#14,764
It is inevitable that as more novel coronavirus cases are examined and their close contacts are tested, we are going to learn more about this emerging pathogen, its carriage by human hosts, and its virulence.
Yesterday, Japan repatriated a plane load of Japanese nationals from the epicenter of China's epidemic (se Japan MOH: Status Of 206 Evacuees From Wuhan - 5 Hospitalized), and this morning we have the first test results indicating at least one symptomatic returnee, and while two others were asymptomatic but PCR positive.We've seen a fair number of asymptomatic PCR positive MERS-CoV patients over the past 8 years and serological studies found a relatively small number of asymptomatic SARS infection in HCWS, and so these findings are not wholly unexpected.
In recent days we've also seen reports of what appears to have been the asymptomatic carriage, and transmission, of the nCoV2019 virus to 4 other people in Germany (see Germany : Bavarian MOH Confirms 3 More Positive Coronavirus Cases), along with some anecdotal reports from China.
The prevalence of asymptomatic carriage of nCoV2019 is unknown, nor how often or efficiently it might be transmitted to others. But this is something public health officials are going to watch carefully and - if necessary - make adjustments for.First the (translated) MOH report from Japan, then I'll return with a postscript:
Development of patients associated with the new coronavirus (9th case) and asymptomatic pathogen holders
With asymptomatic pathogen holders, there are no symptoms, but PCR tests were positive.
Today (January 30) around 8:00 a.m., the National Institute of Infectious Diseases reported three cases of infectious diseases related to the new coronavirus. One case is a patient, and two are asymptomatic pathogen holders.
These people were Japanese who returned to Japan yesterday on a charter flight from Wuhan City, and a new coronavirus was detected as a result of PCR tests conducted at the National Center for International Medical Research.
One patient had symptoms such as fever, and it was the ninth case in Japan that the incidence of infectious diseases associated with the new coronavirus was confirmed in Japan. We will ensure that we conduct proactive epidemiological surveys on this matter, including the understanding of the person scrutiny of the person in contact with the high-level contact.
This is the first case in which two other cases have been identified as asymptomatic pathogen holders. We will also ensure that we conduct proactive epidemiological surveys, including the understanding of people with strong contacts.
A press conference on this matter will be held from 10:30 a.m.
With asymptomatic pathogen holders, there are no symptoms, but PCR tests were positive.
Overview
9th patient
(1) Age: 50s
2 Gender: Male
3 Residence: People's Republic of China (Wuhan, Hubei Province)
4 symptoms, progress: Returned at about 8:30 on January 29.
At the time of arrival at the medical institution, nasal discharge and sore throat were observed, and after a detailed examination, it rose to 37.9 degrees Celsius after hospitalization, rising to 38.7 degrees Celsius at 21: 23:00 Test positive
5 Behavioral history: Currently being confirmed
The first case of asymptomatic pathogen holders
(1) Age: 40s
2 Gender: Male
3 Residential areas: Under investigation
4 symptoms, progress: Returned at about 8:30 on January 29. There are no symptoms, and it is positive in the test just in case.
5 Behavioral history: Currently being confirmed
The second case of asymptomatic pathogen holders
(1) Age: 50s
2 Gender: Female
3 Residential areas: Under investigation
4 symptoms, progress: Return d at about 8:30 on January 29. There are no symptoms, and it is positive in the test just in case.
5 Behavioral history: Currently being confirmed
Message to the people of Japan
New coronavirus infection has been recognized in Japan from human to human current, but at this time it is not a situation where epidemics are widely recognized. We ask that the public do not worry too much and try to take measures against basic infectious diseases such as cough etiquette and hand washing as well as seasonal influenza.
If you are returning to or entered the country from Wuhan City or have come into contact with such persons, please wear a mask, etc., and contact the medical institution in advance, and ask for your cooperation so that you can see a doctor. In addition, please inform us in advance that you have stayed in Wuhan City or have been in contact with a person who has lived in Wuhan City.
(Others)
We will continue to strive to provide information promptly and accurately, so we ask for your cooperation in providing accurate information to the public. Please refrain from on-site coverage from the viewpoint of protecting the privacy of patients.
(Reference) What is Coronavirus?
It is a virus that causes widespread infection among people and animals. There have been six known types of infections in humans, but except for SARS-CoV (Severe Acute Respiratory Syndrome Coronavirus) and MERS-CoV (Middle East Respiratory Syndrome Coronavirus), which can cause serious respiratory diseases, infection softens not severe symptoms such as normal colds. For more information, please refer to the information page of the National Institute of Infectious Diseases.While this emerging virus in China is not MERS-CoV or SARS, our past experience with these two coronaviruses provides a foundation from which to work. And over the past few years we've seen a number of studies illustrating how difficult it can be to identify cases, even when you have a diagnostic test.
Coronavirus infecting human sprees at the National Institute of Infectious Diseases
https://www.niid.go.jp/niid/ja/from-idsc/2482-2020-01-10-06-50-40/9303-coronavirus.html
J. Korean Med Sci: Atypical Presentation Of A MERS Case In A Returning Traveler From Kuwait
mBio: High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia
AJIC: Intermittent Positive Testing For MERS-CoV
JIDC: Atypical Presentation Of MERS-CoV In A Lebanese Patient
Evaluation of a Visual Triage for the Screening of MERS-CoV Patients
The upshot here is, that nothing is clear-cut, or easy, when trying to subdue an emerging epidemic, and that we need to be prepared for surprises along the way.
