MELBOURNE, AUSTRALIA / SEOUL – The World Health Organization warned years ago that a mysterious “disease X” could trigger international contagion. The new coronavirus, with its ability to quickly transform from mild to deadly, is emerging as a contender.
From recent reports on the stealthy ways in which the COVID-19 virus spreads and mutates, an image of an enigmatic pathogen emerges whose effects are mainly mild but occasionally – and unpredictably – become fatal in the second week. In less than three months, it infected nearly 78,000 people, mainly in China, and killed over 2,400. The emerging hot spots in South Korea, Iran and Italy have raised further alarm.
“Whether it will be contained or not, this outbreak is rapidly becoming the first real pandemic challenge that fits the category of disease X”, Marion Koopmans, head of viroscience at the Erasmus University Medical Center of Rotterdam and member of the emergency committee of the ‘WHO, wrote Wednesday in Cell magazine.
South Korea and China reported an increase in new cases last Sunday and a diplomatic row erupted after Israel dismissed a South Korean airliner, emphasizing fear and tensions over the rapidly expanding epidemic, which the prime minister South Korean claimed to have entered serious stage. “
Some virus clusters have shown no direct connection to travel to China.
The death toll in Iran has risen to six, the highest out of China.
A dozen cities in northern Italy were effectively blocked while authorities tested hundreds of people who came in contact with around 79 confirmed cases there. Two people died in Italy.
The Korea Centers for Disease Control and Prevention stated that 113 of the 123 new cases came from the fourth largest city, Daegu, and the surrounding areas. More than 300 of the country’s more than 600 patients have confirmed that they have connections to a branch of the local Shincheonji church in Daegu, which has become the largest group of viral infections. Test in progress on thousands of other people.
The disease has now spread to over two dozen countries and territories. Some of the infected ones have caught the virus in their local community and have no known connection to China, said the US Centers for Disease Control and Prevention (CDC).
“We are not yet seeing the spread of the community here in the United States, but it is very probable – even probable – that it will eventually happen,” Nancy Messonnier, director of the CDC’s National Center for Immunizations and Respiratory Diseases, told reporters.
Unlike its cousin, severe acute respiratory syndrome (SARS), the COVID-19 virus replicates at high concentrations in the nose and throat akin to the common cold and appears to be able to spread to those with mild or absent symptoms. This makes it impossible to control using the fever control measures that helped stop SARS 17 years ago.
It is assumed that a group of cases within a family living in Anyang, China, began when a 20-year-old woman brought the virus from Wuhan, the epicenter of the epidemic, on January 10th and spread it without any disease. , researchers said Friday in the Journal of the American Medical Association.
Five relatives subsequently developed fever and respiratory symptoms. COVID-19 is less fatal than SARS, which had a 9.5 percent case fatality rate, but seems more contagious. Both viruses attack the respiratory and gastrointestinal tracts, from which they can potentially spread.
While over 80 percent of patients have a mild version of the disease and will recover, about 1 in 7 develop pneumonia, breathing difficulties and other serious symptoms. About 5% of patients have a critical illness, including respiratory failure, septic shock and multiorgan failure.
“Unlike SARS, COVID-19 infection has a broader spectrum of severity ranging from asymptomatic to mildly symptomatic to severe disease requiring mechanical ventilation,” Singapore doctors said in an article in the same medical journal Thursday. . “The clinical progression of the disease appears similar to SARS: patients developed pneumonia around the end of the first week at the beginning of the second week of the disease.”
The elderly, especially those with chronic conditions such as hypertension and diabetes, have found a higher risk of serious illness.
Li Wenliang, the ophthalmologist who was one of the first to warn about coronavirus in Wuhan, died this month after receiving antibodies, antivirals, antibiotics, oxygen and pumping his blood through an artificial lung.
The doctor, who was healthy before his infection, appeared to have a relatively mild case until his lungs became inflamed, leading to his death two days later, said Linfa Wang, who heads the emerging infectious disease program. at Duke-National University of Singapore medical school.
A similar pattern of inflammation observed among COVID-19 patients has been observed in those who succumbed to the 1918 Spanish flu pandemic, said Gregory Poland at the Mayo Clinic in Rochester, Minnesota.
“Whenever you have an infection, you have a battle going on,” Poland said. “And that battle is a battle between the damage the virus is causing and the damage the body can do when it tries to fight it.”
Doctors studying a 50-year-old man who died in China last month found that COVID-19 gave him mild chills and a dry cough in the beginning, allowing him to continue working. But on his ninth day of illness, he was hospitalized with fatigue and shortness of breath, and was treated with a flurry of treatments to fight germs and the immune system.
He died five days later with lung damage reminiscent of the first SARS and MERS coronavirus outbreaks, doctors said in a February 16 study in the medical journal Lancet. Blood tests showed hyperactivation of a cell type that fights infections that represented part of the “serious immune damage” that it suffered, the authors said.
Conversely, he had been given 80 milligrams twice daily of methylprednisolone, an immunosuppressive corticosteroid that is commonly used in China for severe cases, although it has been linked to a “prolonged viral spread” in previous MERS, SARS and influenza studies. , according to WHO.
He was given at least twice what would generally be recommended for patients with syndrome and other respiratory indications, said Reed Siemieniuk, general internist and health research methodologist at McMaster University in Hamilton, Ontario. Based on MERS observations, the drug may delay viral clearance in COVID-19 patients, he said.