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First death in TIANJIN. Newborn Test Positive
Published on: 2020-02-06
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First death in Tianjin

010 2The patient had developed fever and cough after shopping in a department store on January 22. The patient had a history of type 2 diabetes and hypertension.

001aWho was the carrier? 5 coronavirus cases traced to Chinese department store.

Chinese experts were left puzzled after five cases of the new coronavirus were linked to a department store in the northern megacity of Tianjin - until their investigations shed light on the extent of the rapidly spreading illness’ transmissibility.
 

Four women and a man, all of whom had shown symptoms then been confirmed as infected in the past two weeks, had one thing in common: their connections to the store, in the Baodi district in Tianjin.
 

But only when the fifth case was discovered did their ability to infect one another become apparent.

004None of them had been to the city of Wuhan, where the virus is believed to have originated, nor did they have close physical contact with one another except for two who were a married couple, according to the city’s infectious disease prevention centre.
 

Their cases have helped to reveal the transmission pattern of the deadly virus, which has infected more than 20,000 people in mainland China, killing over 400, and spread to more than 20 countries.
 

It is known to be spreading primarily between people in close proximity, through respiratory droplets - such as saliva or mucus via coughs and sneezes - or by physical contact with viral material followed by its oral ingestion.
 

Of the five people in these Tianjin cases, the first two who sought medical help were a couple, of whom the woman was a salesperson in the store’s electronic appliances department. She had a fever on January 22, then her husband, who had not visited the store, had diarrhoea, also a symptom, two days later.

002aThe next person was another member of sales staff who worked on the same floor as the first but had not had close contact with her. She showed symptoms on January 24, after leaving town for a business trip on January 18, during which she met a person who health experts have said had a fever.
 

Scientists previously thought this third Tianjin person was the original virus carrier, although her link to the couple was not fully explained.
 

However, Zhang Ying, a section head at Tianjin Centre for Disease Control and Prevention (CDC), said in a press briefing on the matter on Sunday: “The place this third case visited outside Tianjin also has infected cases recorded, but there is no confirmation whether the person this salesperson met was a confirmed case of the virus or not, because that person did not seek medical help. We therefore were not able to confirm the origin of the third case’s infection.”
 

Then a fourth person, also a salesperson at the department store, who sold shoes on the same floor, sought medical help. This patient, too, had left Tianjin, on January 12 to buy stock, and had shown symptoms of infection as early as January 21.
 

Health experts said this fourth person may have been infected on that trip, because her destination - which the experts did not disclose - had recorded confirmed infections. Nonetheless, they could not yet see a connection to the two other colleagues who became infected.
 

It was only when a fifth confirmed case related to the department store emerged on February 1 that the experts were able to map the spread of the virus among the five. The fifth person was a female shopper who spent three hours on January 23 shopping in the shoes and jewellery sections, on the floor where the third and fourth people were working.

003Epidemiologists concluded that the shopper’s temporary exposure to the coronavirus showed it to be possible for the fourth person, bringing it back from her business trip, to have been the carrier who spread the disease to all three other women, the first of whom passed it on to her husband.
 

“Although the salespersons were working in different departments in the store, all the sections were on the same floor without any physical barriers separating them,” Zhang, the CDC official, said.

020“They were neighbouring each other and were less than four to five metres away from each other most of the time, and sometimes they would even be at a proximity of one metre. In such an environment, a visiting customer was infected in just three hours, so imagine how unavoidable the environment would have been for someone who works there eight hours a day.”
 

As of 6am on Thursday, Tianjin had a total of 69 confirmed cases of the new coronavirus.
 

天津首例死亡病例

2月5日凌晨,本市一名新型冠状病毒肺炎确诊病例出现急性左心功能衰竭、急性冠脉综合征,经海河医院奋力抢救无效死亡,为本市首例死亡病例。

死亡病例为第50例患者【宝坻区第6例】,女,66岁,天津市宝坻区人,1月22日曾到宝坻区百货大楼购物。2月2日,患者出现发热、咳嗽,就诊于宝坻区人民医院;后经市专家组确认为我市第50例病例,2月3日转入海河医院治疗。

该患者既往2型糖尿病史30余年,高血压9年,冠脉搭桥手术史2年;入院后完善相关检查,2月3日经市专家组会诊,按照《新型冠状病毒感染的肺炎的诊疗方案(试行第四版)》诊断标准,结合患者病情,予抗病毒等对症治疗;2月5日凌晨1时10分患者如厕后出现喘息,间断咳嗽,咳少许粉红色泡沫痰,结合患者既往病史、症状和体征表现,考虑急性心力衰竭,予吸氧、利尿、强心、扩血管等对症治疗,并予气管插管、胸外按压等系列抢救治疗。

2月5日凌晨3时16分宣布临床死亡。初步判断死亡原因:急性左心功能衰竭,急性冠脉综合征。
 

No New Cases Yesterday on 5th Feb

034As of February 5th, there were no new confirmed cases of coronavirus-related pneumonia.
 

