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Reducing the spread of the Wuhan coronavirus

23 Jan 2020 / 19:39 H.

THE Wuhan coronavirus outbreak has worried most of us. The Chinese New Year period is one where there’s a mass movement of people in many countries. In Malaysia, many of us use the holidays to travel. The outbreak is expected to grow significantly during this period.

Some commonly asked questions might help us reduce transmission.

Has this coronavirus spread to Malaysia?

It is not “if” but “when” the virus will reach Malaysia, if it is not already here. The high volume of travel between countries in the region makes such viruses easy to spread. The Wuhan coronavirus has spread to various parts of China (571 confirmed cases from 25 provinces and municipalities), with four cases reported in Thailand, Japan (one), Macau (one), South Korea (one), Taiwan (one), and the United States (one). It is estimated that the actual number infected is 10 times as many as reported.

Will screening visitors from China prevent its spread?

Fever scanners at entry points are useful but have limited value. There may be a five- to seven-day gap between exposure to the virus and infection symptoms. Infected individuals may be asymptomatic (show no signs of the infection as yet) or only be mildly ill and not show a fever (or fever may be suppressed by medication). Of course, any person with an acute respiratory infection or pneumonia returning from China should be notified to the medical authorities and be isolated.

How severe is the virus infection?

So far, 17 people are known to have died from it. We do not know what percentage of individuals infected will have a severe infection. The virus infection may be mild, cause a pneumonia, or it could be life-threatening. From available information, 15-20% of those hospitalised require oxygen or ventilation. The virus appears to start with a fever and then a cough develops. The person may then develop a shortness of breath due to a lung infection.

How can we help reduce its spread?

It is important to act responsibly.

First, limit the spread of infection when you cough or sneeze. There is no way, when you cough or sneeze suddenly, that you can reach a tissue or handkerchief in time. So it is important to learn how to cough or sneeze into a flexed elbow or sleeve. If you have time to use a tissue that is also OK. Do not cough or sneeze into your hands or openly.

Second, if you are unwell with an acute respiratory infection wear a mask. Although there is doubt if the common masks can keep out airborne viruses, but there is some evidence to suggest that masks can help reduce transmissions. The three-ply surgical masks or cloth masks are no longer effective once they are wet. They have to be changed frequently (at least hourly) and be worn correctly. Remember to dispose of them safely in a closed bin. So it is best if you are unwell to avoid other people, stay in your room and use a mask when you have to meet others. It would be the responsible thing not to travel if you are unwell, especially not in a closed environment like an aeroplane, bus or train. If one person becomes unwell others should not sleep with them; there may be an exception for young children.

Third, if you have just returned from China and have an acute respiratory infection or pneumonia you should immediately notify the medical authorities.

Fourth, consider carrying some spare masks and offer them to individuals who cough or sneeze. We need to help others learn to be responsible.

Fifth, avoid contact with people coughing and sneezing.

Sixth, wash your hands with soap and water or an alcohol-based rub after coughing or sneezing or if you have come in contact with an ill person. Keep an alcohol-based rub handy with you when you travel. You may want to use it to clean your hands after touching door knobs, public tables, etc. Remember to try and limit touching your face.

We do not know how worried we should be about this new virus. There is no definitive treatment for the Wuhan coronavirus and no vaccine developed as yet. The way we can contain this virus is to identify and isolate infected persons quickly, limit contact with infected individuals, reduce our travelling and have no unnecessary mass gatherings.

Datuk Dr Amar-Singh HSS

Senior Consultant Paediatrician

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