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Could that cough be the coronavirus infection?

Q: My child has a fever and a cough. Could she have the coronavirus I’ve been hearing so much about?

A: Unless, within the last 14 days, she has traveled to China or had close contact with someone who is known to have the new coronavirus infection, then no, she could not have it. It is much more likely that she has a common circulating respiratory viral infection or the flu.

The coronavirus that has been garnering so much attention is named the 2019 novel (new) Coronavirus (2019-nCoV), which was first detected in Wuhan, China. The 2019-nCoV is a newly identified strain of the coronavirus family, so-named because it has the appearance of wearing a crown when viewed under a powerful microscope.

Members of the coronavirus family commonly infect animals such as bats, camels, cattle, and cats, and rarely evolve to infect humans. It is even rarer for them to spread from human-to-human and it is not yet known how this virus evolved to infect humans.

Two other well-known coronavirus infections that caused severe infections in humans are the Severe Acute Respiratory Syndrome (SARS) from 2003, and the Middle East Respiratory Syndrome (MERS) from 2012.

SARS was believed to spread to humans from civet cats in Asia, and there have been no infections since 2004.

MERS also likely has an animal source, possibly dromedary camels, and originated near the Arabian Peninsula.

While there are still some ongoing MERS infections in Saudi Arabia, this is no longer considered to be an outbreak situation.

The 2019-nCoV is believed to have first spread to humans from exposure in a large live animal and seafood market in China. While the numbers are changing daily, as of Feb. 9, there were over 40,100 known cases of the 2019-n-CoV and over 900 deaths. In the U.S., there have been only 12 documented cases in five states, most of these in individuals who traveled to Wuhan, China, or their close contacts.

The virus is spread through contact with respiratory droplets formed when an infected individual coughs or sneezes, usually within a six-foot radius. The virus may be able to survive on surfaces for a few hours, but this is not entirely clear yet.

It is not possible to contract the virus through mail or packages shipped from China.

Individuals are most contagious when they are experiencing severe symptoms but it is possible to have asymptomatic spread. The incubation period is believed to be approximately 5 to 14 days.

The most common symptoms are fever, cough, and shortness of breath, but the infection can progress to pneumonia, sepsis, organ failure, and death.

Individuals who are more severely affected are usually older and have chronic medical issues such as asthma, diabetes, or heart disease.

Due to concern of more infected individuals coming into the U.S., on Jan. 31, the White House implemented travel restrictions suspending entry of foreign nationals for 14 days after visiting China.

Additionally, the CDC is evaluating passengers on certain international flights from China arriving in the U.S. to evaluate the passengers for possible infection or carriage of the virus. For the most up-to-date information, visit the cdc.gov website.

While the 2019-n-CoV outbreak is concerning, it is not nearly as devastating as hospitalizations and deaths from annual influenza infections. Each year, influenza infects about 19 million people (5 to 20% of the U.S. population), leads to 180,000 flu-related hospitalizations, and causes approximately 10,000 deaths.

In New Mexico, there have been 52 adult deaths and 1 pediatric death due to the flu and flu-related illnesses as of January 2020. Influenza is spreading in all regions of our state and has not yet peaked. Additionally, there is more than one strain of influenza circulating.

The best protections from flu (and coronavirus) are: good hand washing for 20 seconds (or hand sanitizer that is at least 60% alcohol, if unable to access soap and water); avoidance of touching your face, eyes, nose, and mouth with dirty hands; staying home if you are sick; wearing a mask if you are experiencing coughing or sneezing; covering your mouth and nose with a tissue when coughing or sneezing and immediately disposing of the tissue (clean hands afterward); and wiping down commonly-touched surfaces.

There is no vaccine to prevent coronavirus infection, and no treatment, only supportive care measures.

Check in with your child’s health care provider for any concerning symptoms, and remember, it’s not too late to get your flu shot!

Melissa Mason is a general pediatrician with Journey Pediatrics in Albuquerque. Please send your questions to her at melissaemason@gmail.com.

 

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