Until now, 69 cases of pneumonia diagnosed of coronavirus-related pneumonia have been reported in Tianjin, including 4 critical cases, 20 severe cases, and 42 common cases. 2 patients were discharged from the hospital and 1 died. 171 suspected cases.
 

截止2月5日天津无新增确诊病例
 

市疾控中心获悉,2月5日6时至18时,本市无新增新型冠状病毒感染的肺炎确诊病例。
 

截至目前,本市累计报告新型冠状病毒感染的肺炎确诊病例69例,其中危重型4例、重型20例、普通型42例,治愈出院2例,死亡1例。疑似病例171例。


CORONAVIRUS FEB/6:

Deaths 565, confirmed cases 28,276

01 Coronavirus in Beijing CNNPHThe Hubei health authority reported that 70 more people died after contracting the coronavirus in Hubei province on Wednesday, raising the Hubei death toll since the beginning of the outbreak to 549. This brings the total number of deaths in mainland China to at least 563.

a001The global death toll is 565, with one death in Hong Kong and one death in the Philippines. Authorities confirmed an additional 3,694 cases of the virus in Hubei on Wednesday, which brings the total number of cases in the epicenter of the outbreak to 19,665.

a002There has been 14,314 patients have been hospitalized in Hubei, including 756 who are in critical condition, according to the health authority.
 

The number of confirmed cases in mainland China is at least 28,018. The global number of confirmed coronavirus cases now stands at 28,276.
 

It says there are 24,702 suspected cases. A total of 282,813 close contacts have been traced, and 186,354 close contacts are still in medical observation.
 

Of the deaths in the past 24 hours, of the 73 new deaths recorded, 70 were in Hubei Province, and one each in Tianjin, Heilongjiang, and Guizhou.
 

The vast majority of new infections were also in (Hubei 2,987 out of 3,694).
 

Newborn tests positive

just 30 hours after birth

035An infant in Wuhan has reportedly tested positive for the coronavirus just 30 hours after birth, raising concerns that the infection could be contracted in the womb.
 

Citing sources from the city’s children’s hospital, two infants were infected with the virus, the youngest just 30 hours old. “The mother of the newborn was a confirmed patient of the coronavirus. At present, the infant’s vital signs are stable,”.
 

Zeng Lingkong, a senior physician at the hospital’s neonatal department, said the case was a signal that “we should be concerned about the possible new transmission route of the coronavirus”.
 

Zeng said pregnant women should stay away from infected patients. The Wuhan Children’s Hospital had set aside an area to treat pregnant women with suspected symptoms.
 

武汉出生30小时新生儿确诊!专家:可能存在母婴垂直传播

武汉儿童医院获悉,该院确诊两例新生儿新型冠状病毒肺炎,最小确诊的宝宝出生仅30小时。武汉儿童医院新生儿内科专家考虑可能存在母婴垂直感染传播途径,应该引起重视。
 

这名早期新生儿出生于2020年2月2日,母亲是确诊的新冠病毒肺炎感染者。为避开羊水等因素的影响,在出生30小时后进行新冠核酸检测,显示为阳性(感染),该新生儿从武汉一家三甲医院转至新冠病毒感染的肺炎患儿定点救治医院——武汉儿童医院。
 

目前,该新生儿收治在新冠病毒感染确诊及疑似病例新生儿专用病区,生命体征稳定,尚无发热、咳嗽,但有呼吸急促症状,胸片有肺部感染表现,肝功能稍有异常,对其进行对症支持治疗,并对新生宝宝病情进行严密观察。“这提示我们要关注新冠病毒可能存在的一种新传播途径——母婴垂直传播。”该病区负责人、武汉儿童医院新生儿内科主任医师曾凌空提示,专家、医务人员需对此高度重视。
 

Asymptomatic transmitters

011Chinese health authorities have identified a number of patients who have become carriers and transmitters of the coronavirus despite showing no outward symptoms of the disease.
 

Li Xingwang, chief infectious diseases expert at Beijing Ditan Hospital, said most of the “dormant” carriers were related to and had caught the virus from patients with symptoms.
 

“These [carriers] have the virus and can transmit it. The amount of virus correlates to the severity of the illness, which means these patients carry less of the virus and their ability to transmit disease is weaker,” Li said.
 

In new treatment and diagnosis guidelines released on Wednesday, the National Health Commission said people with milder symptoms, such as fever, fatigue, a cough but no lung infection, should be quarantined and treated to curb further infections.
 

The guidelines also said airborne and digestive tract infections were other possible modes of transmission after traces of the coronavirus were found in patients’ faeces.
 

Li said the two modes were still only possible routes and further investigation was needed to confirm them.
 

