On January 13, 2020, the Wuhan Municipal Health Commission’s website announced on the 12th that Wuhan has reported a total of 41 cases of pneumonia patients infected by the coronavirus, with 6 cases fully cured and discharged. Seven cases involve severe illness and are under treatment, whilst one person has died. The remaining patients are in a stable condition, with 717 people still being under medical observation – as no related cases have been found among close contacts. Fortunately, this pneumonia is not as infectious as SARAS. Why do different strains of the coronavirus differ so markedly in fatalities?
On the evening of December 30, 2019, news of an unexplained pneumonia in Wuhan spread on the Internet. The next day, the Wuhan Municipal Health Commission issued a notice stating that some medical institutions recently discovered that multiple cases of pneumonia recorded were related to South China Seafood City. At the time, no obvious person-to-person transmission had been found through investigation, and no frontline medical staff had been infected.
On the 12th, the Wuhan Municipal Health Commission issued a notice again, stating that between 0-24:00 on January 11, there were no new cases of pneumonia caused by the new coronavirus in Wuhan, 4 cases were cured and discharged, and no new deaths had been reported.
The deceased person from this unexplained pneumonia in Wuhan was a 61-year-old male who had purchased from the seafood market all year round. The patient is a 61-year-old male who was admitted to the hospital due to respiratory failure and severe pneumonia. He also suffered from abdominal tumours and chronic liver disease. After admission, he was given symptomatic support, anti-infection, ventilator assisted breathing, continuous ECMO extracorporeal life support and other treatments. The symptoms did not improve. On the evening of January 9, 2020, his heart stopped and could not be restarted. The aetiology test result indicated that the new coronavirus nucleic acid was positive. The death was diagnosed as severe pneumonia, acute respiratory distress syndrome (severe), septic shock, multiple organ failure, severe acid-based metabolism disorder, and liver cirrhosis. The immediate cause of death was respiratory and circulatory failure.
Why is the coronavirus deadly? Coronavirus is a pathogen that mainly causes respiratory and intestinal diseases. There are many regularly arranged protrusions on the surface of this type of virus particle. The entire virus particle is like the crown of an emperor, hence the name “coronavirus.” In addition to humans, coronaviruses can also infect a variety of mammals such as pigs, cattle, cats, dogs, camels, and bats, as well as a variety of birds. Coronaviruses belong to the order Mectovirus, Coronavirus family, and Coronavirus genus. The genome is a linear, single-stranded positive-stranded RNA virus, which is a large group of viruses that exist widely in nature. The virus genome has a methylated cap structure at the 5’end and a poly(A) tail at the 3’end. The genome is about 27-32 kb in length. It is currently the largest virus of the known RNA viruses. Coronavirus only infects vertebrates and is related to various diseases found in humans and animals. It can cause diseases of the respiratory tract, digestive tract and nervous system of humans and animals. So far, in addition to the new coronavirus that caused the outbreak of viral pneumonia in Wuhan, a total of six coronaviruses (HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HCoV- HKU1 and MERS-CoV) have been identified. Research on the new coronavirus that causes Wuhan pneumonia has ruled out some possibilities. It is not influenza, avian influenza, adenovirus, severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) or other respiratory pathogens. Because it is a new type of virus, it takes time to develop accurate diagnostic methods and therapeutic drugs, so it is inevitable that the treatment will not be timely or accurate in this early stage.
To solve the mystery of the unexplained pneumonia in Wuhan, scientists from various countries urged China to share more detailed data – China made a full report to the World Health Organization (WHO) on December 31, 2019. According to China Central Television (CCTV), the virus isolated from a patient in the laboratory showed a spike-like surface typical of coronavirus under an electron microscope. As of 21:00 on January 7, 2020, Chinese scientists sequenced the whole genome of the virus and detected a total of 14 positive results for the new coronavirus using nucleic acid testing methods. This expert group believes that the pathogen of this unexplained viral pneumonia case was initially determined to be a new type of coronavirus. On January 9, 2020, Beijing time, the official website of the world’s top academic journal Science published a scientific report on the pneumonia outbreak again, titled: Scientists urge China to quickly share data on virus linked to pneumonia outbreak. Outbreak-related virus data).
According to the report, scientists from all over the world eagerly hope that China can share more information about this new pathogen as soon as possible, including sequence information, the disease that the new pathogen may cause, and the route of transmission. The following is the full translation of Science report. Peter Daszak, President of the Eco-Health Alliance, said: “Chinese virologists are the best virologists in the world. They work very fast and are extremely efficient. They have much more information than we know now. This outbreak is an opportunity for China to demonstrate their efforts in public health and virology in the 21st century.” Although the link between the pathogen and the disease has yet to be confirmed, many scientists praised the discovery, saying it is a testament to China’s strength in virology. But they urged China to share more information about this new pathogen as soon as possible, including the sequence information of the new pathogen, the possible diseases it may cause, and the route of transmission. Marion Koopmans, a virologist at Erasmus Medical Centre, said: “I think they really should share sequenced data so that we can ensure that if we have travellers from this area, we can detect this virus.” In addition, Xinhua News Agency today confirmed that the person in charge of the epidemic investigation is Xu Jianguo. Although the agency did not disclose his specific work unit, Xu Jianguo apparently worked at the China Institute for Infectious Disease Control and Prevention under the Chinese Centre for Disease Control and Prevention. Xu Jianguo told Xinhua that the researchers are continuing their work to confirm that the coronavirus is the culprit.
