Corona Virus - An Emerging Epidemic
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What is 2019 Novel Corona virus?

As the world has been involved in modern medical technologies and developments, it is relentlessly getting encountered with new species as a threat to the human race. Recently, there have been incidences of new viral epidemics occurring among the human population which are going undiagnosed and undetected. General physicians, pulmonologists, internal medicine specialists, respiratory therapists and general dentists are being challenged by such communicable viral diseases which are constantly occurring as global health emergencies. Learn about 2019 Novel Coronavirus.

What are the symptoms and complications that Novel Coronavirus 2019 can cause?

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What is the source of 2019 Novel Coronavirus?

Recently, researchers have found a virus which is of a bat origin that is implicating to cause respiratory syndromes of unknown origin. This virus typically binds to hCD26 human binding sites and initiates the viral entry into the human tissue. These viruses are known as Corona Viruses (CoVs).

CoVs are generally large enveloped RNA viruses composed of structural protein and a positive stranded genome (approximately 30kb) that infect mammals, birds, camels and humans. Right now, six CoVs have been identified that infect the human species.

Is 2019-nCoV the same as the MERS-CoV or SARS virus?

No. Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. The recently emerged 2019-nCoV is not the same as the coronavirus that causes Middle East Respiratory Syndrome (MERS) or the coronavirus that causes Severe Acute Respiratory Syndrome (SARS) in 2003. There are ongoing investigations to learn more. This is a rapidly evolving situation and information will be updated as it becomes available.

Has anyone in India gotten infected?

Chandigarh: In the first suspected case of coronavirus infection in the tricity, a 28-year-old banker from Mohali has been quarantined at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh.

The patient with symptoms of coronavirus infection reported at the emergency unit of the institute on Monday morning. He had returned from China recently, and has a history of travelling to the neighbouring country in the past too, said doctors.

In India, at least a dozen people, including two Bengaluru residents, a Chinese national in Kolkata, a 19-year old MBBS student in Jaipur, a 36-year-old Mumbai resident, and a 29-year-old woman research scholar in Patna, have been kept under medical observation

Read more.

This virus shows current incidence in the year 2020 January affecting large number of Chinese population including migrants. The population that suffers from this viral disease leaves medical doctors and other health professionals in perplexed by its unknown disguised clinical symptoms and appearance.

Researchers predict the transmission of CoVs occurs mainly from birds (bats) and cats globally and camels especially in the Middle Eastern countries. Communicable transfer of this disease from human to human does not occur that frequently but it may occur among migrants, frequent travellers returning to their home countries post visiting the affected places.

Dentists are one among the health professionals who encounter themselves more frequently to this kind of life threatening unknown medical emergencies. Care must be taken to record history of frequent travel, social history, family history and any medical history related to respiratory system for all the patients who visit dental clinics. Dentists must understand all the patients who visit them may not be clean or disease free. Many patients may have undiagnosed, untreated medical conditions apart from medical health issues like hypertension and diabetes which may go unnoticed by the patients themselves.

As a health professional we are very well aware of the fact that most of the viral infections have symptomatic treatment but not absolute cure. This is because of the variations and multiplications among the same viruses into multiple non identical vectors which may have similar genomic background but shows non identical virulence when they infect the human host. That is the reason we have many strains of H1N1, influenza and other viruses in the human body and these viruses target mainly the pulmonary tract and affecting the entire respiratory system thus masking the treatment to a preventive form rather than a complete cure.

What are the treatments?

The best available treatment rather management of this new epidemic of corona virus after cell culture will include interferons, ribavirin, cyclosporin A, mycophenolic acid, chloroquine and lopinavir. Other clinical benefits with the use of monoclonal and polyclonal neutralizing antibodies also help at the earliest stage of the disease by preventing its long- term complications.

What should I do if I had close contact with someone who has 2019-nCoV?

Prevention of any contact or communicable disease needs to follow strict norms of infection control. Clinics and hospitals are the main source of cross infection among health professionals including medical, dental professionals, paramedical, dental staff and housekeeping. Dentists must adhere to the recommendations by Centres of Disease Control (CDC) for infection control that includes standard, contact and airborne precautions.

What should dentists and healthcare providers do?

  • We must always follow to use mouth mask and sterile gloves for every patient.
  • Personal protective devices like head cap, mouth mask, eyewear face shields and contact preventative measures should be added in a dental clinic
  • Wear a clean sterile gown over the apron when he is expected high volume spill during any dental treatment.
  • Dental clinics should have adequate ventilation with a minimum of 6-12 air exchanges per hour.
  • Proper hand washing technique and hygiene instructions should be followed before and after the contact with patient.
  • Both para dental staff and housekeeping should be informed about these kind of emergency viral epidemics and asked to follow strict barrier techniques without admitting themselves to these emergencies.

Am I at risk for novel coronavirus from a package or products shipping from China?

Currently there is no evidence to support transmission of 2019-nCoV associated with imported goods and there have not been any cases of 2019-nCoV in associated with imported goods. Information will be provided on the 2019 Novel Coronavirus website as it becomes available.

Conclusion

Corona virus respiratory syndrome is an alarming a disease with a high mortality rate which is presently showing its occurrence among the Chinese population. In the past, it was popularly recognised as Middle East Respiratory Syndrome Corona Virus affecting mainly the population of Middle Eastern countries. Although, following strict precautions of infection control, sterilisation, crusading camels and bats, still this viral disease has its own existence and possesses a great threat to human life.

As health professionals the only way of survival from this viral disease is to bring awareness among the general population and health staff. Allowing a health professional to arrive at a quick diagnosis and perform isolation of this virus by doing chair side investigations, thereby preventing the spread of this deadly disease.

Dr Syed Ahmed Raheel
BDS, MDS. Reader and Incharge, HOD, Department of Oral Medicine. KGF college of dental sciences

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