Friday, March 20, 2020

First Case of Novel Coronavirus: Who is 'Patient Zero' in COVID-19 Outbreak?

In medical science, "Patient zero" ( or index case) may refer to the first case of a condition or the first documented patient in the epidemic disease within a population.
According to a Chinese government study reviewed by the South China Morning Post (SCMP), the Chinese authorities detected the first case of Coronavirus disease 2019 (COVID-19) on 17 November 2019.
There are differences between Chinese authorities and experts regarding the origin of coronavirus, particularly on the issue of who is the 'patient zero' of the coronavirus outbreak?
coronavirus outbreak
Chinese scientists identified a novel coronavirus as the main causative agent that cases coronavirus disease 2019 (COVID-19). Coronavirus pandemic is rapidly evolving, and outbreak investigations are ongoing.

First Case of Novel Coronavirus: Who is 'Patient Zero' in COVID-19 Outbreak?

With advances in genetic analysis, it is possible to find out the lineage of a virus, so that it can be known who the first person to spread the infectious disease is.
Finding this can provide answers to some important questions about when, where and how the disease started spreading. This information can help protect more people from getting infected in the present and future.
Do we know who the 'Patient Zero' of Coronavirus or Covid-19 is? The short answer is - 'No'.



First Case of Novel Coronavirus

Coronavirus disease 2019 (COVID-19) outbreak was first reported in Wuhan, Hubei, China.  
According to a Chinese government study, reviewed by the South China Morning Post (SCMP), the Chinese authorities detected the first case of Coronavirus disease 2019 (COVID-19) on 17 November 2019.
Yet it has still not been confirmed that this case is really the fabled “Patient Zero.”
The World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) as a pandemic on 11 March 2020

The Chinese authorities had earlier reported that coronavirus first case was identified on 31 December 2019 and that many people with pneumonia-like symptoms were among the first cases of COVID-19 and they all belonged to the Huanan Seafood Wholesale Market in Wuhan city of Hubei province.

The Huanan Seafood Wholesale Market was been linked to the early cases of coronavirus. Wuhan city is considered the epicenter of the outbreak and according to data gathered by Johns Hopkins University, about 82% of the cases reported in China and the rest of the world, ie more than 75,000 cases, have been found here. The Chinese administration closed this market soon.

However, according to a study report published by Chinese researchers in Lancet Medical Journal, the first person to be infected with Covid-19 was reported on December 1, 2019 and this person was not exposed to the fish wholesale market of Huanan.

BBC reported: The first novel coronavirus disease (COVID-19) patient was a bed-bound pensioner who had no connection to the Huanan Seafood Wholesale Market, where Beijing officials say the outbreak began.
The earlier paper stated that 14 of the first 41 patients were not linked to the Huanan seafood wholesale market.

Wu Wenjuan, a senior doctor at the Wuhan Jinyintan Hospital and one of the researchers who produced the report told the BBC's Chinese Service that the patient was aged and had Alzheimer's disease.
Wu Wenjuan said, "The patient lived four to five bus stops away from the fish bar. He was ill and therefore did not go out."

Researchers also found that in a sample of 41 patients admitted to the hospital in the initial phase of the outbreak, there were 27 people who were 'exposed to the fish market'.

According to the World Health Organization, the hypothesis that came out at the beginning of the coronavirus outbreak is still considered the most likely that the disease spread to humans through an animal before spreading human-to-human.



Can a Person Really Trigger a Massive Outbreak?

According to the World Health Organization, the West African Ebola virus epidemic spread from 2014 to 2016 was the most widespread epidemic outbreak, killing more than 11,000 people and infecting more than 28,000 people.

The virus that gave rise to the disease was first discovered in 1976. The Ebola outbreak lasted for two years. However, Ebola cases were found in ten countries, most of them in West Africa. But some cases were also found in the USA, UK, Spain, and Italy.

Scientists concluded that the Ebola outbreak in western Africa originated from a two-year-old boy from Guinea and is believed to have been infected with the virus by bats. It is believed that this child must be playing outside the house under a tree where there was a flock of bats.

But before publishing their report on the source of the Ebola virus epidemic, the scientists visited this child's village and collected samples and talked to the people there.

But the world's most famous 'patient zero' is Mary Mallon, also known as Typhoid Mary. The 1906 Typhoid outbreak in New York started with her. She came to live in America from Ireland. She used to cook for rich families in New York. Doctors found that typhoid infection occurred in all the families where she worked.

The doctors called her a healthy carrier, ie a person in whom the symptoms of the disease do not show up despite the infection of the disease, but they keep infecting many other people.
Some people can spread the infection far more effectively than others and are called 'super spreaders'.



'Patient Zero'
'Patient zero' or 'index case' means the first person to be infected with a viral or bacterial disease.

It is scientifically important for people and public health to understand index cases so that scientists know how diseases are coming into a community and how to prevent their spread.
But a sense of stigma is associated with the term 'Patient Zero'.
Many scientists and public health officials avoid the term "patient zero" and are loath to identify those patients because of the possibility of discrimination or harassment.

The most famous example of this is the person who was mistakenly considered the 'patient zero' of the AIDS epidemic.

Gaëtan Dugas, a Canadian flight attendant, was an HIV patient who would be seen as the most condemned patient in history as he was held responsible for the spread of HIV in the United States in the 1980s.

Gaëtan Dugas once was widely regarded as "Patient Zero" or the primary case for AIDS in the USA. But, thirty years later, scientists found that he could not be the first patient of HIV.
In 2016, research showed that the virus had already reached America from the Caribbean region in the early 1970s. However, the term 'patient zero' was mistakenly introduced due to the HIV epidemic.

It's 'Patient O,' Not 'Patient Zero'
Researchers at the Center for Disease Control and Prevention investigating the outbreak of AIDS in Los Angeles and San Francisco in the early 80s used the letter "O" to indicate any case outside the state of California but other researchers erroneously deemed it 0 (zero) and so the term 'patient zero' was born.

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