ST. PAUL — Calling it a "low immediate risk for the general public," Minnesota state health officials on Friday briefed news media on preparations being taken for surveillance and detection of novel coronavirus monitoring in the region.
The outbreak off flu-like respiratory illness known as 2019-nCoV was first detected at the end of December in the city of Wuhan in central China. Authorities there say the virus has caused hundreds to become ill with respiratory symptoms, killing 25, and has since spread to Taiwan, Thailand, Japan and South Korea.
The Chinese government on Thursday closed travel out of Wuhan, a city of 11 million. U.S.-bound travelers from the region have been re-routed to five U.S. cities for screening. On Friday, the CDC confirmed the second case of the virus within the U.S., identified in a traveller from Wuhan arriving in Chicago. The first case was attributed to a traveler to Seattle.
Health officials also disclosed Friday that in keeping with a CDC advisory, they have sent samples from two people in Minnesota to CDC headquarters for testing. Both have a mild respiratory illness and recently travelled to Wuhan. Health officials say the persons under review are currently isolated at home, and that they do not know when the results of that testing will be complete.
"They (CDC officials) are rather inundated with specimens," says Kris Ehresmann, director of infectious disease, MDH. "If at any point CDC testing were to confirm a case of the novel coronavirus in a Minnesota resident," she added, "the available details and protective recommendations would be shared with the affected parties and the general public as quickly as possible."
The symptoms of coronaviruses include standard flu and cold afflictions like runny nose, headache, cough, sore throat fever and a general feeling of being unwell. There are no specific treatments for coronaviruses, and most will fight them off on their own.
"The tough part of this is that there are many reasons a person might experience respiratory symptoms during cold and flu season," she added. "The symptoms we were talking about with this novel coronavirus really very closely mirror regular cold and flu symptoms."
State Commissioner of Health Jan Malcolm says she believes many ill people in the state will get tested over time, and turn out to have influenza or some other infection. "We would rather err on the side of caution and test a lot of folks who turn out not to have novel coronavirus."
Among the many unknowns is whether the virus is easily transmitted, and even whether those who contact the virus can commonly develop severe illness.
"We do not know how easily or sustainably the virus is passed among people," says Dr. Ruth Lynfield, state epidemiologist and medical director at MDH. "We do not yet have robust data on the severity of the virus." Most of the deaths so far related to the illness have been among older patients and those with cardiovascular conditions.
"It is not that a person traveling to Chicago or Seattle is at increased risk," says Lynfield. "We do not have this virus circulating in our communities right now. This is about people who have travelled to an area where the virus has circulated."
Wuhan, sometimes referred to as "the Chicago of China," is home to hundreds of Global 500 firms and over 350 research institutes. Though Mayo Clinic in 2012 had announced a partnership between Mayo Medical Laboratories and the Wuhan-based medical testing firm Kindstar, Mayo Clinic Laboratories Marketing Channel Manager Suzanne Ferguson on Friday told Forum News Service that "we no longer have an official collaboration with Kindstar in Wuhan," adding that the organization "does not have any activities in Wuhan."
"We always ensure precautions are taken for our staff who do travel internationally," Ferguson said.
Regarding transmission, state health officials stressed on Friday that while viruses like measles can hang in the air, infecting the next persons who walk through the room, they believe the novel coronavirus is likely transmitted from coughing in the presence of an uninfected person, or close personal contact.
"At this point we're looking at travel history," says Lynfield, "or likely interaction with someone who recently travelled to China. If you have not had any of those interactions, the likelihood your symptoms have anything to do with this novel coronovirus are exceptionally low. You should be thinking about influenza and the common cold."
"We just ask that people cover their cough or cough into their elbow, wash hands, stay home when you get sick, and get a flu shot," says Malcolm.
Clinicians add that ever since outbreaks in recent years of of Ebola, MERS and SARS, hospitals increasingly have standing procedures for unknown viruses.
"Basically, the number of infections that can exist are innumerable, says Dr. Pritish Tosh, infectious disease specialist at Mayo Clinic, "and the number of ways it can present are innumerable. But the number of things a hospital has to do are quite finite."
"We have core teams of nurses, physicians, respiratory therapists, laboratory medicine personnel, everyone who is needed to take care of a patient, as well as a designated part of our hospital with a designated laboratory so we can properly take care of these patients while minimizing the risk to the rest of the population."
'What we're seeing is a moving target, and taking the numbers with a grain of salt," Tosh says, "... but what we do know is this is a new disease with the potential to cause severe illness, and are taking the appropriate steps to insure that our health care facility is prepared for it."