Note: notifiable medical conditions.
Consult the most recent guidelines from the National Department of Health or NICD.
DESCRIPTION
Viral respiratory illness caused by coronaviruses, including Middle East respiratory syndrome (MERS-CoV), severe acute respiratory syndrome (SARS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 causes coronavirus infectious disease-2019 (COVID-19).
Individuals present with a wide spectrum of clinical presentation ranging from asymptomatic infection to acute upper respiratory illness, and rapidly progressing lower respiratory illness; respiratory failure, septic shock and multi-organ failure resulting in death.
A typical presentation includes:
- fever (>38°C), chills or rigors, cough, shortness of breath
Presentation may include:
- hemoptysis, sore throat, myalgias, diarrhoea, vomiting, abdominal pain
Complications:
- severe pneumonia
- acute renal failure
- ARDS
- refractory hypoxaemia
GENERAL MEASURES
All suspected, probable cases and contacts must be discussed and managed in consultation with the regional virologist or infectious diseases specialist at the referral centre.
Transfer of patients will only occur once all relevant arrangements have been made to limit further exposure to a potential contagious and life threatening agent.
Droplet precautions should be added to the standard precautions. Airborne precautions should be applied when performing aerosol-generating procedures.
Isolate suspected symptomatic cases at all times.
If MERS coronavirus is suspected, isolate patient to limit further exposure.
Management
Treatment
Treatment is supportive.
No antiviral agents or vaccines are currently available.
Management of contact: consult with NICD and isolate contact.
Record and follow-up all patient contacts.
Prevention
Handwashing and the careful disposal of materials infected with nasal secretions. Antiseptic/disinfectant solutions: choroxylenol, benzalkonium chloride, and cetrimide. Chlorhexidine has been shown to be ineffective.
REFERRAL
All cases, after consultation with infectious diseases and NICD.