Clinical update

Novel coronavirus: how to spot suspected cases

New government guidance for nurses stresses importance of infection control measures

Transmission electron microscope view of coronavirus Picture: SPL

Essential information

Coronaviruses are a family of viruses that cause illnesses ranging from colds to more severe diseases such as Middle East respiratory syndrome, or MERS, and severe acute respiratory syndrome, known as SARS.

The World Health Organization (WHO) announced a new name - Covid-19 - for the new strain of coronavirus first identified in Wuhan City, China.

Based on the WHO declaration that this is a public health emergency of international concern, the UK chief medical officers have raised the risk to the public from low to moderate. But the risk to individuals remains low.

What’s new?

Guidance for all NHS healthcare staff on how to spot suspected cases of the coronavirus in hospitals and GP practices has been issued by the government in response to the outbreak.

The Department of Health and Social Care and Public Health England have also issued advice stating that people who have travelled from Wuhan and Hubei province in the previous 14 days should stay indoors and avoid contact with other people, as they would with flu, and call NHS 111 to inform them of recent travel to the area.

They also advise anyone who has travelled to the UK from mainland China, Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan, or Thailand in the previous 14 days and is experiencing cough, fever or shortness of breath to stay indoors and call NHS 111, even if symptoms are mild.

More essential clinical updates

Signs and symptoms

Fever, cough, chest tightness and shortness of breath are the main symptoms reported, PHE says. While most cases have involved a mild illness, some severe cases have required intensive care.

Causes and risk factors

Although evidence is still emerging, human-to-human transmission of the virus appears to be occurring, according to PHE. The transmission is likely to be via large respiratory droplets from coughing or sneezing, and direct or indirect contact with respiratory secretions. Other coronaviruses have been detected in blood, faeces and urine.

Standard recommendations to prevent infection spread should be followed, including regular handwashing with soap and water or alcohol rub, covering the mouth and nose when coughing and sneezing, and thoroughly cooking meat and eggs, according to the WHO. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.

How you can help your patient

  • Consider Covid-19 in patients who have been to China, Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan, or Thailand in the previous 14 days, or have been in contact with someone with the virus, and have any signs of acute respiratory infection
  • For suspected cases, isolate the patient in a single occupancy room, preferably a respiratory isolation room and ideally under negative pressure; positive pressure rooms must not be used
  • Wear personal protective equipment – as a minimum, this should be a correctly fitted FFP3 respirator, gown, gloves and eye protection
  • Ask the patient to wear a surgical face mask while transporting them to the isolation room
  • In primary care, stop a consultation as soon as the virus is considered a possibility, and isolate the patient in a room away from staff and patients with the door closed. Any further discussions and history taking should take place by phone
  • Report potential cases to the local PHE health protection team

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