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New Strain of Coronavirus Behind Lung Infections in China
On Dec. 31, 2019, the World Health Organization (WHO) country office in China was informed of 27 patients with pneumonia of unclear cause in Wuhan — a metropolis with 19 million inhabitants in Hubei province.
The municipal health commission reported that many of the infections could be attributed to visits to the fish market, which also sells live animals other than fish. The market hall was then closed until further notice and has been disinfected.
By Jan. 5, 59 patients had been identified. Seven of them are in a critical condition, according to a report by the Robert Koch Institute; no deaths were reported.
In addition, South Korea reported that its first suspected case involved a 36-year-old Chinese woman who visited Wuhan last month, according to authorities. She is being treated in a hospital in Bundang, south of Seoul.
The Good News
Eight patients are currently considered cured and have reportedly left the hospital.
Having identified the virus, experts are one step further in their search for what is triggering the mysterious lung disease.
The pathogen's gene sequence has been deciphered, according to the head of the team of Chinese experts, Xu Jianguo.
He said the cause is a new type of coronavirus found in the blood and saliva of 15 patients. An investigation into what brought about the outbreak will continue.
Gauden Galea, a WHO representative in China, also confirmed the discovery of the new strain of the coronavirus in a statement.
According to the WHO, the quick preliminary identification of the novel virus is a notable achievement and demonstrates China's increased capacity to manage new outbreaks.
Chinese authorities have made a preliminary determination of the cause of #pneumonia in Wuhan as a novel (new)… https://t.co/zG6QTeZSpI— World Health Organization Western Pacific (@World Health Organization Western Pacific)1578553468.0
What are coronaviruses?
Coronaviruses were first found in humans in the 1960s. The name is derived from their appearance under the microscope: The peplomers, the outwardly protruding protein structures of the virus envelope, are arranged in the form of a crown (from Latin: corona).
Coronaviruses are common and infections are often harmless with patients developing only flu-like symptoms, such as fever, cough and shortness of breath. Gastrointestinal complaints, especially diarrhea, can also occur. The incubation time for a coronavirus can vary from a few days to two weeks.
However, coronaviruses are also dangerous and can mutate. They are RNA viruses and have high genetic variability, meaning they can easily overcome barriers between different species. Often, an outbreak among humans originates with other mammals, rodents or birds.
As a consequence, the infections also can take more severe paths, causing respiratory distress and pneumonia, which can even lead to death.
In 2002 and 2003, for example, the aggressive coronavirus SARS-CoV triggered an epidemic. At that time, more than 8,000 people in 29 countries became ill and 774 people died of SARS-CoV. In 2012, the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was discovered and spread across the Arabian Peninsula.
In both cases, experts suspect animals were the source. The first infections were typical zoonoses — cases where pathogens manage to jump from an animal host to a human host.
How is the virus transmitted?
Zoonoses can be transmitted through direct contact between animals and humans as well as — like with many germs — simply through the air, such as by coughing or sneezing.
But there are many other ways of infection, for example through food or vectors. A mosquito, tick or other insect can transport a pathogen from the host to another organism without becoming ill itself.
In addition, zoonoses can also be transmitted via food, for example when eating meat or animal products. If these are not sufficiently heated or if they were prepared under unhygienic conditions, they also represent a source of infection.
Lunar New Year: Be safe
Compared to the major instances of SARS and MERS, the current coronavirus outbreak is small, but experts said it should not be underestimated.
China is, therefore, exercising caution regarding the Chinese Lunar New Year celebrations in late January. Millions of people travel in buses, trains and airplanes to celebrate the holiday.
Wang Yang, the Chinese Transport Ministry's chief engineer, said authorities will step up efforts to prevent the pneumonia outbreak from spreading further during the holiday period, including ensuring proper disinfection in major public transportation hubs like airport and train stations.
Other Asian countries also stepped up precautions on entry, especially for travelers from Wuhan, and introduced fever controls to prevent the feared spread of the virus. To date, there are 16 suspected cases in Hong Kong, and a possible patient has been reported in Singapore. Not in all of the cases have a direct connection to Wuhan.
How to protect yourself?
The U.S. Centers for Disease Control and Prevention (CDC) released a statement warning travelers to Wuhan to avoid animal markets and contact with animals or uncooked meat. People in the area should also avoid the sick and wash their hands frequently with soap and water.
Those who have been to Wuhan and feel ill should seek medical help immediately and avoid contact with others, the report said.
Before the doctor is consulted, the practice or clinic should be informed about the travel history and symptoms.
The WHO did not issue a specific travel warning.
Reposted with permission from Deutsche Welle.
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By Kristen Fischer
It's going to be back-to-school time soon, but will children go into the classrooms?
The American Academy of Pediatrics (AAP) thinks so, but only as long as safety measures are in place.
