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'Most coronavirus patients will recover'

KUALA LUMPUR: MOST people affected by the novel coronavirus (2019-nCoV), or Wuhan coronavirus, will recover from the disease.

Universiti Malaya Tropical Infectious Diseases Research and Education Centre (TIDREC) director Professor Dr Sazaly Abu Bakar said unlike SARS (Severe Acute Respiratory Syndrome), the 2019-nCoV had a case fatality ratio (CFR) of only about three per cent, thus giving patients a high chance of recovery.

The World Health Organisation (WHO) estimated that SARS’ CFR ranged from zero to 50 per cent, depending on the age group affected, with an overall estimate case fatality ratio of 14 to 15 per cent, while the Middle East Respiratory Syndrome’s (MERS-CoV) CFR stood at 35 per cent.

Sazaly, a virologist, biosafety and biosecurity expert, said the 2019-nCoV appeared to be less virulent at present, with the exception of the elderly and those with underlying health conditions.

He said while it could be true that the virus could spread before the symptoms show, making it harder for the disease to be contained, precautionary measures should be continued.

This includes thermal screening at entry points and the issuance of travel advisories.

“The report was true for SARS and could be true for this outbreak.

“But the fatality rate of the 2019-CoV infection is relatively low, at slightly more than three per cent, suggesting the possibility that those who died could have other predispositions. Most (of the patients) would fully recover.

“The viral load of the virus remains to be determined. Observation suggests the elderly with predispositions are vulnerable to 2019-CoV,” he told the New Straits Times.

Sazaly was referring to a BBC report, which quoted Chinese officials who said “a person may not know if he has the infection, but still be able to spread it”.

The virus has an incubation period of between one and 14 days.

Sazaly said since the 2019-nCoV shared a genetic code similar to that of the SARS virus, theoretically, it was possible that those who had SARS or other closely-related viruses, could have developed an immunity to it.

On what could have triggered the Wuhan epidemic, he said it could be the mixing of coronaviruses from different animal species, allowing it to exchange parts of the genetic code, thereby enabling the new virus to jump to humans and cause infections.

“This could have happened repeatedly over time until a ‘human competent virus’ (ability to replicate in humans well) emerged from the selection process.

“Another possibility is an otherwise human competent virus that naturally infects an exotic animal species, but did not come in contact with humans in large enough numbers until recently, and the virus adapts to establish an efficient replication in humans.”

In a study, published in the Journal of Medical Virology on Jan 22, researchers found that 2019-nCoV appears to be a mix, or recombination of two coronaviruses — one that is known to infect bats and another of unknown origin.

Further analysis revealed that the virus may have come from snakes.

Up to yesterday, the virus has claimed 81 lives of the more than 2,700 people infected. There are four confirmed cases in Malaysia. Other countries with reported cases are Thailand, Hong Kong, Macau, the United States, Australia, Singapore, Japan, South Korea, France, Taiwan, Vietnam and Nepal.

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