Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with MERS and SARS. The 2019 Novel Coronavirus, or 2019-nCoV, is a new respiratory virus first identified in Wuhan, Hubei Province, China. Initially, many cases reported in the outbreak in Wuhan, China had some link to a large seafood and animal market, suggesting animal-to-person spread.

However, with increased number of cases being reported without any history of exposure to animal markets, suggests person-to-person transmission might be occurring. Patients present with respiratory illness, including fever, cough, shortness of breath and conjunctivitis. Severe complications include pneumonia. These can appear as soon as two days or as long as 14 days after exposure. Among the newly published literature on coronavirus is a paper in The Lancet suggesting patients may be infectious to others even before they experience symptoms of infection. The virus appears to be spread via respiratory droplets. It also could be spread if people touch an object with the virus and then touch their mouths, noses or eyes.

The Director-General of the WHO declared that the outbreak of 2019-nCoV constitutes a PHEIC (Public Health Emergency of International Concern)

What you need to know ?
• Anecdotal reports suggest the virus can cause conjunctivitis and possibly be transmitted by aerosol contact with conjunctiva.

• Patients who present to ophthalmologists for conjunctivitis who also have respiratory symptoms and who have recently travelled internationally, and certainly those recently in China or with family members recently back from China, could represent cases of 2019-nCoV.

• Health officials recommend protection for the mouth, nose and eyes when caring for patients potentially infected with 2019-nCoV.

In view of the spurt of cases being reported from China and travel related cases appearing in many countries, the travellers to China are advised the following:

Those planning a visit to China
• All non-essential travel to China to be avoided.

Travelers to China should follow simple public health measures at all times as under:
• Observe good personal hygiene.
• Practice frequent hand washing with soap.
• Follow respiratory etiquettes - cover your mouth when coughing or sneezing.
• Avoid close contact with people who are unwell or showing symptoms of illness, such as cough, runny nose etc.
• Avoid contact with live animals and consumption of raw/undercooked meats.
• Avoid travel to farms, live animal markets or where animals are slaughtered.
• Wear a mask if you have respiratory symptoms such as cough or runny nose.
• All travelers to China to monitor their health closely

During your stay in China, if you feel sick and have fever and cough:
• Cover your mouth while coughing or sneezing.
• Don’t plan any further travel, if sick.
• Seek medical attention promptly.
• Report to Indian Embassy in China (+8618612083629 and +8618612083617)

If you feel sick on flight, while traveling back to India:
• Inform the airlines crew about illness.
• Seek mask and the self-reporting format from the airline crew.
• Avoid close contact with family members or fellow travelers.
• Follow the directions of airline crew while disembarking.
• Immediately report facts to the Airport Health Office/Immigration Office and Helpline number (011-23978046) also.
• Follow the direction of the airport health officer or as issued by the helpline.

If you feel sick within a span of one month after return from China:
• Immediately call the Helpline number (011-23978046) and follow the direction issued.
• Maintain effective self-isolation at home and with others.
• Observe good personal hygiene.
• Practice frequent hand washing with soap.
• Follow respiratory etiquettes - cover your mouth when coughing or sneezing.
• Report the illness to the nearest health facility and also inform the treating doctor regarding your travel history.

Resources.
1. https://www.worldometers.info/coronavirus/
2. https://www.thelancet.com/coronavirus
3. https://www.aao.org/headline/alert-important-coronavirus-context
4. https://mohfw.gov.in/diseasealerts/novel-corona-virus
5. https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Contributed by Dr. Aditya Pradhan , Consultant Cornea and Anterior Segment Services, Disha Eye Hospitals, Barrackpore.