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expert reaction to five British nationals who tested positive for coronavirus in France

There has been a five confirmed cases of a British nationals who have tested positive for coronavirus in France.

 

Prof Jonathan Ball, Professor of Molecular Virology, University of Nottingham, said:

“Apparently these five cases can be linked back to a male who was diagnosed with the virus in Brighton on the 6th February. He had returned from Singapore on the 24th January.  It is unclear if the individual was showing any symptoms whilst he was staying in France, or in the few days when he was in the UK before his diagnosis. It is important to understand this, as we need to know whether or not somebody who is not showing symptoms can transmit the virus. Either way, the fact that this led to 5 new infections highlights how transmissible this virus can be. It also shows that contact tracing can work across international borders.”

 

Prof Sheila Bird, Honorary Professorship at Edinburgh University’s College of Medicine and Veterinary Medicine and formerly Programme Leader at MRC Biostatistics Unit, Cambridge, said:

“Today’s account of travel from Singapore via French ski resort chalet before return to UK on 28th January 2020 yet UK-diagnosis of this index case confirmed only on 6th February suggests that the index case was pre-symptomatic when he was in France. Five chalet-related transmission occurred, nevertheless, to members of two families.

“Effective diagnostic testing for the novel coronavirus earlier in the exposure-period of at-risk contacts is clearly desirable. The five Britons’ symptoms are mild and, hopefully, their early treatment will speed their recovery.”

 

Dr Bharat Pankhania, from the University of Exeter Medical School, said:

“These new cases in France are no surprise. As infection is ongoing and we have a large number of potentially exposed and infected people, we expect that cases will start to arise, both in other parts of the world and in the UK, from people whose infection did not originate in China or the countries that have so far been the focus of attention, such as Thailand, Hong Kong and Singapore. 

“The confirmation of cases arising from countries very distant from China implies a need to further review what we can do to delay the introduction of the infection into the UK as much as is possible.  This signals that it could be time to review our control guidance, information and advice for people arriving into the UK from anywhere, however this is not an easily accomplished task.

“The important advice for  travellers to be cautious for 14 days after arriving in the UK to help control the spread of infection is still very valid.  The advice is if they have symptoms such as cough or shortness of breath, fever,  – even if they are relatively mild – they should isolate themselves and seek medical advice by phone, via their GP or NHS 111. It is important that they don’t turn up at a hospital of GP surgery. Thus far the strategy to contain the virus appears to be working.

“It’s reassuring that the UK has increased capacity for testing to regional laboratories, outside the main laboratory in London, as this will speed up the process of testing samples.”

 

Prof. Rowland Kao, Sir Timothy O’Shea Professor of Veterinary Epidemiology and Data Science, Royal (Dick) School of Veterinary Studies, University of Edinburgh, said:

“ These cases originating from contacts in Singapore change the game as far as contact tracing is concerned. As we know there will be a substantial window of risk around when the cases occurred, as well as the additional risks associated with the British cases, as the French ski resort where they were staying is likely to result in a wide range of international contacts themselves. We are likely reaching the point where the tendrils of transmission risks reaching out from China are becoming a web; one that would require considerably greater resources to control.”

 

Prof Paul Hunter, Professor in Medicine, University of East Anglia (UEA), said:

“The recent report of transmission to british nationals in France are a worrying but perhaps not unexpected development.  This reports reinforces the fact that transmission is no longer restricted to China. It is still to early to know when and if the epidemic will become pandemic and whether we will see start to see sustained person to person transmission in Europe. 

“There have been relatively few reports of infection in children but it does appear that children have a relatively mild illness. It is not yet clear whether infection in children will be an important source of infection for others. 

“The group of affected British Nationals will be isolated until recovery and will be being questioned in depth about their recent contacts with others. Any such contracts will be advised to avoid crowded environments and seek immediate medical attention if they develop symptoms. 

“As yet this report does not substantially affect the risk assessment for people in the UK but Public Health England will be frequently reviewing this.” 

 

Prof William Keevil, Professor of Environmental Healthcare, University of Southampton, said:

“The new British cases in the French ski resort included a child, showing that this virus is not limited to older, more vulnerable people and one infected person can cause a cluster of cases. The clinical status of the Singapore guest is not known but ideally, they should have self-isolated if they experienced any symptoms, although this would be difficult in a shared chalet. Alternatively, they may have shed virus without showing any respiratory symptoms. A recent paper by Wang and colleagues1 showed that fit hospital staff in Wuhan are just as susceptible as patients.  One infected patient with asymptomatic abdominal pains infected 10 medical staff and 4 patients in one ward; asymptomatic abdominal pains have been linked to faecal shedding, as with SARS which also spread in urine.  This may suggest spread of the virus in faeces, for example after using the toilet, and highlights the importance of good hand hygiene and regular surface disinfection not just in hospitals but in the home. “

  1. https://jamanetwork.com/journals/jama/fullarticle/2761044

 

Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton, said:

“Singapore is a major transport hub in south-east Asia, so going forward, we may well find further international cases that have travelled through Singapore.  This cluster of cases in France illustrates how the coronavirus can spread to countries indirectly of China. The French ski resort will have citizens from numerous other countries there, so there are implications for potential onward transmission. Hopefully further people will not also have been exposed and infected, and this specific localised outbreak can be immediately contained.”

 

All our previous output on this subject can be seen at this weblink: http://www.sciencemediacentre.org/tag/wuhan-coronavirus/

 

Declared interests

None received. 

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