Walking Coronavirus Pneumonia Can Spread the Disease

A study was published in the January 24, 2020 edition of Lancet Journal, A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a concerning family cluster study.

Summary of the Study About the Wuhan or 2019 New Coronavirus

Person to person transmission has been ongoing since December 29, 2019.
People can have the 2019 new coronavirus or 2019-nCoV in their lungs and have no symptoms. These people can go about in their normal lives and infect the people surrounding them.
Wearing a mask is critical in preventing coronavirus infection
The attack rate is 83%.

Background on the 2019 New Coronavirus

Wuhan is a big city of 11 million people in central China. It is a transport hub for high-speed railways, ships and has an international airport. Thousands travel in and out of Wuhan every day.

Top_20_flight_routes_from_Wuhan_with_data_on_IDVI_for_each_country — Top 20 Passenger Airline Routes Out of Wuhan

In Wuhan is the Huanan Seafood Wholesale Market is now known to be the source of the 2019-nCoV. It is believed that 2019-nCoV is a new coronavirus. It has a mixture of the genes from the coronaviruses of bats and possibly snakes and humans.

The Story of a Family Infected with the Coronavirus

Travel History

A family of 6 went to Wuhan from Hong Hong between Dec 29, 2019, and Jan 4, 2020. Five out of the six patients became infected with the 2019-nCoV. Not all family members went to the market; this means they got infected by another person.

As they got back to Hong Kong, four of the sick family members contacted another family member who later acquired the infection. That family member did not go to Wuhan. This confirms the person-to-person transmission.

Incubation Period

The five family members who got sick developed the symptoms 3-5 days after the exposure to an infected person. Therefore it seems that the incubation period of 2019-nCoV is 3-5 days. The incubation period is the time from getting acquiring the virus to having the symptoms of the illness.

Symptoms of Coronavirus

The sick members of the family went to hospital 6-10 days after their symptoms started. Their symptoms are fever, cough, weakness, nasal congestion, sneezing, runny nose, chest pains with coughing, and diarrhea. Diarrhea occurred 5- 8 times a day.

Chest X-Ray, CT Scans, and Viral Studies

All of their chest x-rays and CT scans of the chest showed viral pneumonia.

The swab tests to look for the usual causes other than coronavirus (18 viral and 4 bacterial) came back negative.

However, their swab tests were positive for the 2019-nCoV. The test is a real-time polymerase chain reaction or RT-PCR that identified the new coronavirus.

The Asymptomatic Carrier

Two children, ages 10 and 7, visited a sick family member in the hospital. The 10-year-old did not want to wear a mask, and the 7-year-old wore a mask.

The 10-year old who did not wear a mask later developed CT scan findings of viral pneumonia even though he did not have any symptoms. The CT scan was done despite the absence of signs because of the insistence of the nervous parents. The 10-year old tested positive for the coronavirus.

This shows that someone can have no symptoms and still have coronavirus pneumonia and spread it—the asymptomatic carrier.

Walking Coronavirus Pneumonia

Two of the infected adults who later tested for the coronavirus did not have any fever when presented to the hospital.

This means the airports’ thermal cameras to screen for people with the coronavirus will not be 100% effective. That’s because not all have a fever. (My note)

Why is Wearing a Mask Important?

The 7-year old who wore the mask when she visited a relative with coronavirus did not have the coronavirus by CT scan and by virological studies using the RT-PCR. Probably at the time the visit was made, the new coronavirus is not yet identified. That is why the children were allowed to visit.

How are they now?

All six patients were admitted to the hospital under isolation, supportive care and remained stable as of Jan 20, 2020

Lessons to Be Learned

Even with the widespread travel restrictions right now in China, the 2019 coronavirus has spread internationally. Who knows how many have walking pneumonia or asymptomatic carriers are out there?
Wear a mask in public places. You may be next to an asymptomatic carrier with walking pneumonia.
Wash your hands regularly.
The symptoms of a coronavirus infection are non-specific. It can manifest like a regular upper respiratory tract infection, ordinary sore throat, diarrhea, sinusitis, or bacterial pneumonia. There is a risk of misdiagnosis and delayed or wrong treatment. A clinician should be mindful of the possibility of a 2019 new coronavirus infection.

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Don’t Get Sick!

1280px-2019-nCoV_Outbreak_Cases_in_the_United_States.svg — Map of Coronavirus Outbreak in the US. Red Confirmed. Blue suspected. As of Jan 24, 2020

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Reference:

Jasper Fuk-Woo Chan et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster
Lancet. Published:January 24, 2020DOI:https://doi.org/10.1016/S0140-6736(20)30154-9

Image Credits:

Map of Coronavirus Outbreak By Pharexia – https://www.cdc.gov/coronavirus/2019-ncov/index.html, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=86236603
Airline flight out of Wuhan By Donal Bisanzio, Richard Reithinger, and RTI International (www.rti.org) – available online and the author sent it to me, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=86024244

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