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      SARS-CoV-2 Transmission in a Dental Practice in Spain: After the Outbreak

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      Publication date (Electronic):
      Journal: International Journal of Dentistry
      Publisher: Hindawi

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          Abstract

          The World Health Organization declared a pandemic on March 11, 2020, due to a virus named SARS-CoV-2 discovered in Wuhan, China, in December 2019. Many countries have been hit hard including Spain, with the highest number of healthcare workers being infected (>50,000). A lack of personal protective equipment and protocols at the time of the outbreak led to many fatalities. Although few of these healthcare workers are dental professionals, this community required protective measures as well. Fortunately, there are no reported cases of SARS-CoV-2 transmission in dental practices. Dental professionals were advised only to treat dental emergencies, and such cases were screened via telephone to maintain social distancing. Nevertheless, new protocols and measures are needed as dental professionals return to normal practice after weeks of confinement in many countries. Relatively, few articles have discussed the management of dental practice during the SARS-CoV-2 with no known articles on postpandemic outbreak guidelines. Though some protocols and measures are the same, there are also many differences. Here, we describe protocols and measures for dental practice in Spain in accordance with the Spanish Health Ministry.

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          A Novel Coronavirus from Patients with Pneumonia in China, 2019

          Na Zhu, Dingyu Zhang, Wenling Wang … (2020)
          Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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            Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

            Qun Li, Xuhua Guan, Peng Wu … (2020)
            Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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              A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

              Jasper Chan, Shuofeng Yuan, Kin-Hang Kok … (2020)
              Summary Background An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. Methods In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. Findings From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36–66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3–6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6–10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. Interpretation Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. Funding The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).
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                Author and article information

                Contributors
                Shashi Dadlani:
                ORCID: https://orcid.org/0000-0002-7834-8467
                Journal
                Journal ID (nlm-ta): Int J Dent
                Journal ID (iso-abbrev): Int J Dent
                Journal ID (publisher-id): IJD
                Title: International Journal of Dentistry
                Publisher: Hindawi
                ISSN (Print): 1687-8728
                ISSN (Electronic): 1687-8736
                Publication date Collection: 2020
                Publication date (Electronic): 29 June 2020
                Volume: 2020
                Electronic Location Identifier: 8828616
                Affiliations
                Section of Periodontology, Faculty of Medicine and Health Sciences, University Clinic of Odontology University of Oviedo, Oviedo, Spain
                Author notes

                Academic Editor: Sreekanth Kumar Mallineni

                Author information
                https://orcid.org/0000-0002-7834-8467
                Article
                DOI: 10.1155/2020/8828616
                PMC ID: 7341376
                PubMed ID: 32676111
                SO-VID: 8c38fdb1-1743-4665-b876-0f52e82370f8
                Copyright © Copyright © 2020 Shashi Dadlani.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 May 2020
                Date revision received : 6 June 2020
                Date accepted : 15 June 2020
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Dentistry
                Data availability:
                ScienceOpen disciplines: Dentistry

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