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New Outbreak Shows Signs the Virus May Be Changing
Published on: 2020-05-21
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change 01Chinese doctors are seeing the coronavirus manifest differently among patients in its new cluster of cases in the northeast region compared with the original outbreak in Wuhan, suggesting the pathogen may be changing in unknown ways, complicating efforts to stamp it out.
 

Patients in the northeast provinces of Jilin and Heilongjiang appear to carry the virus for a longer period of time and take longer to test negative, Qiu Haibo, one of China’s top critical care doctors, said Tuesday on state television.

change 03Patients in the northeast also appear to be taking longer than the one to two weeks observed in Wuhan to develop symptoms after infection. This delayed onset is making it harder for authorities to catch cases before they spread, said Qiu, who is now in the northeastern region treating patients.


“The longer period during which infected patients show no symptoms has created clusters of family infections,” said Qiu, who was earlier sent to Wuhan to help in the original outbreak. Over the past two weeks, 46 cases have been reported across three cities — Shulan, Jilin city and Shenyang - in two provinces. The resurgence of infection sparked renewed lockdowns over a region of 100 million people.


Scientists still do not fully understand whether the virus is changing in significant ways. The differences Chinese doctors are seeing could reflect their ability to observe patients more thoroughly and from an earlier stage than in Wuhan. When the outbreak first exploded in the central Chinese city, the local health-care system was so overwhelmed that only the most serious cases were being treated. The northeast cluster is also far smaller than Hubei’s outbreak, which ultimately sickened more than 68,000 people.

chang 05Still, the findings suggest that the remaining uncertainty over how the virus manifests will hinder governments’ efforts to curb its spread and reopen their battered economies. China has one of the most comprehensive virus detection and testing regimes globally and yet is still struggling to contain the new cluster.


Researchers worldwide are trying to ascertain whether the virus is mutating in a significant way to become more contagious as it races through the human population, but early research suggesting this possibility has been criticized for being overblown.


"In theory, some changes in the genetic structure can lead to changes in the virus structure or how the virus behaves,” said Keiji Fukuda, director and clinical professor at the University of Hong Kong’s School of Public Health. “However, many mutations lead to no discernible changes at all.”


It’s likely that the observations in China don’t have a simple correlation with a mutation, he said. “Very clear evidence” is needed before concluding that the virus is mutating, he said.


吉林新冠肺炎病毒的潜伏期更长,输入性病例和武汉有区别


舒兰洗衣工确诊后的近两周时间以来,新冠病毒在吉林持续传播,目前被确诊的病例已经增加至43人,并且出现了非密切接触病例。


国家卫健委救治专家组成员邱海波指出:


第一,从基因的测序来讲,吉林和黑龙江的病例多数是输入相关病例,跟输入病例的病毒完全一致,跟湖北本土病例的病毒不太一样。

第二,从临床上看,黑龙江、吉林两省确诊病例的病程潜伏期较长,病人没有症状,造成一些家庭聚集性传播。

第三,黑龙江、吉林两省确诊病例的临床症状不太典型,发烧的病人不是太多,有不少病例都没有发烧,就是乏力或者有点咽痛的表现。而武汉病例的临床特点是病人多器官受累,不仅仅是肺受累,还往往有心肌、肾脏、肠道的损害,而输入关联病例往往以肺的损害为主,很少心脏损耗、很少有肌酐蛋白损伤的标志,而且很少看到有肾脏损害或者肠道损害。所以临床的损害以肺部为主,单器官为主,不是多器官的模式。

第四,黑龙江、吉林两省确诊病例病毒携带时间较长。在武汉,患者一般有症状以后,一周或者顶多两周他的核酸就转阴了,而黑龙江、吉林两省输入关联病例核酸转阴速度也比较慢。比较好的一点是,黑龙江、吉林重症病例的比例比武汉低,发展成重症的比例不超过10%,另外治疗反应相对也比较好,这样病人对抗病毒,包括中医治疗更有信心。

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