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Country Preparedness to the Novel Coronavirus Outbreak

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Coronavirus – 17,390 Confirmed cases worldwide, 362 Deaths worldwide as of 03 February 2020 as reported by Bloomberg, link to live map of outbreak tracking. #coronavirus #Zambia #ZASA

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Background

  • Novel coronavirus in Wuhan City, Hubei Province, China.
  • More than 1000 confirmed human infections in China with 41 deaths
  • Possible zoonotic origin China (linked to a large seafood and animal market)
  • Exported cases in Asia, France, Australia and USA

Locations with Confirmed 2019-nCoV Cases

What is a coronavirus?

  • Coronaviruses are named for the crown-like spikes on their surface.
    • There are four main sub-groupings of coronaviruses, known as alpha, beta, gamma, and delta
  • Coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or upper throat.
    • People commonly infected with human coronaviruses 229E, NL63, OC43, and HKU1.
  • Sometimes new human coronavirus.
  • Sometimes due to mutation new coronaviruses emerge
    • Three recent examples of this are Severe Acute Respiratory Syndrome (SARS-CoV), 2002 and Middle East Respiratory Syndrome (MERS-CoV), 2017, Novel Coronavirus 2019-nCoV,
  • Known to cause illness ranging from the common cold to more severe diseases.

Transmission

  • Animal to human and human to human transmission
    • Airborne transmission—respiratory droplets
  • SARS and MERS both with animal sources
    • Source for 2019-nCoV yet to be established

Signs and symptoms

  • Fever (>38C),
  • Respiratory symptoms,
    • Cough,
    • Shortness of breath,
    • and breathing difficulties.
  • In more severe cases, infection can cause pneumonia, severe acute respiratory distress syndrome, organ failure and even death

Treatment

  • No specific treatment, No vaccine
  • Symptomatic and supportive treatment available

Testing

  • RT-PCR test for diagnosis of 2019-nCoV
  • Currently unavailable in-country
    • Africa CDC to support diagnostic capacity in three regional ref lab – NICD (RSA), UVRI (Uganda) AND IP (Senegal)

Case definition

Person presenting with severe Acute Respiratory Infection(SARI) with history of fever and cough (with no other etiology that fully explains the clinical presentation) and any one of the following:

  1. A history of travel to China (or other affected country) in the last 14 days prior to symptom onset; or
  2. Close physical contact with a confirmed case of nCoV infection; or
  3. Visit to a healthcare facility in a country where hospital-associated nCoV infections have been reported
  4. A health care worker who has been working in an environment where patients with severe acute respiratory infections are being cared for.

Prevention

  • Frequent hand hygiene and standard surgical masks are key steps for prevention.
  • Perform hand hygiene after potential contact with respiratory secretions.
  • Isolation where necessary

ZNPHI Interventions

  • PHEOC on high alert and following evolving events
  • Enhancing active traveller screening at the POEs
    • case definitions (travel history and symptom screening)
    • temperature checks on all passengers
    • Meetings with stakeholders to coordinate response efforts for the novel Coronavirus
      • Meeting held at KKIA on 21 January 2020
  • Promotion of infection prevention and control (IPC) measures
  • Health promotion with deployment of personal hygiene and other health education messages
  • Prepositioning of IPC materials
  • Repurposing of already designated isolation facilities

Recommendations

  • Coordination at high-level possible SC meeting
  • Possible activation of national Influenza TWG
  • PHEOC to coordination stakeholders with possible set up of a preliminary IMS
  • Ensure all airports have IEC materials
  • Training/reorientation of national, provincial and district rapid response teams on novel Coronavirus and IPC measures suited for its control.
  • Orient nearby HF and ensure clinical guidelines are in place
  • Develop, print and disseminate IEC materials for novel Coronavirus including clinical guidelines
  • Enhance lab capacity for preliminary diagnosis before sample referral to NICD

Dr. Victor Mukonka
DIRECTOR – Zambia National Public Health Institute

Sources: Mapping the Coronavirus Outbreak Across the World

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