Transcript Corona Virus

Corona virus
Coronaviridae
Corona Virus
Corona Virus
•
Coronaviruses are
believed to cause a
significant percentage
of all common colds
in human.
•
It is primarily infect
the upper respiratory
and gastrointestinal
tract of mammals and
birds.
The three major antigenic
groups of CoV

Group I contains canine, feline, porcine
coronaviruses and a human corona virus
HCoV 229E the prototype of the group
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Group II contains bovine, porcine, rat and
mouse CoV and the other human strain
which is OC43
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Group III no human strains only Turkey and
Avian CoV
Evolution of SARS 2003

A novel human corona virus named
SARS associated corona virus
represents a new fourth antigenic
group intermediate between groups I
& III
•
In 2003 The SARS epidemic resulted in
over 8,000 infections, about 10% of
which resulted in death.
2012 Jun – Jeddah, Saudi Arabia – Sporadic case
60y male, occupation
unknown, no travel
history, “limited exposure
to animals prior to onset”,
onset on 06.06,
hospitalized on 06.13,
died on 06.20.
Middle East Respiratory Syndrome
Coronavirus
(MERS-CoV)
2012 Apr – Zarqa, Jordan – Hospital cluster
On 19 Apr 2012,
Jordan MOH reported
an outbreak of
pneumonia in the
Zarqa Public Hospital’s
ICU. 7 nurses, 1
doctor and 1 brother
of a nurse were
among the 11
affected. 1 of the
nurses died.
In Nov 2012, testing of
stored samples from
two died patients of
this cluster confirmed
novel coronavirus
infection.
2012 Sep – Doha, Qatar – Sporadic case
49y male, occupation
unknown, travel history to
Saudi Arabia, “limited
exposure to animals prior
to onset”, onset on
2012.09.03, hospitalized
on 09.07.
2012 Oct~Nov – Qatar & SA
– Sporadic cases & family cluster
SA case: 45y male.
Qatar case: 45y male.
SA household cluster:
 Father: 70y, many
comorbidities, hospitalized
on 2012.10.14, died on
10.24.
 Son A: 39y, onset on
10.28, died four days later.
 Son B: 31y, similar illness,
test positive, discharged on
11.20.
 Grandson: similar illness,
test negative, discharged on
11.20.
2013 Jan~Feb – SA – Sporadic cases
61y female, onset on
2013.01.24, died on
02.10, travel history to
Egypt (2013.01.10-18).
69y male, onset on
2013.02.05, died on
02.19, no contact or
travel history.
39y male, onset on
2013.02.24, died on
03.02.
2013 Jan~Feb – SA→UK – Family cluster
Index case: 60y male, travel to
Pakistan (2012.12.16~2013.01.20)
and Saudi Arabia (01.20~01.28),
onset on 01.26, hospitalized on
01.31, co-infected with influenza
A(H1N1).
Adult female member of extended
family, limited exposure to the
index case on three occasions in
hospital (possibility of an
intermediary case), onset on
02.05, mild influenza-like illness.
Adult male household member, in
sustained close contact with the
index case at home, pre-existing
medical conditions, onset on 02.06,
died on 02.17.
Saudi Arabia
Transmission of MERS-Cov
MERS-CoV Transmission

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Airborne
Incubation period is 10-14 days
The following have been observed:
 Transmission between close contacts
 Transmission from infected patients to healthcare
personnel
Eight clusters of illnesses have been reported
by six countries
 So far, all cases have a direct or indirect link
to one of four countries: Saudi Arabia, Qatar,
Jordan, and the United Arab Emirates

2014 concern
•
Hajj creates a perfect
opportunity for infectious
diseases, especially respiratory
tract infections like
coronavirus, to spread. Millions
of people from all over the
world are gathered in tight
spaces over the span of several
weeks, and they take back any
diseases they might have
caught when they return
home.
First Reported MERS-CoV Case
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60 year old Saudi man
Presented on June 13th with 7d h/o fever
and cough; recent shortness of breath
Increasing blood urea nitrogen (BUN) and
creatinine, starting day 3 of admission
White cell count normal on admission (but
92.5% neutrophils) and increased to a peak
of 23,800 cells per cubic millimeter on day
10 with neutrophilia, lymphopenia, and
progressive thrombocytopenia
Zaki et al. N Engl J Med 2012 367:1814-20
First Case Outcome
Patient developed acute respiratory
distress syndrome (ARDS) and multiorgan
dysfunction syndrome
 Died June 24th
 No close contacts with severe illnesses
reported
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Patient Under Investigation (PUI)
A person with an acute respiratory infection,
which may include fever (≥ 38°C , 100.4°F) and
cough; AND
 suspicion of pulmonary parenchymal disease
(e.g., pneumonia or acute respiratory distress
syndrome based on clinical or radiological
evidence of consolidation); AND
 history of travel from the Arabian Peninsula
or neighboring countries* within 10
days.AND
 not already explained by any other infection or
etiology.
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Collection of Laboratory Specimens
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Determine if patient meets PUI criteria
Collect:
 An upper respiratory specimen:
 Nasopharyngeal AND oropharyngeal swab
 A lower respiratory specimen:
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Broncheoalveolar lavage, OR
Tracheal aspirate, OR
Pleural fluid, OR
Sputum
 Serum for eventual antibody testing (tiger top tube)
 Should be collected during acute phase during first week
after onset, and again during convalescence ≥ 3 weeks
later
Therapeutics
No vaccines developed as of yet
 No antivirals identified as of yet
 Treatment is supportive
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