无症状感染者可能成为传染源

早在1月28日,国家卫生健康委召开新闻发布会,国家医疗专家组成员、北京地坛医院感染性疾病诊疗与研究中心首席专家李兴旺就表示,在散发病例密切接触者中,观察到一些无症状的感染者,虽然没有症状,但是做核酸检测是阳性的。
 

李兴旺称,随着感染地区的人外溢到全国各地,可能在全国很多地方造成了散发的病例出现。在散发病例密切接触者中,观察到有一些可能会出现无症状的感染者,虽然没有症状,但是做核酸检测是阳性的。还有一些病人有这样的症状,比如发热不明显,偶尔干咳或者乏力,这些病人也是由于我们主动搜索,增加检测能力之后发现的。这样的病人,从传染病规律来讲,也是有一定传播力的,给我们的防控工作带来一定的困难和复杂性。
 

李兴旺表示,从这个病传播的主要途径来讲,主要是通过近距离的飞沫传播,但是轻病人的咳嗽症状一般还比较少。所以从这方面来讲,可能传播力不会那么强。
 

李兴旺表示,更多的无症状感染者还是在密切接触者中发现的,这些密切接触者按现在的要求,都在进行医学观察,他们可能不会随意到公共场所进行自由活动,还是更多的进行居家隔离,这样也就保证了对传染源的控制。所以,更重要的是把传染源控制住,疫情扩散才能够得到最大程度的缓解。
 

2月5日下午,国家卫生健康委召开国务院联防联控机制新闻发布会,会上有记者提问,第五版新版的诊疗方案明确,无症状感染者也有可能成为传染源,春运返程高峰即将到来,通过现有的体温筛查措施,很难识别无症状患者,有没有其他更有效的措施?
 

国家医疗专家组成员、北京地坛医院感染性疾病诊疗与研究中心首席专家李兴旺回应,目前临床确实发现了无症状感染者的情况存在,但所发现的无症状感染者主要还是和病人有密切接触的患者,其家庭成员的情况更多一些,这种病人本身没有明显的临床表现,没有发热、乏力等症状,但是如果做咽拭子检查,其核酸病毒呈阳性,因此将其定义为无症状感染者。
 

这部分人为什么可能是传染源?李兴旺说,从发病机制来讲,这部分病人既然带有病毒,就可能会造成传播。但这类病人因是无症状感染者,所以相对病情偏轻,病毒多少和病情的轻重有一定的相关性,其病毒量比较少,传播能力比重症病人传播力弱一点。
 

还有一个问题,是不是咳嗽两声就要隔离,我们在传染病诊断上,除了比较关注临床症状之外,更多要关注流行病学表现,就像刚才讲到的,无症状感染者更多的是在和病人的密切接触中发生的,尤其是家庭聚集现象比较明显,如果没有接触感染者,偶尔咳嗽一下,没有必要恐慌。
 

Quarantine on all arrivals

to Hong Kong from mainland China

Carrie Lam HKAll travelers entering Hong Kong from mainland China will be placed under quarantine for 14 days, Hong Kong Chief Executive Carrie Lam announced at a news conference today. The rule includes Hong Kong and mainland residents, Lam said.
 

There are 21 confirmed cases of coronavirus in the semi-autonomous city, of which three are locally infected cases - suggesting transmission between the community, rather than being brought in from somewhere else.
 

Travel restrictions: The government suspended four more border crossings yesterday, which has seen entries by travelers from mainland China drop by 60%.
 

However, the city cannot close all borders because many of the arrivals from the mainland are Hong Kong residents who need to return into the city, she said. Besides, Hong Kong relies on the mainland for crucial supplies including food.
 

"Closing all borders is not workable and may affect the supply of food and daily necessaries. The measures we applied last few days proved that these measures can decrease the number of arrivals and decrease the risk of infection," Lam said.
 

What the government has done: The government will allocate over 10 billion Hong Kong dollars (about $1.3 billion) in resources to fight the outbreak, Lam said. It has already closed most of Hong Kong's borders with the mainland - but many in the medical field say that's not enough, and have been on strike for three days.
 

WHO: Asks for $675 million donation

to fight coronavirus

WHO director general CNNThe World Health Organization (WHO) has called for $675 millions in donations as an investment to combat the 2019 novel coronavirus especially in countries “at risk.”
 

"We are requesting $675 million to fund the plan for the next three months. $60 million of that is to fund WHO’s operations – the rest is for the countries that are especially at risk,” said WHO Director-General Tedros Adhanom Ghebreyesus in a press briefing at Geneva, Switzerland.
 

The 2019-nCoV, which originated from Wuhan in Hubei, China, has already spread in more than 25 countries with 191 infected.
 

Ghebreyesus pointed out that the amount needed is part of the Strategic Preparedness and Response Plan, which aims to help countries prevent, detect, and diagnose transmission.
 

“Our message to the international community is: invest today, or pay more later,” he said. "$675 million is a lot of money, but it is much less than the bill we will face if we do not invest in preparedness now.”
 

The WHO also said that it has released a total of $9 million from its own contingency fund for emergency situations such as this coronavirus outbreak.
 

Further, the organization will be sending half a million masks; 350,000 pairs of gloves; 40,000 respirators; and almost 18,000 isolation gowns to the countries affected by the outbreak.

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