From World Health Organisation (WHO) 23 May 2013

What is the novel coronavirus?

This is a new strain of coronavirus (nCoV) that has not been seen in humans before.

Coronaviruses are a large family of viruses that cause illness in humans and animals. In people, coronaviruses can cause illnesses ranging in severity from the common cold to Severe Acute Respiratory Syndrome (SARS). A more specific name for the disease caused by nCoV, Middle East Respiratory Syndrome CoV, has been recently proposed.

Where are nCoV infections occurring?

Several countries in the Middle East have reported cases of human infection with nCoV, including Jordan, Qatar, Saudi Arabia, and the United Arab Emirates. Cases have also been reported by three countries in Europe – France, Germany, and the United Kingdom – and from Tunisia. All of the European and the Tunisian cases have had some connection (whether direct or indirect) with the Middle East. However, in France, Tunisia, and the United Kingdom, limited local transmission has occurred in people who had not been to the Middle East but who had been in close contact with a sick traveller recently returned from the Middle East.

How widespread is nCoV?

How widespread this virus may be is still unknown. WHO encourages Member States to continue to closely monitor for severe acute respiratory infections (SARI) and to carefully review any unusual patterns of SARI or pneumonia. WHO will continue to share information as it becomes available.

What are the symptoms of nCoV?

Common symptoms in patients with nCoV are acute, serious respiratory illness with fever, cough, shortness of breath, and breathing difficulties. Most patients have had pneumonia. Many have also had gastrointestinal symptoms, including diarrhoea. Some patients have had kidney failure. About half of people infected with nCoV have died. In people with immune deficiencies, the disease may have an atypical presentation. It is important to note that the current understanding of illness caused by this infection is based on only a few cases and may change as we learn more about the virus.

How do people become infected with this virus?

We do not yet know how people become infected with this virus. Investigations are underway to determine the source of the virus, the types of exposure that lead to infection, the mode of transmission, and the clinical pattern and course of disease.

Can the virus be transmitted from person to person?

Yes. We have now seen multiple clusters of cases in which human-to-human transmission is either strongly suspected or confirmed. These have all occurred either in a health care facility or among close family members. However, the mechanism by which transmission occurred in all of these cases, whether respiratory (e.g. coughing, sneezing) or contact (contamination of the environment by the patient), is unknown.

Is there a vaccine for nCoV?

No vaccine is currently available.

Does treatment exist for nCoV?

There is no specific treatment for disease caused by nCoV. Treatment should be based on the patient’s symptoms. Supportive care can be highly effective.

Is there anything a person can do to avoid becoming infected?

Exactly how people become infected with this virus is not known. Since neither the source of the virus nor the mode of transmission is known, it is not possible to give specific advice on prevention of infection. However, prudent measures to prevent respiratory illness are to avoid close contact, when possible, with anyone who shows symptoms of illness (coughing and sneezing), and to maintain good hand hygiene. Other good preventive measures include avoiding uncooked or undercooked meats, unwashed fruits or vegetables, and drinks made without sterilised water. If you become sick while travelling, you should avoid close contact with other people while you are symptomatic and use good respiratory hygiene, such as coughing or sneezing into a sleeve or flexed elbow, medical mask, or tissue, and throwing used tissues into a closed bin immediately after use.

The chances of contracting the virus are small. However, people who meet the following criteria should see a doctor as soon as possible: people with breathing difficulties that are not explained by any other illness or virus who have recently traveled to the Middle East; ill people who are immunocompromised and have recently traveled to the Middle East should be examined promptly by their physician regardless of the type of illness they have.

How many people have been infected by nCoV?

The latest information on cases is found at:

http://www.who.int/csr/disease/coronavirus_infections/en/.

Are health workers at risk from nCoV?

Yes. Transmission has occurred in health care facilities, including spread from patients to health care providers. WHO recommends that health care workers consistently apply appropriate infection prevention and control measures. See

http://www.who.int/csr/disease/coronavirus_infections/prevention_control/en/index.html.

Is nCoV like SARS?

SARS is a coronavirus that was identified in 2003, and is distantly related to nCoV. However, although both viruses are capable of causing severe disease, current information indicates that they have key differences. Most importantly, nCoV does not appear to transmit easily between people whereas the SARS virus was much more transmissible.

Did nCoV originate in bats?

This is one possibility, but the origin of the virus has not yet been established.

Can animals give people nCoV infection?

There is currently no evidence that people have become infected through contact with animals.

How is WHO responding to the emergence of nCoV?

Since the emergence of this virus, WHO has been working under the International Health Regulations to provide information to Member States. WHO is also working with affected countries and international partners to coordinate the global health response, including the provision of updated information on the situation, guidance to health authorities and technical health agencies on interim surveillance recommendations, laboratory testing of cases, infection control, and clinical management, based on the current understanding of nCoV and the disease in humans. WHO will continue to work with Member States and international health partners and share updated information as it becomes available.

What is WHO recommending that countries do?

WHO encourages all Member States to enhance their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns of SARI or pneumonia cases. WHO urges Member States to notify or verify to WHO any probable or confirmed case of infection with nCoV. Current recommendations for surveillance can be found on the WHO website at :

http://www.who.int/csr/disease/coronavirus_infections/en/index.html.

Has WHO recommended any travel or trade restrictions related to this new virus?

No. WHO does not recommend any travel or trade restrictions with respect to nCoV. WHO will continue to review all recommendations as more information becomes available.

See also iNews Cayman story today “Respiratory virus in Middle East warning to Caymanians who travel”