Lisa Schnirring 
Staff Writer
Staff Writer
Sep 27, 2012 (CIDRAP News) – British health officials said today
that a Rotterdam lab that first characterized the novel coronavirus
linked recently to two severe illnesses hopes to publish the whole
genome in the next 24 to 48 hours, and the UK's Health Protection Agency
(HPA) launched guidance to help clinicians investigate and manage
possible cases.
The HPA said in an update that the full genome sequence will be
published by Ron Fouchier, PhD, based at Erasmus University in the
Netherlands. The sequence will be based on cultured virus that has been
at the lab since early July.
Yesterday the agency gave the same time frame for release of the
full sequence and did not change the estimate in today's update.
The HPA had earlier released the partial sequence for the virus's
polymerase gene, obtained from an infected patient undergoing treatment
in London, which enabled scientists to compare it with others and
determine that the new virus is related to bat coronaviruses. The HPA
said it doesn't yet have a viral isolate, but clinical material from the
patient is being cultured to make isolates.
Also, the HPA shared new details about molecular diagnostics for
identifying the new virus. It said pan-coronavirus primers described by
an international group of researchers in 2003 and in a 2008 report from
Belgian researchers should both be useful. However, the clinical
material the HPA has does not react with specific assays it has for
OC23, 229E, NL64, or SARS. It said it welcomed offers of reagents and
information from scientists who specialize in the area.
In other developments, the HPA published some clinical tools to
help clinicians manage suspected and confirmed cases along with close
contacts. The tools include an algorithm for investigating and managing
possible cases; it describes the testing process, protective actions to
take if an infection is confirmed, and the next steps to take for sample
collection and data reporting.
Another algorithm walks clinicians through investigating close
contacts of patients with confirmed novel coronavirus infections. For
contacts who don't have clinical symptoms during the initial visit, the
HPA recommends that baseline clotted blood samples be taken as soon as
possible, ideally no later than 7 days after exposure. The algorithm
recommends that follow-up samples be taken at least 14 days after
baseline or 28 days after exposure if a sample couldn't be taken when
the case-patient was asymptomatic. It says a contact form should be
completed 10 days after the initial data is collected.
The HPA also issued a nine-page infection control resource for
handling confirmed and suspected cases. It noted that coronaviruses are
mainly transmitted by large respiratory droplets and direct or indirect
contact with secretions. The agency also said the viruses can be
detected in feces and urine and in some instances can be transmitted by
aerosolized respiratory droplets and feces. It detailed steps to take in
addition to standard precautions, such as what type of respirator and
personal protective equipment (PPE) to use.
In developments elsewhere, Hong Kong's Centre for Health
Protection (CHP) said today that the process to make novel coronavirus
infection a notifiable disease is under way. It said a legislative
amendment will be recorded tomorrow, taking effect immediately. Health
practitioners will be required to notify the CHP's director of health if
they suspect the disease, and labs will be required to report virus
leaks that may pose a public health risk.
No new infections involving the novel coronavirus have been
detected beyond the Qatari man hospitalized with a severe respiratory
illness and renal failure in a London intensive care unit and a
60-year-old Saudi Arabian man who was infected with a virtually
identical virus who died in June.
The identification of a new coronavirus has raised global health
worries, because a then-novel one in 2003 caused the SARS epidemic that
sickened 8,422 people, killing 916 of them. Health officials have said
the new virus is clearly different than the one that caused SARS, and
some have said that an animal source can't be excluded.
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