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How to cite this article:
Fasina FO. Novel coronavirus (2019-nCoV) update: What we know and what is unknown. Asian Pac J Trop Med 2020;13:97-8

How to cite this URL:
Fasina FO. Novel coronavirus (2019-nCoV) update: What we know and what is unknown. Asian Pac J Trop Med [serial online] 2020 [cited 2020 Feb 28];13:97-8. Available from: http://www.apjtm.org/text.asp?2020/13/3/97/277795



The year 2020 was welcomed and characterized with a report of pneumonia of unknown etiology, which occurred primarily in Wuhan City of Hubei Province of China. Between 31 December 2019 and 3 January 2020, a total of 44 cases in human was reported to the World Health Organization (WHO) by the Chinese Health Authorities[1]. By 3 February 2020, a total of 17 391 cases have been confirmed globally with 2 838 new cases (China: 17 238; 2 831 new cases and 361 deaths; Outside China: 153 with 7 new cases and 1 death from 23 countries)[1]. Wuhan City of Hubei Province has accounted for approximately 64.8% of all cases from China. Globally, the risk of infection and spread remains high. The pathogen causing the infection has been classified as 2019 novel coronavirus (2019-nCoV). Due to a surge in numbers of cases from the third week of January 2020, and after intense consultations and deliberations by the International Health Regulations (2005) Emergency Committee, the WHO, on 30 January 2020 declared the outbreak of 2019-nCoV a Public Health Emergency of International Concern (PHEIC)[2],[3]. Since the date of this declaration, global attention has been focused on 2019-nCoV[4],[5].

Preliminary clinical features indicated that most of the infected patients were men with underlying diseases (comorbidities) including diabetes, hypertension, cardiovascular disease, chronic obstructive pulmonary disease, malignancy and chronic liver disease[6]. Patient presented with fever, cough, myalgia, sputum production, headache, haemoptysis, diarrhea and dyspnea[6]. Person- to-person transmission and familiar association have also been confirmed[7]. To date, a diagnostic kit has been developed for 2019- nCoV[8], and efforts are ongoing to develop other protocols.

Whilst several important aspects of 2019-nCoV epidemiology, virology, mode of transmission, pathogenesis, diagnosis, clinical features, have been defined, there remain many unanswered questions, including source, transmission and epidemic potential. The Wuhan outbreak is a stark reminder of the continuing threat of zoonotic diseases.

Detailed clinical, laboratory and epidemiological findings are available in several studies[3],[6],[7], and further works are ongoing to solve the several unknown about the virus (more details on the source, epidemiology, virology, mode of transmission, pathogenesis, diagnosis, clinical features and epidemic potential). These information will be needed to solve many unanswered questions.

Specifically, it has been confirmed that many of the patients with ongoing outbreak in humans have linkages with a large seafood and live animal market in Wuhan, Hubei Province[3]. Evidence also suggests that the 2019-nCoV is closely related to coronavirus from bats[9], a strong indication that the virus may have an animal source (with bats acting as the primary source and the animals available in the seafood market serving as intermediate hosts between human and bats). However, while it is known that humans are the terminal hosts for 2019-nCoV, it still needs further investigations whether this is similar to the situation in Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), where masked palm civet is the intermediate host, and MERS-CoV where dromedary camels have been identified as intermediate hosts[9]. The yet-to-be-identified wild animal(s) may be the intermediate host for the ongoing 2019- nCoV. It therefore becomes important to utilize one health approach in the implementation of investigation and control of the ongoing 2019-nCoV.

Recent models have suggested that a lot more cases than those confirmed and reported to the WHO may have occurred[10]. It was also suggested that human-to-human transmissibility is highly likely and the epidemic may spiral out of control without the implementation of effective control measures[11]. In Germany, an asymptomatic contact served as a source of 2019-nCoV transmission to other patients and this has introduced another dimension to the transmission dynamics in the current outbreaks[12]. The health authorities have quarantined several cities in Hubei Province in an unprecedented public health response, yet outbreak continues to be reported in several locations in China, as well as in the Western Pacific, South East Asia, North America, Europe and Middle East where intense import control measures have been implemented. It is important for the infectious disease community globally to draw from the lessons of SARS-CoV, Asian highly pathogenic avian influenza H5N1 (HPAI H5N1), MERS-CoV and other public health emergencies, particularly those that have originated from the South East Asia axis, to combat the current situation in South East Asia and elsewhere. Finally, global efforts continue to target vaccine development, an urgently needed biological that may stem an epidemic. The world will continue to monitor the 2019-nCoV ‘zoonotic’ respiratory diseases as progress is made in global health security.

Conflict of interest statement

The author declares that there is no conflict of interest.



 
  References Top

1.
World Health Organization (WHO). Novel coronavirus (2019-nCoV) situation reports, 2020. [Online]Available at: https://www.who.int/ emergencies/diseases/novel-coronavirus-2019/situation-reports/. [assessed on 4 February 2020].  Back to cited text no. 1
    
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Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet 2020; doi: 10.1016/S0140-6736(20)30185-9.  Back to cited text no. 2
    
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Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel coronavirus from patients with pneumonia in China, 2019. New Engl J Med 2020; doi: 10.1056/NEJMoa2001017.  Back to cited text no. 3
    
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Hui DS, Azhar EI, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health-The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis 2020; 91: 264-266.  Back to cited text no. 4
    
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Heymann DL. Data sharing and outbreaks: Best practice exemplified. Lancet 2020; doi: 10.1016/S0140-6736(20)30184-7.  Back to cited text no. 5
    
6.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; doi: 10.1016/S0140-6736(20)30183-5.  Back to cited text no. 6
    
7.
Chan JFW, Yuan S, Kok, KH, To KKW, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Lancet 2020; doi: 10.1016/S0140-6736(20)30154-9.  Back to cited text no. 7
    
8.
Corman V, Bleicker T, Brünink S, Drosten C, Landt O, Koopmans M, et al. Diagnostic detection of Wuhan coronavirus 2019 by real-time RT-PCR: Protocol and preliminary evaluation as of January 13, 2020. 2020. [Online]Available at: https://www.who.int/docs/default-source/ coronaviruse/wuhan-virus-assay-v1991527e5122341d99287a1b17c1119 02.pdf?sfvrsn=d381fc88_2. [accessed on 4 February 2020].  Back to cited text no. 8
    
9.
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; doi.: 10.1016/S0140- 6736(20)30251-8.  Back to cited text no. 9
    
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Imai N, Dorigatti I, Cori A, Donnelly CA, Riley S, Ferguson NM. Report 2: Estimating the potential total number of novel Coronavirus cases in Wuhan City, China, 2020a [Online]Available at: https://www.imperial. ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/2019- nCoV-outbreak-report-22-01-2020.pdf. [accessed on 4 February 2020].  Back to cited text no. 10
    
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Imai N, Cori A, Dorigatti I, Baguelin M, Donnelly CA, Riley S, et al. Report 3: Transmissibility of 2019-nCoV, 2020b[Online]Available at: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/ gida-fellowships/Imperial-2019-nCoV-transmissibility.pdf. [accessed on 4 February 2020].  Back to cited text no. 11
    
12.
Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. New Engl J Med 2020; doi: 10.1056/NEJMc2001468.  Back to cited text no. 12
    




 

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