Wuhan Coronavirus (2019-nCoV) Facts, Concerns and Prevention 2020

Wuhan Coronavirus
(2019-nCoV)
Facts, Concerns and Prevention
2020
Dr.T.V.Rao MD
1/31/2020 Dr.T.V.RaO MD @ CORONA VIRUS 2019 -2010 1

How to Sensitize on Viral infections
Current topic of importance
• It is a time to think about training our Medical students and health care
professionals on the emerging and newer challenges associated with Epidemic
and pandemic Viral Infections, NIPAH in the past and CORONA
VIRUS EMERGING IN China makes us to realize what are our weaker
points to control the matters in TIME , above all our curriculum to teach
Under graduates needs the revision to make our core Microbiology to be
dealt as Infectious diseases and train better to the present needs of the
Society in the changing world of Infectious diseases
1/31/2020
Dr.T.V.RaO MD @ CORONA VIRUS
2019 -2010
2

Emerging infectious diseases -
Every one at Risk
•In 1992, the Institute of Medicine (IOM) in the
United States produced a report on emerging
infectious diseases (EID), and identified the
following causes: human demographics and
behavior; technology and industry; economic
development and land use; international travel
and commerce; microbial adaptation and
change; breakdown of public health measures.

What is the coronavirus?
•Coronaviruses are a family
of viruses that cause
illnesses ranging from a
cold to more severe
diseases. Typically,
symptoms include a fever,
fatigue, sore throat and dry
cough, and may later
develop into breathing
difficulties.

Coronavirus
Coronaviruses (CoV) are a large
family of viruses that cause
illness ranging from the common
cold to more severe diseases
such as Middle East Respiratory
Syndrome (MERS-CoV) and
Severe Acute Respiratory
Syndrome (SARS-CoV). A novel
coronavirus (nCoV) is a new
strain that has not been
previously identified in humans.

Coronaviruses are Zoonotic
• Coronaviruses are zoonotic,
meaning they are transmitted
between animals and people.
Detailed investigations found
that SARS-CoV was transmitted
from civet cats to humans and
MERS-CoV from dromedary
camels to humans. Several
known coronaviruses are
circulating in animals that have
not yet infected humans.

It's entirely New Virus
• The virus appears to be a never-
before-seen strain of
coronavirus - a large family of
viruses that can cause diseases
ranging from the common cold
to Severe Acute Respiratory
Syndrome (SARS), which killed
349 people in mainland China
and another 299 in Hong Kong
between 2002 and 2003

Why New
Viral Infections
Emerging
• New viral diseases
typically emerge because
of human activity that
brings people into contact
with wildlife, such as road
building, hunting and
agriculture expansion,
About 75 percent of
emerging diseases in
people come from
animals, according to Eco
Health Alliance.

A possible transmission from Snakes to
humans
•These viruses are
transmitted between
animals and people.
This novel coronavirus,
currently named 2019-
nCoV, is a new strain
that had not been
previously identified in
humans.

Human-to-human transmission
• Human-to-human
transmission — spread from
close contact, some such as
among family members —
could make the virus spread
more quickly and widely, if it
spreads easily. The outbreak
is believed to have started
from people who picked it up
at a seafood market in the
city of Wuhan in central
China.

Signs and Symptoms of Corona Virus
• The clinical signs and
symptoms reported are
mainly fever, with a few cases
having difficulty in breathing,
and chest radiographs
showing invasive pneumonic
infiltrates in both lungs.
National authorities report
that patients have been
isolated and are receiving
treatment in Wuhan medical
institutions.

Clinical Manifestations of Corona
Virus infections
• Common signs of infection
include respiratory
symptoms, fever, cough,
shortness of breath and
breathing difficulties. In
more severe cases,
infection can cause
pneumonia, severe acute
respiratory syndrome,
kidney failure and even
death.

Standard recommendations to prevent infection
spread
• Standard recommendations to
prevent infection spread include
regular hand washing, covering
mouth and nose when coughing
and sneezing, thoroughly
cooking meat and eggs. Avoid
close contact with anyone
showing symptoms of
respiratory illness such as
coughing and sneezing.

Corona viral infection makes everyone
Scary

Why Humans are at
greater Risk Today
• As human beings come to
experience greater
opportunities to be exposed to
animal reservoir host in natural
settings than before, and
because of intensified
international travel, the chance
to encounter emerging disease
epidemic has grown with time,
and the spread of epidemic has
become faster than in the past.1/31/2020 Dr.T.V.RaO MD @ CORONA VIRUS 2019 -2010 16

What we should need to know about Corona
virus Epidemic Pandemic
• The source of the coronavirus
is believed to be a seafood
market in the central Chinese
city of Wuhan. The city's
health commission said the
infection broke out between
December 12 and 29, with
some of the patients
employed at the market.

