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January 28, 2020

What are Coronaviruses?

Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with MERS and SARS. When person-to-person spread has occurred with SARS and MERS, it is thought to have happened via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. Spread of SARS and MERS between people has generally occurred between close contacts. Past MERS and SARS outbreaks have been complex, requiring comprehensive public health responses.

Early on, many of the patients in the outbreak in Wuhan, China reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread. However, a growing number of patients reportedly have not had exposure to animal markets, suggesting person-to-person spread is occurring. At this time, it’s unclear how easily or sustainably this virus is spreading between people. There are ongoing investigations to learn more.

Outbreaks of novel virus infections among people are always of public health concern. The risk from these outbreaks depends on characteristics of the virus, including whether and how well it spreads between people, the severity of resulting illness, and the medical or other measures available to control the impact of the virus (for example, vaccine or treatment medications).

More cases are likely to be identified in the coming days, including possibly more cases in the United States. Given what has occurred previously with MERS and SARS, it’s likely that some person-to-person spread will continue to occur.

Excerpted from CDC website https://www.cdc.gov/coronavirus

What does this mean for patients with primary immune deficiency?

This is a respiratory virus that clearly can be spread by person-to-person contact, e.g. cough, sneezing, etc. Thus, patients with immune deficiency are at risk. There is no data on how severe this respiratory virus can be in PI patients, but judging from the China experience this virus is very serious.

We do not know if there are protective specific antibodies in immunoglobulin (Ig) preparations (IVIG or SCIg). Therefore, we cannot depend on replacement Ig to protect PI patients. Thus, PI patients have to be cautious and stay connected in their geographic location (CDC or local health department) whether there has been any persons in their location with coronavirus infection. If possible, avoid gatherings in which people may be coughing. This time of year there are many respiratory viruses around but it is not possible to identify which persons with respiratory symptoms have the coronavirus.

While masks can catch bacteria and some virus-containing droplets, they are less effective in filtering out fine viral particles in the air. If you decide to wear a mask, it must be worn consistently and correctly. Face masks will not provide protection if they do not have a good fit over your mouth and nose. Additionally, face masks get soiled and need to be changed regularly. As always, frequent hand washing is a must.

IDF will be monitoring this situation closely and if any updates become available as they relate to the PI community, we will provide an updated statement.

Additional information can be found directly from the Centers for Disease Control at https://www.cdc.gov/coronavirus/.