SARS-Like Virus Can Probably Transmit Between People, UK

Editor's Choice
Main Category: Flu / Cold / SARS
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 13 Feb 2013 - 12:00 PDT


The Health Protection Agency, UK, believes it has compelling evidence that a new SARS-like coronavirus can spread from human-to-human.

A newly confirmed case of a person with coronavirus infection indicates that it occurred as a result of person-to-person transmission - the patient has no history of recent travel anywhere and no short- or long-term history of travel to the Middle East, the Health Protection Agency (HPA) announced today.

This latest case, involving a UK resident, brings the total number of confirmed coronavirus infection cases worldwide to 11 - three of them in the United Kingdom. Patient number 11 is currently receiving intensive care treatment at The Queen Elizabeth Hospital, Birmingham.

Hospital officials informed that the patient has an existing medical condition which could increase susceptibility to respiratory infections.

Head of the respiratory diseases department at the HPA, Professor John Watson, said:

"Confirmed novel coronavirus infection in a person without travel history to the Middle East suggests that person-to-person transmission has occurred, and that it occurred in the UK. This case is a family member who was in close personal contact with the earlier case and who may have been at greater risk of acquiring an infection because of their underlying health condition."

So far, evidence showing that the coronavirus is human transmissible has been scarce. This latest case, however, provides strong evidence of this. Even so, Prof. Watson emphasized that the risk of infection is still considered to be very low in most circumstances.

There have been very few infections, a highly human-transmissible novel coronavirus would have infected many more people than just 11 globally (including the 3 in the UK) over the last three months, the HPA wrote in a communiqué today.

This new development, however - evidence of probable human-to-human transmission in a person with no recent travel history - justifies the measures that have been put into place straight away to help stem the spread of infection and to track down and follow up contacts of known cases.

Professor Watson said: "We will continue to provide advice and support to healthcare workers looking after the patients and to contacts of both cases. In light of this latest case we would like to emphasise that the risk associated with novel coronavirus to the general UK population remains very low. The HPA will continue to work closely with national and international health authorities and will share any further advice with health professionals and the public if and when more information becomes available."

Last week, the HPA confirmed that another patient who is currently hospitalized in a Manchester hospital with SARS-like symptoms and receiving intensive care has coronavirus infection. This was the second UK case (or the 10th case worldwide). The patient had recently returned from the Middle East and Pakistan.

Below is a list of where the eleven confirmed laboratory cases of SARS-like coronavirus infections occurred:

• Saudi Arabia - 5. Three died.
• Jordan - 2. Both died.
• UK - 3. One Qatari and two British citizens. One of the Brits has no history of travel to the Middle East and no recent travel history at all. They are all being treated.
• Germany - 1. The patient, a Qatari, made a full recovery and is no longer in hospital.

The Health Protection Agency says it has a wide range of laboratory tests, developed by the HPA, that can identify coronavirus infection. They are available for patients whose severe respiratory infection has an unexplainable cause. According to Professor Maria Zambon, Director of Reference Biology Services, HPA, these tests are currently available for use at some of the Agency's frontline laboratories.

The full genome sequence of a coronavirus from the first UK patient was published in November 2012. The HPA says this will help scientists around the world gain a deeper understanding of the diversity of this virus, determine its origin, and to develop strategies for treatment and prevention, Prof. Zambon added.

What are coronaviruses?

First identified in the mid-1960s, human coronaviruses are thus called because of their crown-like projections on their surfaces. "Corona" is Latin for "crown" or "halo". Coronaviruses are a group of viruses that cause respiratory infections in animals and humans.



Coronaviruses viewed under an electron microscope. You can see their crown- halo-like (corona) appearance.

Primarily, coronaviruses infect the upper respiratory and gastrointestinal tract of birds and mammals. Scientists know of four to five coronavirus strains that infect humans. The strain that has been most covered by the media during the last decade is the SARS-Cov, which causes SARS. SARS-Cov is unique in that it causes infections in both the upper and lower respiratory tract; it can also cause gastroenteritis.

Experts say that coronaviruses cause many of the common colds in human adults, mainly during the winter and early spring seasons. Unlike rhinoviruses, another common cold virus, human coronaviruses cannot be grown in the laboratory easily, making it hard to know what impact they have on public health and national economies.

According to the HPA, the Coronavirus "IBV (Infectious Bronchitis virus), which infects chickens, targets the uro-genital tract as well as the respiratory tract. It can spread to various organs in the chicken's body".

Some coronaviruses can cause serious damage to the farming livestock industry, while others can infect cats, dogs, mice and some other mammals.

What is SARS?

