Novel Coronavirus Infections
Roberto Posada, MD
Associate Professor of Pediatrics (Infectious Diseases) and Medical Education
Icahn School of Medicine at Mount Sinai
New York, NY 10029
roberto.posada@mssm.edu
A novel coronavirus (nCoV) has been identified as the cause of a severe respiratory illness initially
reported to the World Health Organization in September of 2012 by the United Kingdom following
isolation of the virus from specimens of a patient with a travel history to Saudi Arabia and Qatar 1, 2. The
first two known cases have been retrospectively identified as having occurred in Jordan in April 2012.
According to the Centers for Disease Control and Prevention (CDC), there have been 43 confirmed cases
in people from Saudi Arabia, Qatar, Jordan, the United Kingdom, the United Arab Emirates, and France.
Most cases of infection have been characterized by fever, cough and shortness of breath, and a total of
21 patients have died. Renal failure has occurred in some patients. Milder cases have also been reported
3, 4
. There is evidence of person to person transmission of the virus. Two family members of a patient in
the UK 5 and two health-providers in Saudi Arabia were infected after contact with a confirmed case.
Several clusters of cases have occurred, including an ongoing outbreak in Saudi Arabia which began in
April of 2013 and has resulted in 22 cases. No cases have been reported in the United States, but
infection should be considered in individuals with fever and either respiratory distress or pneumonia,
who have a history of travel to the Arabian Peninsula or neighboring countries within 10 days of
presentation, and in whom another explanation for the symptoms has not been identified. Infection
should also be considered in patients who are close contacts of a patient meeting the above case
definition and who present with a severe acute respiratory infection. Laboratory testing is not
commercially available but can be performed at CDC by PCR4. No specific treatment is available against
nCoV. Physicians should alert travelers to the Arabian Peninsula region to immediately seek medical
attention if they develop fever and respiratory symptoms. Currently CDC is not recommending that
travelers to the Arabian Peninsula region change their plans, but travelers are advised to avoid contact
with sick people and wash hands frequently6.
nCoV is a virus genetically different from other coronaviruses known to cause respiratory illness and
from the SARS Coronavirus responsible for the 2003 outbreak 7. It is similar to coronaviruses found in
bats 4, 8.
1.
Global Alert and Response. Coronavirus Infections. World Health Organization. (Accessed May
22, 2013, 2013, at http://www.who.int/csr/don/archive/disease/coronavirus_infections/en/index.html.)
2.
Bermingham A, Chand MA, Brown CS, et al. Severe respiratory illness caused by a novel
coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012.
Euro Surveill;17:20290.
3.
Khan G. A novel coronavirus capable of lethal human infections: an emerging picture. Virol J
1186;10:10-66.
4.
Novel Coronavirus. Centers for Disease Control and Prevention. (Accessed May 23, 2013, at
http://www.cdc.gov/coronavirus.)
5.
Evidence of person-to-person transmission within a family cluster of novel coronavirus
infections, United Kingdom, February 2013. Euro Surveill;18:20427.
6.
Travelers' Health. Novel (New) Coronavirus in the Arabian Peninsula. (Accessed May 23, 2013,
2013, at http://wwwnc.cdc.gov/travel/notices/watch/coronavirus-arabian-peninsula.)
7.
Update: severe respiratory illness associated with a novel coronavirus--worldwide, 2012-2013.
MMWR Morb Mortal Wkly Rep;62:194-5.
8.
van Boheemen S, de Graaf M, Lauber C, et al. Genomic characterization of a newly discovered
coronavirus associated with acute respiratory distress syndrome in humans. MBio 1128;3:00473-12.