China’s new deadly virus is more difficult to contain than other pandemics because those infected may not get a fever, a symptom governments around the world are using to screen for the pathogen.
China’s National Health Commission (NHC) told local governments and hospitals on Jan. 18 that some of those with the virus might not have a fever and the pathogen’s incubation period could be up to two weeks, according to people familiar with the matter, who asked not to be named discussing the situation.
A spokesman for the NHC said that the understanding of the new virus and its symptoms changes over time and that doctors have observed some patients with low or even no fever as the number of infections has increased.
The lack of fever as a symptom means that temperature screening — the main method now being deployed at airports and transport hubs to control the outbreak — would fail to pick up on at least some cases.
”The whole airport screening exercise is to simply give people comfort that there is some government action to protect the public,” said Ramanan Laxminarayan, director of the Center for Disease Dynamics, Economics & Policy in Washington. “It has no real public health utility in the case of coronaviruses. What really matters is surveillance, infection control and isolation.”
The discovery that people could be infected without their temperatures spiking, and that the virus could lie dormant for a relatively long period of time, increases the likelihood that carriers are currently traveling freely, intensifying the virus’ spread.
Several people who have died from the virus in China did not display symptoms of fever, details released by the NHC on Thursday showed, although they displayed other symptoms such as breathing difficulty, chest tightness and coughing.
Relying solely on thermometers is not sufficient to catch all possible cases, according to David Heymann, an infectious disease researcher in the UK who advises the WHO.
“Alone as a means of keeping infection out of countries, they provide a false security,” he said.
People can cross borders without a fever then get sick after their arrival and taking paracetamol or aspirin can bring a fever down so it is not detected, he said.
China has confirmed 830 coronavirus cases as of yesterday, including 26 deaths.
“Screening is not 100 percent efficient, but without screening you are even worse,” said Wang Linfa, a diseases expert at the National University of Singapore. “Other than monitoring temperature, the other thing is to encourage citizens to stay in and do not go out.”
The most accurate method for detecting if someone has the Wuhan virus — known as 2019-nCoV — is through test kits that use the genetic makeup of the novel virus, which Chinese scientists have made available to public health authorities around the world.
However, those are in short supply and have already run out in some hospitals in Wuhan, local media said.
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