The source of Infection
•The animal source of
the outbreak has not
been identified but
two recent research
papers have pointed
to bats and snakes
as the possible
culprits.

Possible
source of Infection
• According to the preliminary
epidemiological investigation,
most cases worked at or were
handlers and frequent visitors
to the Huanan Seafood
Wholesale Market. The
government reports that
there is no clear evidence
that the virus passes easily
from person to person

How quickly has it spread?
• Since the outbreak in mid-
December, cases have
escalated at pace. Within a
month, two people in China
had died while about 40
cases were identified. As of
January 28, the death toll
stood at 170 with more
than 7,711 cases.

China Shares the Information to Make
Diagnostic Kits
• China shared the genetic
sequence of the novel
coronavirus on 12
January, which will be of
great importance for
other countries to use in
developing specific
diagnostic kits.

The Lancet Reports on Corona Virus 2019
• The Lancet, researchers report on a genomic analysis of 2019-
nCoV from nine patients in Wuhan, China, all of whom had a
connection to the Huanan seafood market. Genetic sequences
from the patients' samples were almost identical, which
indicates that the virus emerged in humans very recently, the
researchers note. Additionally, the virus appears most similar to
two SARS-like coronaviruses that originated in bats. The
researchers say that taken together, their findings suggest that
bats are the original host and an animal sold at the market
might have served as an intermediate host that facilitated
transmission to humans.

New England Journal of Medicine
study
• New England Journal of
Medicine study offers more
evidence supporting person-to-
person transmission of the virus.
Of 425 cases studied, over half
of those with onset in December
were linked to the market, while
just 9% of those occurring in
January were thus linked.
Overall, the mean incubation
period was 5.2 days.

The Great
suggestions and to
be adopted
•They suggested better
surveillance, vaccine
and drug development,
vector control
(primarily through
better pesticides) and
behavioral changes
among individuals at
risk.

We have achieved a
great success
• Humans have come a long way in
preventing viral diseases over the
last century. Today, children in
the India and many other
countries . routinely receive
vaccinations against several viral
diseases, including many that
used to cause life-threatening
complications, such as polio.

WHY VIRAL
INFECTIONS ARE
DIFFICULT TO
TREAT
• Viruses are inherently difficult
targets," for modern medicine,
said Derek Gatherer, a
bioinformatics researcher at
Lancaster University in the
United Kingdom. "They have, in
general, smaller genomes than
bacteria," so there are fewer
places to look for ways to
combat them, and many drug
molecules do not reach the
targets to control the spread
and growth .

The Great Problem with
Viral Infections t cure
• However, although there are
"broad-spectrum" antibiotics,
which are single drugs that work
against dozens of bacteria, the
spectrum for antivirals is much
narrower, . Most antiviral drugs
are specific for one type of virus,
although some work against two
or three.

Epidemics, Pandemics
and Outbreaks

PREVENTING
VIRAL
INFECTIONS
• What can we do to
prevent outbreaks of
infectious diseases from
becoming epidemics or
pandemic? In this
course, you’ll learn the
facts about infectious
diseases and medical
responses.

BIO SECURITY IS NEW
SCEINTIFIC APPRAOCH
TO STOP SPREADING
VIRAL INFECTIONS
We should focus on
the public health laws
and policies that
provide the framework
for effective
prevention, like
quarantine laws, drug
development policies,
and bioterrorism and
biodefense

What we are really
Missing
• What was missing was
consideration of the
complex interactions
among the ecological and
social conditions, what and
how we eat and use water,
how we define waste, how
we manage it, wilderness
conservation,
transportation,
employment, meaningful
lives, research and action.

Ways to Stop Spread of
Infections

SCIENTIFIC ADVANCES
HAVE REDEFINED THE
CONCEPT OF EIDs
• Genomics techniques, like PCR
and high-throughput deep and
whole-genome sequencing,
that now greatly facilitate the
discovery of EIDs (e.g., the
etiologic agents of hantavirus
pulmonary syndrome and
Kaposi sarcoma) also reveal
previously unimagined
genomic diversity among
microbes.

Molecular Methods shaping
the future control of Viral
Infections
• This diversity includes
complex and evolving
viral quasispecies and
microbes that have
undergone
considerable
interbacterial
horizontal gene
transfer, creating new
phenotypic properties
of virulence and drug
resistance.

