Coronaviruses

Coronaviruses are a large family of viruses that are common in many different types of animals. This includes camels, cats, cows, and bats. In humans, coronaviruses cause infections like the common cold and most people will become sick with a coronavirus at some point during their life. Rarely coronaviruses cause more severe disease like COVID-19, MERS, and SARS.

 

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Coronavirus Disease 2019 (COVID-19) (Information as of 2/25/2020 at 2:00 PM EST)

TRAVEL ALERT: The U.S. Department of State and U.S. Centers for Disease Control and Prevention (U.S. CDC) issued travel advisories for China and South Korea. Do not travel to China and South Korea due to the novel coronavirus outbreak.

Healthcare Providers: U.S. CDC updated the definition for patients under investigation on 1/31/2020.

The U.S. Centers for Disease Control and Prevention (U.S. CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus first detected in Wuhan City, Hubei Province, China and which has not been detected in 37 locations internationally, including cases in the United States. The virus is named "SARS-CoV-2" and the diseases it causes is named "coronavirus disease 2019" (abbreviated "COVID-19"). COVID-19 illnesses are reported in a growing number of international locations, including the United States. Person-to-person spread of this virus is reported outside China. The United States reported the first confirmed instance of person-to-person spread with this virus on January 30, 2020.

Infogrpahic of Common vs Novel Coronavirus

On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a “public health emergency of international concern” (PHEIC).

Early on, many of the patients in the COVID-19 outbreak in Wuhan, China had some link to a large seafood and animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread. Chinese officials report that sustained person-to-person spread is occurring in China.  In addition, other destinations have apparent community spread, meaning some people are infected and are not sure how or where they became infected.

Signs and symptoms of COVID-19 include fever and/or cough and difficulty breathing. Sore throat is also reported in some patients. If you have these symptoms and did not recently travel to China or did not have contact with someone with 2019 Novel Coronavirus, it is likely to be a cold or the flu. If you are sick you should stay home, cover your coughs and sneezes, and wash your hands regularly.

 

Situation in the United States and Maine

The United States reports imported cases of COVID-19 in travelers. Person-to-person spread of COVID-19 also has been seen among close contacts of returned travelers from Wuhan, but at this time, the virus is NOT currently spreading in the community in the United States. More cases are likely to be identified in the coming days, including more cases in the United States. It is also likely that person-to-person spread will continue to occur, including in the United States.

On January 31, 2020, Health and Human Services Secretary Alex M. Azar II declared a public health emergency (PHE) for the United States to aid the nation’s healthcare community in responding to COVID-19. Also on January 31, the President of the United States signed a presidential “Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus". These measures were announced at a press briefing by members of the President’s Coronavirus Task Force. On arrival to the United States, travelers from China will undergo health screening. Travelers with signs and symptoms of illness will have an additional health assessment. The U.S. government has taken unprecedented steps related to travel in response to the growing public health threat posed by this new coronavirus, including suspending entry in the United States of foreign nationals who visited China within the past 14 days. Measures to monitor the health of those who are allowed entry into the United States (U.S. citizens, residents, and family) who have been in China within 14 days also are being implemented.

Maine has no confirmed cases for 2019-nCoV and no patients under investigation at this time. Maine CDC is working with U.S. CDC to monitor the situation, provide healthcare providers with the latest information, and stay up-to-date on any potential cases they may see. There are ongoing investigations to learn more. This is a rapidly evolving situation and information will be updated as it becomes available. For more information on the situation, visit U.S. CDC's COVID-19 situation summary webpage.

 

Interim Guidance for Healthcare Professionals

Healthcare providers should obtain a detailed travel history for patients with fever and acute respiratory illness. Healthcare providers in Maine should immediately notify Maine CDC (1-800 821-5821) in the event of a patient under investigation (PUI) for COVID-19.

Limited information is available to characterize the spectrum of clinical illness associated with 2019-nCoV. No vaccine or specific treatment for COVID-19 infection is available; care is supportive.

For more information, visit U.S. CDC's webpage on evaluating and reporting a PUI and U.S. CDC's webpage on infection control.

Additional Coronavirus Resources for Providers:

What Travelers Can Do

The U.S. Department of State issued a Level 4 Do Not Travel Advisory for China. Travelers should not travel to China due to the novel coronavirus outbreak. Travelers should be prepared for travel restrictions to be put into effect with little or no advance notice. Commercial carriers have reduced or suspended routes to and from China. More information on this advisory can be viewed on the Department of State’s website.

U.S. CDC issued a Level 3 Travel Warning for all of China and South Korea. Travelers should avoid nonessential travel to China (this does not include the Special Administrative Regions of Hong Kong and Macau, or the island of Taiwan) and South Korea.

U.S. CDC issued a Level 2 Travel Alert for Iran, Italy, and Japan. These locations are experiencing sustained community spread of COVID-19. Older adults and those with chronic medical conditions should consider postponing nonessential travel.

Other destinations with community spread include Singapore, Thailand, Taiwan, and Vietnam.

If you must travel:

  • Avoid contact with sick people.
  • Discuss travel to affected areas with your healthcare provider. Older adults and travelers with underlying health issues may be at risk for more severe disease.
  • Avoid animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat).
  • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.

If you traveled to an affected area in the last 14 days and feel sick with fever, cough, or difficulty breathing, you should:

  • Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms.
  • Avoid contact with others.
  • Not travel while sick.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
  • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.

Visit U.S. CDC's Travelers' Health website for more information.

 

Additional Resources for COVID-19:


 

Middle East Respiratory Syndrome (MERS-CoV)coronavirus

A novel coronavirus called "Middle East Respiratory Syndrome Coronavirus" (MERS-CoV) was identified in 2012 as the cause of respiratory illness in people.  This particular strain of coronavirus has not been previously identified in humans.  There is very limited information on transmission, severity, and clinical impact.  Currently, all cases are associated with either direct travel to the Arabian peninsula, or contact with a returned traveler from the Arabian peninsula.

Currently there are no reports of anyone in the US getting infected with MERS-CoV .

Symptoms:  Symptoms of MERS CoV include severe acute respiratory illnesses with symptoms of fever, cough, and shortness of breath.  Some mild respiratory illnesses were reported.  Atypical signs and symptoms such as diarrhea may be present in patients who are immune-compromised.

Diagnosis:  MERS CoV can be diagnosed through laboratory testing.  To increase the likelihood of detecting infection, it is recommended to collect specimens from different sites.  Lower respiratory tract, serum, and stool samples are preferred for PCR testing.  Upper respiratory samples may also be collected, but appear to be less sensitive than lower respiratory tract samples.  Samples from suspect cases should be sent to Maine's Health and Environmental Testing Laboratory (HETL) for testing.

Infection Control:  Standard, contact, and airborne precautions are recommended for management of hospitalized patients with known or suspected MERS-CoV infection.

Treatment:  There is no specific treatment or vaccine for MERS-CoV.  Treatment is supportive.

For more information on MERS-CoV


 

Severe Acute Respiratory Syndrome (SARS)SARS

Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. The illness spread to more than two dozen countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained.

Since 2004, there have not been any known cases of SARS reported anywhere in the world.

For more information on SARS: