Emergencies preparedness, response

Background and summary of novel coronavirus infection – as of 14 March 2013

WHO continues to receive reports of new cases of human infection with novel coronavirus (details of reported cases are given in the Disease Outbreak News updates, posted on WHO’s main novel coronavirus webpage. Also see the Public Health England webpage).

A recent family cluster of cases from the United Kingdom provides the strongest evidence to date of limited human-to-human transmission; however, the mode of transmission is unknown (see the 15 February 2013 Public Health England press release). At least one confirmed case in this cluster was also infected with influenza A virus (see the 15 February 2013 Center for Infectious Disease Research & Policy news).

Interim guidance on clinical management has been posted:

All WHO guidance is being reassessed in light of new information. Updates will be posted as soon as possible.

WHO recognizes that the emergence of a new coronavirus capable of causing severe disease raises concerns because of experience with SARS. Although this novel coronavirus is distantly related to the SARS CoV, the two viruses are different. Based on current information, it does not appear to transmit easily or sustainably between people, unlike the SARS virus.

WHO has closely monitored the situation since detection of the first case and has been working with partners to ensure a high degree of preparedness, should the new virus be found to be sufficiently transmissible to cause community outbreaks. Some viruses are able to cause limited human-to-human transmission under condition of close contact, as occurs in families, but are not so easily transmissible that they are likely to cause larger and sustained community outbreaks.

Actions taken by WHO in coordination with national authorities and technical partners include the following:

  • Investigations are ongoing to determine the likely source of infection and the route of exposure. Close contacts of confirmed cases are being identified and followed up.
  • An interim surveillance recommendation is now undergoing revision to assist clinicians to determine which patients should undergo laboratory testing for the presence of novel coronavirus.
  • WHO has created a laboratory network in all WHO Regions to assist countries with testing. Information and reagents for laboratory assays for the virus that have been developed by laboratory partners are available, including protocols, algorithms and reference laboratory services. WHO has also issued preliminary guidance for laboratory biorisk management.
  • WHO has created a webpage for coronavirus infections, with guidance for surveillance, infection control, biorisk management, and laboratory testing, which can be found at http://www.who.int/csr/disease/coronavirus_infections/en/index.html.

Based on the current situation and available information:

  • WHO requests that all Member States continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.
  • When collecting specimens for testing, priority should be given to collection of lower respiratory tract specimens, which have been shown to be more likely to yield accurate results.
  • In addition, any clusters of SARI or SARI in health care workers should be thoroughly investigated, regardless of where in the world they occur. These investigations will help determine whether the virus is distributed more widely in the human population beyond the four countries that have identified cases.
  • Health care workers should be advised to scrupulously adhere to standard infection control precautions for all patients. Droplet precautions should be added to standard precautions for any patient known or suspected to have an acute respiratory infection, including patients with suspected or confirmed infection with novel coronavirus. Airborne precautions should be used for aerosol-generating procedures, including intubation and related interventions.
  • WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied.
  • Any new cases should be promptly reported both to national health authorities and to WHO, along with information about exposures and clinical course.

WHO continues to monitor this situation closely. Case definitions, surveillance recommendations and other guidance are undergoing continuous reassessment in light of new information and reports of new cases. Revisions will be posted as appropriate.

Coronavirus infections