In Spite of many
Developments
• Despite extraordinary
progress during the past 2
decades, infectious
diseases still kill 15 million
people each year , and
new and deadly diseases
continue to emerge and
reemerge. The perpetual
nature of the emergence of
infectious diseases poses a
continuing challenge,
which is volatile and ever-
changing.

We lack many matters
to control and prevent
the emerging infections
• Our capacity to
undertake and maintain
basic and applied
research, and our
commitment to
eradicating certain EIDs
have never been greater
• Crowding in
Hospitals a great
threat to life

How do we cope with
epidemics?
• Countermeasures
against epidemics
can be classified
into specific and
non-specific
measures. Specific
intervention
includes the use of
antibiotics/antivirals
and vaccines.

Specific
Interventions
saves many lives
• They can act very
specifically and directly
against the pathogen or
elicit specific immunity,
and currently approved
specific interventions have
been all demonstrated to
be substantially effective
through epidemiological
studies.1/31/2020 Dr.T.V.RaO MD @ CORONA VIRUS 2019 -2010 40

Non-specific
interventions
• include the case isolation,
contact tracing and
quarantine. Behavioral
intervention and the so-
called “social distancing”
such as school closure are
also classified as non-
specific interventions. Due
to the non-specific nature,
these countermeasures are
applicable to a variety of
diseases, e.g., Ebola virus
disease, Corona virus SARS
especially in the absence of
specific countermeasures.

Creation of
isolation
units in
dangerous
viral
infections

Will the travel
restrictions Help ?
• Full travel restriction (not a
partial restriction) could
effectively delay the epidemic
(e.g. in the case of Ebola virus
disease), but it’s difficult to fully
shut down communication
between two countries and
such a countermeasure (i.e.
complete shut-down of a
border) may not be fully
justified.1/31/2020 Dr.T.V.RaO MD @ CORONA VIRUS 2019 -2010 43

Forecasting
Viral Infections
• When it comes to the prediction,
infectious disease modelling has
seldom been successful in forecasting
past epidemics. This is partly due to the
fact that the expectation for our
forecasting in the public has been too
large compared to other applications of
forecasting, e.g. compared to weather
forecast that predicts tomorrow or day
after tomorrow, epidemic models are
frequently expected to predict a moth
or even a year later.

Do you think we will be able to successfully predict and
prevent epidemics from happening in future
•We are sure that we will
eventually be able to
predict emerging
epidemics at a certain
acceptable success
probability. That will
greatly assist associated
prevention and control
programs.

Organizations work
hard to find solutions
• We are on the clear
path to the eventual
full recognition of
emerging infectious
diseases, and
moreover, the
control of existing
vaccine-preventable
infectious diseases
are also on the path
to be well controlled
by respective
immunization
programs.

Hope our
imaginations will
come true ?
• But we should always
consider potential
drawbacks of such successful
future. Once a serious
infectious disease is fully
cleared out from our society,
human susceptible host will
be left as completely naive
to that pathogen.

TRAINING THE HEALTH CARE WORKERS A TOPIC
PRIORITY

HUMAN COORDINATION A GREAT
PRIORITY

Searching current
Information on
Infectious diseases• Other microbiology and general
medical journals emphasizing
EIDs have been established, e.g.,
PLoS Pathogens, or expanded
their coverage of EIDs, e.g., the
Journal of Infectious Diseases and
Vaccine, while mBio and other
journals published by the
American Society for
Microbiology (ASM) have
remained leaders in publishing
important EID-related research.
1/31/2020
Dr.T.V.RaOMD @ CORONA VIRUS 2019 -2010
5
1

WHO advices
Based on information
provided by national
authorities, WHO’s
recommendations on
public health
measures and
surveillance for novel
coronaviruses apply.

Australian Lab Cultures New
Coronavirus as Infections Climb
Reported in Nature
• The group, the first outside of China
to successfully culture the virus, will
share it with the WHO, which will
distribute samples to research labs
around the globe—Working with the
cultured virus may allow researchers
to develop better treatments as well
as diagnostics by detecting
antibodies specific to 2019-nCoV, for
example. “There are some things that
are much easier to do when you have
the virus,”

WHO declares the new coronavirus outbreak a
Public Health Emergency of International Concern

Hand Hygiene Saves Many Lives

References and Resources
•CDC and WHO on Current challenges with spreading
viral infections
•New England Journal of Medicine
•The Lancet
•NIH
•Google resources on Education and Medicine

•Program Created by Dr.T.V.Rao MD for Medical,
Nursing and Paramedical Professionals for brining
awarenss on Current infection with CORONA VIRUS
•Email
•doctortvrao@gmail.com

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