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CDC Warns Health Officials About Deadly New Virus

Fourteen cases reported outside U.S. (Mar. 7)

In the March 7 issue of Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention (CDC) announced that it is working closely with the World Health Organization (WHO) and other partners to better understand the public health risk posed by a novel coronavirus that was first reported to cause human infection in September 2012. Genetic sequence analyses have shown that the new virus is different from any other known human coronaviruses, including the one that caused severe acute respiratory syndrome (SARS).

As of March 7, a total of 14 confirmed cases of novel coronavirus infection have been reported to WHO, with eight deaths. Illness onsets have occurred from April 2012 through February 2013. To date, no cases have been reported in the U.S.

Three of the confirmed cases of novel coronavirus infection were identified in the U.K. as part of a cluster within one family. The index patient in the cluster — a 60-year-old man with a history of recent travel to Pakistan and Saudi Arabia — developed respiratory illness on January 24, 2013, before returning to the U.K. on January 28. He was hospitalized on January 31 with severe lower respiratory tract disease and has been receiving intensive care. Respiratory specimens from this patient taken on February 1 tested positive for influenza A (H1N1) virus and for novel coronavirus infection.

The second patient was an adult male household member with an underlying medical condition who became ill on February 6 after contact with the index patient. He received intensive treatment but died with severe respiratory disease. This patient's underlying illness might have made him more susceptible to severe respiratory infection.

The third patient is an adult female who developed a respiratory illness on February 5 following contact with the index patient after he was hospitalized. She did not require hospitalization and had recovered by February 19.

Only the index patient had traveled recently outside the U.K. Based on its ongoing investigation of this cluster of illnesses, the U.K. Health Protection Agency has concluded that person-to-person transmission likely occurred in the U.K. within this family.

According to the CDC, this recent cluster provides the first clear evidence of human-to-human transmission of this novel coronavirus, co-infection of this novel coronavirus with another pathogen (influenza A), and a case of mild illness associated with this novel coronavirus infection. In light of these developments, the CDC has posted updated guidance on its coronavirus website (http://www.cdc.gov/coronavirus/ncv).

The CDC offers the following recommendations:

  • Persons who develop severe acute lower respiratory illness within 10 days after traveling from the Arabian Peninsula or neighboring countries should continue to be evaluated according to current guidelines.
  • Persons whose respiratory illness remains unexplained and who meet criteria for “patient under investigation” should be reported immediately to the CDC through state and local health departments.
  • Persons who develop severe acute lower respiratory illness of known etiology within 10 days after traveling from the Arabian Peninsula or neighboring countries but who do not respond to appropriate therapy may be considered for evaluation for novel coronavirus infection.
  • Persons who develop severe acute lower respiratory illness who are close contacts of a symptomatic traveler who developed fever and acute respiratory illness within 10 days of traveling from the Arabian Peninsula or neighboring countries may be considered for evaluation for novel coronavirus infection.

Testing of specimens for the novel coronavirus will be conducted at the CDC.

Source: CDC; March 7, 2013.

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