Keeping Schools Safe<p>What will safer schools look like?</p><p>In a <a href="https://jamanetwork.com/journals/jama/fullarticle/2766822" target="_blank">JAMA article</a> published last month, <a href="https://www.jhsph.edu/faculty/directory/profile/1781/joshua-m-sharfstein" target="_blank">Dr. Joshua Sharfstein</a>, a pediatrician and professor at the Johns Hopkins Bloomberg School of Public Health, outlined suggestions — many of which are similar to AAP's.</p><p>Remote learning protocols must stay in place, especially as some schools stagger home and in-building learning. If another shutdown needs to occur, children will rely on distance learning completely, so it must be easy to switch to, he said.</p><p>He suggested giving parents a daily checklist to document their child's health. Kids should be screened quickly on arrival and be given hygiene supplies. Maintenance staff should use appropriate PPE and have regular cleaning schedules. A notification system should be in place if a case is identified, Sharfstein recommended.</p><p><a href="https://www.albany.edu/rockefeller/faculty/erika-martin" target="_blank">Erika Martin</a>, PhD, an associate professor of public administration and policy at University at Albany, said nutrition assistance and health services should be included. She called for tutoring programs with virtual options as well as technology access.</p>
Supporting Staff<p>Teachers and staff will be affected by safeguarding measures, noted <a href="https://directory.sph.umn.edu/bio/sph-a-z/rachel-widome" target="_blank">Rachel Widome</a>, PhD, an associate professor of epidemiology and community health at University of Minnesota.</p><p>"In order for all of the in-school precautions to work well, we'll be asking a lot of teachers and staff," Widome told Healthline. In addition to their usual workload, they'll now be asked to monitor mask-wearing, ensure children are keeping distance, and be aware of any symptoms.</p><p>Along with Sharfstein, Widome called for an increase in financial support. More employees will likely be required so teachers and staff members can keep up with the added demands.</p>
Should Kids Go Back?<p>While these guidelines may help get some schools to reopen, many people don't think children should go back to school over fears they could contract the disease and spread it to other vulnerable family members like grandparents, infant siblings, or their parents.</p><p>In a <a href="https://pediatrics.aappublications.org/content/early/2020/07/08/peds.2020-004879" target="_blank">Pediatrics</a> commentary, <a href="https://www.md.com/doctor/william-raszka-md" target="_blank">Dr. William V. Raszka, Jr.</a>, an infectious disease specialist at The University of Vermont Medical Center, argued that schools should open because school-aged children are far less important drivers of COVID-19 than adults.</p><p>But he says the risk and benefit is not equal among all students ages 5 to 18.</p><p>"Elementary schools are arguably higher priority for face-to-face schooling, since younger children are at lower risk for infection and transmission, and since parental supervision of younger children's distance learning may be particularly challenging," added Sorensen, who penned a <a href="https://jamanetwork.com/channels/health-forum/fullarticle/2767411" target="_blank">June article in JAMA</a> with reopening tips. "That means middle and high schools are more likely to emphasize distance learning."</p><p>Specific student populations, such as special education students and students with disabilities, would also benefit greatly from more time spent in face-to-face environments, Sorensen said.</p>
What Parents Can Do<p>Parents should ask for and receive frequent updates from schools about plans for the fall. They should also be informed about plans if and when COVID infections are identified, Sharfstein said.</p><p>"I'd like to see parents investing now, during the summer, in doing things that can slow and stop the spread of the virus in their communities," Widome said.</p><p>"Now is a good time for kids to practice wearing masks and get used to them as they may be wearing them for longer stretches if school starts up in person," Widome suggested.</p><p>She recommends parents try different mask designs and materials to see what children are more comfortable wearing.</p><p>"If you are using cloth face coverings, it's good to have extras on hand," Widome added.</p><p>Parents should model healthy behavior at home and while out in public — another thing that could affect how well children adapt to reopening practices, Sorensen said.</p><p>"Children may want to know more about face coverings," added <a href="https://www.linkedin.com/in/leescott/" target="_blank">Lee Scott</a>, chairwoman of the Educational Advisory Board at <a href="https://www.goddardschool.com/" target="_blank">The Goddard School</a>. "Dramatic play, such as creating or wearing a face covering, may help some children adjust to this concept." Schools can also show children photos of what faculty members look like in their masks so the students are familiar with that appearance.</p><p>Johns Hopkins University recently released its eSchool+ Initiative, a slew of resources surrounding education during the pandemic. These include a <a href="https://equityschoolplus.jhu.edu/reopening-checklist/" target="_blank">checklist for administrators</a>, report on <a href="https://equityschoolplus.jhu.edu/ethics-of-reopening/" target="_blank">ethical considerations</a>, and a tracker of <a href="https://equityschoolplus.jhu.edu/reopening-policy-tracker/" target="_blank">state and local reopening plans</a>.</p>
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