The representative of the World Health Organization (WHO) in China, Gauden Galea, wrote in a press statement today: “The initial identification of a new virus in a short period of time is a remarkable achievement, demonstrating that China is capable of dealing with new epidemics.” Scientists all over the world agree with this view, but they still want to know more. Malik Peiris, a virologist at the University of Hong Kong, said, “Chinese researchers should be congratulated for their rapid identification of the pathogen. Now they are sharing this new virus-specific diagnostic RT-PCR test with the WHO and the global public health community.” Peter Daszak, President of the Eco-Health Alliance, said: “What I really want to see is information about epidemiology and pathology, so that we can all be sure: first, this coronavirus is the cause of this outbreak; second, it is under control, and they have been able to track all potential cases for isolation and testing. In my opinion, if we do not get all the information, the epidemic is at risk of further spread.” Christian Drosten of the Charite Hospital of the University of Berlin, Germany, said: “Chinese researchers do not have to worry that sharing information will prevent the publication of this new virus in authoritative journals. No journal will refuse to publish its papers because this sequence needs to be made public.”
News reports have been cautiously claiming that the findings of the investigation are preliminary. During the SARS outbreak in 2003, Chinese authorities and scientists were embarrassed by prematurely reporting that chlamydia was the culprit, which later proved to be a new coronavirus. Wang Linfa, an emerging disease expert at Duke-National University of Singapore School of Medicine, said: “I understand why politicians and scientists must be extra cautious when declaring this new virus. The key step in determining this connection is to reproduce these symptoms in laboratory animals. But it may take weeks or months.” Wang Linfa said the similarities between the outbreak in Wuhan and SARS are interesting. Both cases appeared in winter, and the first cases were related to contact with animals sold in live poultry markets. (In the SARS epidemic, the intermediate host proved to be a civet cat in the market.)
There is also a big difference, however. Facts have proved that SARS is relatively easy to spread among people. Before being controlled, it caused 774 deaths in 37 countries/regions. The pneumonia cases in Wuhan are much lighter than SARS, and there seems to be no human-to-human transmission, although some researchers are not very sure. Another key difference between now and 2003 is the rapid development of science and technology in China. China’s current laboratory capabilities, clinical capabilities, and epidemic control capabilities have now increased by several orders of magnitude. In the Wuhan unexplained pneumonia incident, China’s communication with the outside world was better than during the SARS period, but it was not perfect. Scientists speculate that the patients in Wuhan were infected by animals sold on the market. Malik Peiris, a virologist at the University of Hong Kong, said: “Identifying the exact species is the key. There may be other markets that are spreading similar viruses, so it is important to test these markets to prevent similar outbreaks. Robert Webster, an influenza research expert at St. Jude Children’s Research Hospital, said: “This new disease once again shows that live animals should no longer be allowed to enter the market. They can easily carry the coronavirus. If you keep living animals in contact with humans, the spread of this kind of virus will happen from time to time. So far, we are fortunate that there is no widespread human-to-human transmission.”
Scientists say that no matter which animal is spreading the virus in the market, it may have been infected from a natural host elsewhere. Wang Linfa said: “If you want to bet, I bet it came from bats.” The SARS virus that broke out in China in 2003 was eventually traced back to the Chinese chrysanthemum bat in Yunnan. The coronavirus that caused Middle East Respiratory Syndrome (MERS) that emerged in 2012 can also be traced back to wild bats. Bats carry so many coronaviruses, and they mutate very fast. In Hong Kong, among the 48 people who travelled to Wuhan in recent weeks, some have developed fever, respiratory infection or pneumonia. Singapore and South Korea also quarantined sick travellers from Wuhan. So far, none of these people have been found to be infected with a suspected virus.
China has shared the genetic sequence information of this coronavirus The World Health Organization announced on the 12th that it has received the genetic sequence information of the coronavirus detected in Wuhan cases of viral pneumonia of unknown cause shared by China. The WHO also stated that it does not recommend any travel or trade restrictions on China. The WHO said in a statement that it has obtained more detailed information on Wuhan’s unexplained viral pneumonia from the National Health Commission of China on the 12th, including the genetic sequence information of the coronavirus detected in the case. It is important for the country to develop specific diagnostic tools. With the participation of global forces, it is believed that the virus trap of Wuhan pneumonia will be lifted soon!
Chinese Language Reference:
Wuhan pneumonia 717 people underwent medical observation, 1 death: Why is the coronavirus deadly?