WHO issues new case definition of novel SARS-like coronavirus

January 12th, 2015

Note the distinctive "crown" of a corona virus

The World Health Organization has issued the following revised interim case definition for a novel coronavirus that recently emerged in at least two cases linked to the Arabian Peninsula in the Middle East:

The WHO emphasized that this information was developed based on data from two confirmed cases and thus some degree of clinical judgment is required where individual cases are concerned.

Patients to be investigated (referred to as “Patient Under Investigation”):

• A person with an acute respiratory infection, which may include fever (≥ 38°C , 100.4°F) and cough; AND
• suspicion of pulmonary parenchymal disease (e.g. pneumonia or Acute Respiratory Distress Syndrome (ARDS)) based on clinical or radiological evidence of consolidation; AND
• travel to or residence in an area where infection with novel coronavirus has recently been reported or where transmission could have occurred;* AND
• not already explained by any other infection or aetiology, including all clinically indicated tests for community-acquired pneumonia according to local management guidelines.

Management of Patients Under Investigation:

Patients falling into this category should undergo routinely available laboratory tests as clinically indicated according to local management guidelines for Community-Acquired Pneumonia to determine the presence of other potential primary aetiologies of pneumonia. Examples of other aetiologies might include streptococcus pneumoniae, hemophilus influenza type B, legionella pneumophila, other recognized primary bacterial pneumonias, influenza, and respiratory syncytial virus. It is not necessary to wait for all test results for other pathogens to be available before testing for novel coronavirus. In addition, patients with a clear history and clinical presentation consistent with chemical pneumonitis or smoke inhalation should not be considered as a patient under investigation.

If the respiratory disease is unexplained, appropriate clinical specimens should be sent for laboratory investigation. Rapid progress has been made in the characterization of the novel coronavirus, and in the development of sensitive and specific diagnostic assays. WHO is collaborating with partner laboratories to make these available as quickly as possible. It is anticipated that the first batch of reagents, together with information and testing algorithms, will be available for urgent testing within the coming days.

Until then, WHO is able to provide contact information of laboratories willing and able to test for the presence of the novel coronavirus. For further details, national authorities should contact their respective International Health Regulations Contact Point at their WHO Regional Office.

Appropriate infection control measures should be instituted while the patient is under investigation. Should Member States require further guidance on Infection Prevention and Control, please refer to WHO interim guidelines on Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care