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Travel Advice: Coronavirus

27 Jan 2020

2019-nCoV has caused much concern, with more than 81,000 people infected and 2,762 deaths recorded so far.

Dr RICHARD DAWOOD, travel specialist and MEDICAL DIRECTOR of Fleet Street Clinic answers your questions about coronavirus.

“It is difficult to predict at the moment how the new coronavirus is going to spread, and its impact on international travel.

Coronaviruses make up a large family of viruses that include some that cause the common cold. Cold viruses target the upper respiratory tract and generally cause only a mild illness. However, in recent years, two previous coronaviruses have emerged that cause more serious illness. SARS and MERS viruses. This new coronavirus targets the lower respiratory tract, causing a lung infection (viral pneumonia). The illness seems to have a much lower fatality rate than SARS or MERS – possibly around 2%.

In order to know how easily a disease might spread globally, there are a few technical things we need to know. With a totally new disease,  nobody will be immune, and the entire population is potentially susceptible. Each bug has a special characteristic called its “reproductive number”, or R0 (R nought” for short. This is the average number of people each infected case actually passes the infection on to, during the time that they are infective. British scientists have concluded that on average every individual infected by the coronavirus is passing it on to two or three others. At such a rate, it will be necessary to prevent 60 per cent of cases to bring the outbreak under control.

We do know that many cases are occurring in Wuhan, but so far all of the cases that have been identified in countries outside China are in people who acquired it there. We already know much about the new coronavirus, including its genetic sequence. Simple infection control measures and isolation of cases hold the key to preventing this from turning into a pandemic.

For now, the best approach is to keep track of advice issued by the WHO, CDC, Public Health England, and other public health authorities coordinating the global response.”

 

What is the coronavirus?


Coronaviruses are a large group of viruses that includes some of the viruses responsible for the common cold. Mostly, these viruses attack the upper respiratory tract, causing the symptoms we are all familiar with, of the common cold. In recent years, there have been outbreaks of two viruses that have resulted from human contact with animals. The first of these was the virus causing SARS, which spread from members of the cat family in China from 2002 to 2003. The second was the virus causing MERS that spread from camels in the Middle East in 2008.
This new coronavirus variant has originated from Wuhan province in central China. The outbreak has centred on a large food market in which live animals were in close contact with large numbers of people.

What are the symptoms and what can potentially happen if you contract it?


The characteristic features of infection with this new virus are fever and infection of the lower respiratory tract – viral pneumonia. A person suffering from the infection will have a high temperature and a cough, perhaps with shortness of breath. Quite a large proportion of the people with infection have ended up with serious pneumonia requiring hospital treatment. So far the mortality rates from this infection are much less than with SARS or MERS. The full picture hasn’t yet emerged, but the mortality rate seems to be around 2%, with mostly elderly people among the victims.

How does it spread?


In general, coronaviruses are spread by airborne droplets that are exhaled or coughed out by people suffering from the infection, that are either inhaled by a susceptible person, or that can contaminate hard surfaces and can then be spread by poor hand hygiene. We may yet discover that there are other factors at play in this outbreak.
Since the new coronavirus causes viral pneumonia, affecting tissues deep in the lungs, it has been speculated that it may be less easily transmissible than coronaviruses that cause upper respiratory tract infection, a cold-like infection. This has yet to be confirmed.

Is there a danger it will come to the UK?


Travel takes place on a massive scale, both nationally within China and internationally. Therefore, it is inevitable that cases may arrive in the UK involving people who have travelled from Wuhan. So far, onward spread by arriving travellers has either not been observed or is happening only on an incredibly small scale. It is possible therefore that prompt medical attention and isolation of people reporting symptoms may help contain and control the spread of infection.

What areas of China have been affected?


The centre of the outbreak is Wuhan, in central China. Until now direct flights from Wuhan to the UK have been fairly limited, with only three flights per week. However, the Chinese authorities have now imposed an internal travel ban on flights leaving Wuhan as well as transportation by other means. There has been spread from Wuhan to major cities such as Beijing and Shanghai, and also to Hong Kong and Macau, but the numbers of cases so far have been very small.

Should travellers still go to China? If they do go, what should they keep in mind?


The Foreign & Commonwealth Office is currently advising against all travel to Hubei Province which includes Wuhan city. On 23 January the Wuhan authorities closed all transport hubs including airports, railway and bus stations. Travel restrictions are in place in other cities in Hubei Province. So far no advice has been issued about travel elsewhere in China. China is a huge country and it is very difficult to generalise about risk at this stage. The best advice is to keep plans as flexible as possible. Be aware of updates and changes in advice published by the Foreign and Commonwealth office on its website. Also the official source of health information for international travel from Public Health England, which can be found on the travelhealthpro website.

Travellers to China should be vaccinated against flu in order to reduce the risk of developing an illness that would be easily confused with coronavirus infection. (Flu vaccination does not protect against coronavirus, but flu is currently a much more common and likely problem!) Other sensible precautions include careful attention to hand hygiene with frequent washing and use of hand sanitisers; and “social distancing” – staying at least a metre away from anyone exhibiting cough or cold symptoms. In general, face masks are only limited value. There’s no point wearing them outdoors. If worn at all, care must always be taken when handling them after use, so as to avoid contaminating oneself.

 

At this stage, World Health Organisation officials have not classed the virus as an ­“international emergency”. This is partly because of the low number of overseas cases. It is therefore wise to keep monitoring the situation and following the advice from Public Health England, CDC & WHO.

 

All information stated is correct at time of posting.


For more advice on Coronavirus…

Phone: Get in touch: fleetstreetclinic.com Fleet Street Clinic Travel Specialists Travel Clinic in London

0207 353 5678 ^

^ Lines are open 9:00-17:30, Monday-Friday.

 

 

 

 

 

 

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