LAHORE: After emergence of two suspected coronavirus cases in Multan, the health authorities on Saturday started screening of the passengers arriving from China at Punjab’s international airports and those staying in Chinese camps.

Feng Fen, 40, had landed in Karachi a few days ago from Wuhan city and was shifted from a Chinese camp in the Industrial Estate Multan to the Nishtar Hospital on Friday night with symptoms of the virus. He was supposed to visit Multan-Sukkur Motorway -- a project being constructed under the China-Pakistan Economic Corridor (CPEC).

Another patient, Rehmatullah who returned from China on Jan 24, has also been admitted to the health facility with similar symptoms.

The instructions have been issued to focus particularly those Chinese coming from Wuhan city of Hubei province where the outbreak of the disease has claimed many lives.

Health experts say several Chinese including engineers daily arrive in Punjab through the international airports of Lahore, Sialkot and Multan. A key assignment has been given to the Central Health Establishment working at the airports of the province under the National Health Ministry.

A trained technician with full preventive measures should be deputed to collect samples of suspected pneumonia cases caused by coronavirus case. The test on sample presents an extreme biohazard risk and should only be conducted under maximum biological containment conditions.

The chief executive officers (CEOs) have also been directed to pay emergency visits along with the surveillance teams to the Chinese settlements and camps across the province to collect information of those staying there and send reports to the Directorate of Health Services.

The Primary & Secondary Health Department asked the CEOs to get particulars of the Chinese and assess their health status particularly information about flu-like symptoms, respiratory distress and travel history to China during the last two weeks.

According to the World Health Organization (WHO), the novel coronavirus was reported first time in Wuhan city, Hubei in the first week of this month and 44 case patients with pneumonia of unknown etiology surfaced from Dec 31, 2019 to Jan 3, 2020.

Meanwhile, the WHO announced outbreak of the coronavirus in China following disease impact when the situation got out of control in Wuhan.

Pakistan’s federal health ministry generated countrywide health advisory on Jan 21 a day after the WHO confirmed 282 cases of 2019-nCoV from four countries -- China (278 cases), Thailand (two cases), Japan (one case) and the Republic of Korea (one case).

“The objective of this advisory is to alert and sensitise the health staff at border posts as well as in healthcare institutions of Pakistan to stay vigilant about any suspected cases coming from affected areas for an early detection,” reads the health alert of the ministry.

Following the situation, the primary & secondary health department issued high alert at the teaching hospitals to deal with any emergency. It directed the heads of the government sector teaching institutions to establish or activate high dependency units at their respective hospitals to avert any emergency.

A high-level meeting was also called on Saturday to solicit inputs from technical experts, clinicians and public health specialists at the office of the Directorate Health Services, Punjab. The meeting was apprised that outbreak in China had urged the neighbouring countries, particularly Pakistan, to enhance their surveillance and vigilance for response in case of detection.

Speaking about the mode of transmission, the experts told the meeting that recent evidences are highly suggestive that this is a zoonotic disease and primary causes of infections in humans are through contact with infected animals, and animal product.

Substantial evidences are also suggestive of human to human transmission as secondary infections (confirmed by Chinese authorities).

The experts said the observed clinical signs and symptoms of this illness include fever, cough and difficulty in breathing.

Dr Yahya Gulzar and Dr Irfan Ahmad from the WHO Punjab shared with the participants that a coronavirus website had been established and that included points of entry and travel advice, technical package for preparedness guidelines.

They said the WHO reiterated the commitment and would continue technical support for an effective public health response to the potential threat of novel pneumonia cases.

Punjab Communicable Disease Control Director Dr Shahnaz requested that district focal point and rapid response teams must be in close contact with point of entry for surveillance and vigilance. She also suggested that all teaching hospitals’ focal points contact details be updated for effective coordination.

One hospital should also be notified by the specialised healthcare and medical education department as treatment site for novel coronavirus in case of any suspect received, she said.

Dr Shahnaz also requested that focal person for SHC&ME should update status of supplies like protective equipment, face mask and gloves.

Published in Dawn, January 26th, 2020