Much is still unknown about the novel coronavirus that emerged in China at the end of the last year and now has spread to 15 other countries, including the United States. There are five confirmed cases in the U.S., but 73 cases are pending and 32 patients have tested negative, the Centers for Disease Control and Prevention reported Monday. There have been cases investigated or underway in 26 states, but the CDC declined to name them.
The Georgia Department of Public Health said it would work with the CDC on any suspected cases but will not release information or numbers about them and will release only limited information about confirmed cases, said spokeswoman Nancy Nydam.
Hartsfield-Jackson Atlanta International Airport is one of five airports where passengers coming from Hubei province in China, the epicenter of the outbreak, who are showing symptoms are being screened.
"Right now, we have a handful of patients with this new virus here in the United States," said Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases at the CDC. "However, at this time in the U.S., this virus is not spreading in the community. For that reason, we continue to believe that the immediate health risk from the new virus to the general American public is low at this time."
There is a lot that is still unknown about the new virus, she said. There are basic questions about how infectious the virus is, what is called the basic reproduction number or the number of additional cases that a single case would generate. Messonnier said she has seen that number as anywhere from 1.5 to 3.
But Dr. Jose Vazquez, the chief of the Division of Infectious Diseases at AU, said he has seen estimates among infectious disease experts that range from 2 to 4 or higher.
"It is going everywhere," he said. "I don't think we know yet."
For comparison, seasonal flu is one additional case per infection, while measles can generate 12 to 18, studies have found.
Another big question is the length of the incubation period before people start showing symptoms an whether people who are asymptomatic can transmit the virus.
Messonnier said she has seen incubation estimated at anywhere from two to 14 days but that the CDC has so far not seen evidence of patients being contagious without symptoms.
However, Vazquez pointed to a study published online Friday in the journal The Lancet of a family cluster infected with the virus treated at a hospital in Hong Kong. Though they had been to Wuhan, none of them had gone to the infamous market with wild animals where the epidemic began, and at least one of the family members appeared to be "shedding virus" or becoming contagious before showing symptoms.
"It's possible that it is going to be transmissible or contagious while the patient is asymptomatic," he said.
So far, there has been no human-to-human transmission of the virus in the U.S., Messonnier said. Even if more cases come, it is unlikely to spread as it did in China, Vazquez said.
"I think here we're ready for it," he said. "Everything is in place. It has been in place since SARS (severe acute respiratory syndrome coronavirus) and then later on since Ebola. I don't think it will be that big of a deal here, I really don't. I'd hate for people to start freaking out and changing trips here. I think we are ready for a pre-emptive management."
One big difference is that public health systems here and in Canada and Europe are much stronger than where the virus is currently spreading. Vazquez said.
"I don't foresee seeing a lot of cases in North America and in Europe," he said.
It is much more likely that seasonal flu will cause more infections and deaths than the new virus, Vazquez said.
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