ADVISORY ON VIRAL PNEUMONIA OF UNKNOWN CAUSE IN WUHAN CITY, CHINA

On 30 December 2019, local authorities were alerted to the development of a cluster of 27 cases of severe pneumonia of unknown cause in Wuhan city, Hubei Province of China. By the evening of 3rd Jan 2020, the number had jumped to 44 cases, and by 5th Jan, 59 cases had been identified.  Amongst them, 7 patients are said to be in a critical condition and a further 163 people placed under observation.

Since the start of December, all reported cases had been admitted to hospitals in Wuhan city with suspected viral pneumonia. Their symptoms included fever, shortness of breath.

It was found that the majority of the cases were workers at the Huanan Seafood Market, a wholesale fresh seafood market, located in Jianghan District, Wuhan city.

The cause of the infection and mode of transmission remains unknown with investigations still underway.

It remains unconfirmed whether the infection is linked to Severe Acute Respiratory Syndrome (SARS) that emerged in 2003

Fortunately, no sustained community transmission or infection in healthcare workers has been reported thus far.

Taking no chances, temperature screening was implemented at Changi Airport from 3rd Jan 2020 for all travelers arriving from the central Chinese city of Wuhan, with suspected cases being referred to hospitals for further assessment.

In Singapore, the MOH reported its first suspected case on 4th January involving a three-year-old girl from China who had pneumonia and a travel history to the Chinese city of Wuhan, however, investigation later confirmed that the cause of her pneumonia was due to the respiratory syncytial virus, a common cause of childhood respiratory infection and unrelated to the outbreak in Wuhan.

Meanwhile in Hong Kong, health authorities had also identified 17 suspect cases although none so far were found to have the unidentified strain.

Việt Nam’s health ministry has urged local health authorities to tighten management at border gates in response to China’s Wuhan pneumonia outbreak.

Symptoms:

The clinical manifestations of the disease include fever (predominant), cough and shortness of breath.

When and where to seek treatment

Travellers returning from Wuhan should  monitor their health closely and to seek medical attention promptly if they feel unwell.  They should first put on a face mask and seek medical attention immediately in the nearest hospital.

Suspected cases

Persons who fulfil the following criteria should have been admitted for further management as they might be potential suspect cases:

  1. a) Persons with features of pneumonia or severe respiratory infection with breathlessness AND travel to or residence in Wuhan city within the last 14 days; or
  2. b) Persons with an acute respiratory illness of any degree of severity who, within 14 days before onset of illness, had close contact with a pneumonia case of unknown cause linked to the Wuhan cluster.

Transmission

Viral pneumonia can be spread by coughing or sneezing, which creates small respiratory droplets in the air that are then inhaled into the lungs.

Diagnosis

Based on clinical assessment, relevant testing for pneumonia or other viral respiratory syndromes will be undertaken by the managing physician or infectious disease team.

Treatment

Medical care of viral pneumonia is largely supportive using medication and to help relieve symptoms and address complications such as bacterial infections.

Prevention

  • During travel, avoid contact with live animals, including poultry and birds, and do not eat raw and undercooked meats.
  • Travellers should wash their hands with soap frequently and wear a face mask if they have respiratory symptoms such as a cough or runny nose.
  • Avoid close contact with those who are unwell or showing symptoms of illness. If exposure is unavoidable ensure you protect yourself with a N95 mask.
  • Cover your mouth with a tissue paper when coughing or sneezing, and dispose the soiled tissue paper in the rubbish bin immediately.
  • All suspected and confirmed cases of pneumonia with relevant travel history to Wuhan city should be isolated.
  • Family members and other close contacts of suspect cases need to be vigilant for symptoms of fever or shortness of breath, and to seek medical attention as soon as possible if unwell.
  • Ensure you stay up to date with annual influenza vaccination available at all Raffles Medical clinics

Influenza vaccination

Vaccination to seasonal Influenza does NOT confer protection. However it is advisable to get yourself vaccinated against Influenza if you will be travelling to exposed areas.  This will prevent you from contracting influenza symptoms and signs that may mislead screening authorities at temperature checkpoints and result in unnecessary anxiety and delays to your travel.

To request the 2019 – 2020 flu vaccination, please contact us.

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