SARS (Severe Acute Respiratory Syndrome) is a highly contagious and life-threatening form of pneumonia (lung infection). The World Health Organization says the new coronavirus is not easily human-transmissible. The novel coronavirus, the one that has infected 11 people during the last three months, is a SARS-like virus but is not SARS, WHO (World Health Organization) and the HPA emphasized.

The SARS Coronavirus (SARS CoV) causes SARS.

The 2002/2003 SARS Pandemic

In 2002, in the Guangdong province in southern China, a case of SARS was confirmed. The infection spread rapidly and became a pandemic which led to more than 8,000 cases and 774 deaths - that is a death rate of nearly 10%. Scientists say that a coronavirus strain which only affected small mammals mutated and started to infect humans.

The SARS infection spread incredibly fast, catching many public health authorities in the Far East and some other parts of the world by surprise. It spread rapidly among humans in China, and then to other neighboring countries. Many confirmed cases were reported in Toronto, Canada, and four in the United Kingdom.

According to WHO, thanks to close liaison between public authorities in various countries, the SARS pandemic was brought under control in July 2003. During that year, all air passengers travelling out of affected countries were screened.

The SARS pandemic killed approximately 10% of all infected people, and half of elderly patients (aged 65+ years).

A small SARS outbreak occurred in China a year later. According to WHO, it was caused by human contact with a laboratory virus sample, and not as a result of human-to-human or animal-to-human transmission.

What are the signs and symptoms of SARS?

• Cough
• Sore throat
• Extreme fatigue (tiredness)
• Diarrhea
• Headaches
• Fever - above 38 °C (100.4 °F). According to WHO, this is the only symptom that is common to all patients with SARS
• Lethargy
• Loss of appetite
• Myalgia - pain in the muscles
• Chills
• Shortness of breath - in the later stage
• During the first stage symptoms resemble a cold, and in later stages are more like the flu

During the second stage of SARS, usually within three to seven days after initial symptoms, the infection spreads to the airways and lungs, and the patient develops a dry cough, breathing problems and a gradual fall in blood-oxygen levels, which can become life-threatening.

Novel coronavirus 2012 - Questions and answers

Below are some of the questions people have been sending to the HPA, and their answers regarding the novel (new) coronavirus 2012:

• Why type of coronavirus is this novel one? - this new coronavirus strain was first identified in 2012 in the Netherlands. The virus identified by the HPA's Colindale labs is genetically very similar to the strain identified by Dutch scientists. UK scientists say its nearest relatives are bat coronaviruses. Only a few cases have been reported, so it is not yet possible to assess its clinical impact, transmission and severity.


• What are the main symptoms when people are infected with this novel coronavirus? - Acute, serious respiratory illness, patients have presented with shortness of breath, breathing difficulties, cough and fever. It is not possible yet to determine whether these are typical signs and symptoms or whether the novel virus is circulating more widely and causing milder illness.


• What are the treatment options? - Apart from advising acute respiratory support for those with severe symptoms, there are not enough data at the moment to make specific treatment recommendations.


• How do people become infected? - Coronaviruses spread like colds, influenza and other respiratory infections. It is an airborne virus that spreads in small droplets of water that people sneeze or cough into the air. When people inhale these droplets they may become infected. Coronaviruses may also spread by touching surfaces than an infected person had previously touched. Good hand hygiene is important in stemming the spread of infection.


• How infectious is this novel coronavirus? - According to current data, transmission appears to be very limited. However, with only 11 confirmed cases it is impossible to be sure. If it were highly infectious there would probably have been more cases by now.


• Where does the novel coronavirus come from? - Experts are not sure yet. According to phylogenetic analysis, its closest relatives are bat coronaviruses. "New infections may occur as a result of a mutation (change) to an existing virus changing the way it is transmitted or the illness it causes."


• Is there a coronavirus vaccine? - No.


• Is there a lab test? - a PCR test followed by a more specific confirmatory test. Several laboratories in the UK are equipped to screen test for this virus.


• I plan to travel to the Middle East. Is there anything special I should do? - As there have been very few cases of novel coronavirus infection, those planning to make a trip to the Middle East should go ahead as planned. "Travel advice will be kept under review if additional cases occur or when the patterns of transmission become clearer."


• I recently travelled to the Middle East and have signs of a cold. What should I do? - If your symptoms are mild, it is probably a common cold. However, if you develop a fever, become breathless or develop breathing difficulties you should contact your doctor immediately. Tell your doctor about your recent trips. Even with these more serious symptoms, it is highly unlikely the infection is caused by the novel coronavirus.


• Is the novel coronavirus similar to SARS? - This is not SARS, even though SARS is caused by a coronavirus. They are similar in that the novel coronavirus, being a coronavirus strain, can cause flu-like symptoms, and SARS being a type of coronavirus as well, also has flu-like symptoms.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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