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02/13/2013

SARS-related virus - should we be worried?

British health authorities have confirmed the world's 11th case of the novel coronavirus, which is related to the virus that causes SARS.

What's new and interesting about this case, however, is that the patient had no history of travel to the Middle East, where previous infections seem to have occurred (so far, the evidence suggests that the virus originates in bats, which may also be infecting an intermediary animal that's passing it along to humans). This new patient is also the relative of another person who earlier caught the virus -- so it's likely he or she caught it from them in the UK.

Yes, this is the strongest evidence so far that the virus can transmit from person to person. Although worrisome, however, there is still no need to overreact. For now, this is the most important thing to note:

“Although this case provides strong evidence for person to person transmission, the risk of infection in most circumstances is still considered to be very low,” John Watson, head of the respiratory diseases department at the Health Protection Agency, said in a statement. “If (the) novel coronavirus were more infectious, we would have expected to have seen a larger number of cases.”

There have only been 11 cases so far. And past cases have already suggested the possibility of person-to-person transmission -- there was a family cluster of cases in Saudi Arabia in October 2012, where two people died. And in November, health officials confirmed that retrospective testing of samples from a mysterious outbreak in Jordan tested positive for the novel coronavirus.

Those cases were from an outbreak in April 2012, where 11 people came down with severe respiratory infection. Eight of those people were healthcare workers -- that was a particularly worrisome development because outbreaks in health care settings often signal that a virus has become more infectious. But so far, no further cases of the novel coronavirus have been identified in Jordan.

Here's what a WHO spokesperson told me back in November:

"The timing of the cases in the Saudi cluster does raise that concern (of human-to-human transmission), " said Fadéla Chaib.  "Investigations are ongoing to try and answer this question, however, if (human-to-human transmission) has occurred, it does not appear to be sustained."

Three months later, this still seems to hold true. The latest case in the UK provides the strongest evidence yet to support what was already suspected -- but it is also important to note that the newest patient may have been more suspectible to infection due to an underlying medical condition.

As many have pointed out, SARS also had a sputtering start but ultimately evolved to become more infectious -- and in the end, managed to spread across 30 countries and kill approximately 800 people. The scary quote of today comes from infectious disease expert Dr. Michael Osterholm:

“At any moment the fire hydrant of human-to-human transmission cases could open,” he said. “This is definitely a ‘stay tuned’ moment.”

So it's possible this new coronavirus is following the same trajectory as SARS -- only the world has caught on to it at an earlier stage. Which, we hope, means that we'll have an upper hand if the virus does suddenly evolve to become highly infectious. There have already been some lucky breaks.

Six hospital staffers who came into contact with this latest patient are now being monitored but so far none have shown any symptoms. But if any of them do become ill with the virus -- then, perhaps, it will be time to get worried.

Here's the latest list of the cases so far, courtesy of the European Centre for Disease Control and Prevention. Interesting to note that nearly every single patient so far has been male:

Coronavirus cases

And from a Eurosurveillance paper, here is an interesting timeline of the first novel coronavirus case diagnosed in the UK (it was the second confirmed case worldwide). This patient had travelled to both Saudi Arabia and Qatar before falling ill:

Timeline novel coronavirus

Jennifer Yang is the Toronto Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar

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