Ho Chi Minh City - The incubation period of the coronavirus 2019-nCoV is apparently shorter than previously assumed. Medical professionals report in the New England Journal of Medicine (2020; doi:) about patient who fell ill within 3 days of contact with his father. In addition, there is increasing evidence that symptom-free patients can already be contagious during the incubation period, which is why the Robert Koch Institute () now wants to adjust its recommendations.
Doctors at the Cho-Ray Clinic in Ho- Chi Minh City in the south of the country initially treated 65-year-old patient. According to Lan Phan from the city's Pasteur Institute and staff, the man had entered from Wuhan four days earlier. He had fever on January 17th.
On the same day he received visit from his 27-year-old son. The family spent 3 days together in hotel room with air conditioning. On January 20, the son fell ill with dry cough and fever. He also suffered from vomiting and diarrhea.
The son was also treated at the Cho-Ray Clinic. In both patients, the disease was confirmed by gene detection using the reverse transcriptase polymerase chain reaction (RT-PCR).
As the son, who comes from rural region 40 km from Ho Chi Minh City away, has not traveled to any areas where 2019-nCoV is common, Phan must have contracted his father in the hotel. Proof by sequencing the genes is still pending. The incubation period can be maximum of 3 days.
In contrast to the father, the son only fell ill easy, which corresponds to the experience from other clinics. The 2019-nCoV is particularly risky for older people with concomitant diseases (with the father: type 2 diabetes, hypertension and coronary heart disease with stents). Younger healthy people usually seem to get through it without complications.
The family had traveled to four cities with the sick father and used various means of transport. According to Phan, no infection has ever occurred in 28 close contacts.
We are taking this as an opportunity to adjust our recommendations as to when patients are considered infectious and how contact persons should be dealt with. Lars Schaade, RKI Vice President
RKI wants to adapt recommendations
The case in Bavaria, which was confirmed the day before yesterday, also supports the assumption that reports have already been made China had suggested: 2019-nCoV could be transmitted by symptom-free infected patients - in this case from Germany by the workshop trainer from Shanghai, who only developed symptoms on the return flight to China.
"It seems that the case was infected in Bavaria while the index case (the person from whom the infection originated) was still in the incubation period," explained Lars Schaade, Vice President and Head of the Center for Biological Hazards and Special Pathogens at the RKI in Berlin.
However, it is still unclear whether these are individual cases and how often asymptomatic people actually shed the virus. "We are taking this as an opportunity to adapt our recommendations as to when patients are considered infectious and how contact persons should be dealt with," says Schaade.
Due to the developments in recent days, one must assume that the virus The vice-president of the RKI admits that it is transmitted more easily than assumed at the beginning of the outbreak. “This is shown by the number of cases, but also by the scientific publications used to calculate the basic reproduction rate. It is roughly as high as that of the SARS coronavirus from 2003. “
Geneva - With the first reports of person-to-person Transmission outside of China reduces the chances that the epidemic can be stopped in the foreseeable future. The basic reproduction number R0 is decisive for the further course. This is the average number of people infected by an infected person. A team led by Neil Ferguson from the WHO Collaborating Center for Infectious Disease [...]
Paul Hunter, professor of medicine at Norwich Medical School, also expressed concern about the case in Germany of the University of East Anglia in the UK: "If the Chinese woman was indeed asymptomatic at the time of the training, this would make standard control strategies less effective." In his view, this new information underscores the importance of the current advice from UK Public Health Authority: If someone has returned from Wuhan in the past 14 days, they should 'stay indoors and avoid contact with other people as you would with other flu viruses'. In the United Kingdom, it is also advised to contact the National Health Service (NHS) to inform them about your recent trip to the city.
The President of the RKI, Lothar Wieler, gave the all-clear yesterday in the press statement together with Federal Health Minister Jens Spahn (CDU): The number of deaths would decrease and the severity of the disease would also decrease.