This news takes stock of the cases of Covid-19 (name of the disease caused by a new virus called SARS-CoV-2).
The most likely reservoir for SARS-CoV-2 is the bat, but the virus is believed to have crossed the species barrier for humans from another intermediate animal host. This intermediate animal host could be a wild animal or a domestic animal which has not yet been identified.
Analysis of the genome sequence of the new coronavirus by the Wuhan Virus Institute of the Chinese Academy of Sciences also shows that bats of the genus Rhinolophus are most likely to be the natural host for SARS-CoV-2.
The discovery of several lines of coronavirus in pangolin (Manis javanica) and their similarity to SARS-CoV-2 suggests that pangolins are possible intermediate hosts for this new human virus.
International epidemiological situation as of January 22, 2020
- 77,662 confirmed cases of Covid-19, including 76,291 cases in China (98.4%) and 1,371 cases outside of China;
- 2,360 deaths in China, 1 in France, 2 in Hong Kong, 2 in Italy, 1 in Japan, 1 in the Philippines, 2 in Iran, 2 on the cruise ship “Diamond Princess”, 1 in Taiwan and 1 in Korea from South.
In total, the five continents are affected:
- Asia outside mainland China: 532 cases
- Europe: 47 cases
- America: 25 cases
- Oceania: 17 cases
- Africa: 1 case
Other: 634 cases on a cruise ship off Japan.
As of February 22, 12 cases have been confirmed on French national territory
There is no active transmission chain in France. The response strategy implemented at the national level aims to curb the introduction and spread of the virus on the territory. For this, it involves the detection and early management of cases and contact persons.
The epidemiological evolutions noted concerning the emergence of the new coronavirus Covid-19 in China and its extension to other countries led Public Health France to work out a new definition of the cases with the following changes:
- The restriction on lower respiratory infections for people who have traveled or stayed in a hazardous exposure area has been removed;
- The mention of a risk exposure area now refers to a list which will be regularly updated; outside these zones, a reference has been added concerning the possible inclusion of an exposure in certain specific situations;
- The mention of having worked or stayed in a hospital in China has been removed from the list of exposures to be taken into account;
- The definition of close contact has been completed;
- The definition of a confirmed case now includes asymptomatic people.
Possible case
at) Anyone with clinical signs of acute respiratory infection with fever or feeling of fever AND athaving traveled or stayed in a risk exposure zone within 14 days preceding the date of onset of clinical signs:
- The risk exposure zones are the countries where diffuse community transmission of SARS-CoV-2 is described. Today, these countries are the Mainland China, Hong Kong, Macao and Singapore.
- On a case-by-case basis and after consulting Public Health France, a proven or potential exposure to a cluster-type event (chain of transmission of large size), documented outside these risk exposure zones, may also be considered.
Anyone with clinical signs of acute respiratory infection within 14 days of any of the following:
- Close contact * of a confirmed case of COVID-19, while the latter was symptomatic;
- Co-exposed person, defined as having been subjected to the same exposure risks (that is to say a trip or stay in a risk exposure area) as a confirmed case.
* Close contact is a person who shared the same place of life (for example: family, same room) as the confirmed case or had direct contact with him, face to face, within 1 meter of the case and / or for more than 15 minutes, during a cough, sneeze or during a discussion; flirt; close friends; class or office neighbors; neighbors of the case in a prolonged means of transport; person providing care to a confirmed case or laboratory staff handling biological samples from a confirmed case, in the absence of adequate means of protection.
Confirmed case
Anyone, whether symptomatic or not, with a sample confirming infection with SARS-CoV-2.
These definitions are subject to change at any time depending on the information available.
In order to prepare the entire French health system for the epidemic risk of Covid-19, the Ministry of Health has drawn up a methodological guide intended for all health professionals. The purpose of this document is to support actors in the health system in their local approach to prepare for the care of patients classified as suspected, possible or confirmed cases of COVID-19.
Any healthcare professional taking care of a COVID-19 suspected patient is reminded to contact the Samu-Center 15 for analysis, classification and implementation of the first management measures.
In the event of classification difficulties, the Samu-Center 15 can approach the Regional Health Agency (ARS) which will call upon the expertise of Public Health France if necessary.
World Health Organization (WHO) strategic objectives
Limit inter-human transmission, in particular by reducing secondary infections among close contacts and health care workers, prevention of events of amplification of transmission and prevention of spread from China;
- identify, isolate and care for patients early, including providing optimized care for infected patients;
- identify and reduce transmission from animal sources;
- address critical unknowns regarding clinical severity, extent of transmission and infection, treatment and accelerate the development of diagnostics, therapies and vaccines;
- communicate critical information on risks and events to all communities and fight against disinformation;
- minimize the social and economic impact through multi-sector partnerships.
* This can be achieved through a combination of public health measures, such as rapid identification, diagnosis and case management, contact identification and follow-up, infection prevention and control in health care settings , implementation of health measures for travelers, public awareness and risk communication.
Recommendations and advice for the public
In previous epidemics due to other coronaviruses such as Middle East Respiratory Syndrome (MERS) and Acute Respiratory Syndrome (SARS), human-to-human transmission has occurred through droplets or contact with contaminated surfaces, suggesting that the mode of transmission of COVID-19 may be similar. The basic principles to reduce the general risk of transmission of acute respiratory infections are as follows:
- avoid close contact with people suffering from acute respiratory infections;
- frequent hand washing, especially after direct contact with sick people or their environment;
- avoid unprotected contact with farmed or wild animals;
- people with symptoms of acute respiratory infection should take cough measures (stay away from other people, cover coughs and sneezes with tissues or disposable clothes and wash their hands frequently);
- in health facilities, improve standard infection prevention and control practices in hospitals, especially in emergency departments.
WHO does not recommend any specific health measures for travelers.
Sources: Public health France; World Health Organization ; Flu Trackers; promed; Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.
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