PreprintPDF Available

A theoretical discussion of the possibility and possible mechanisms of using sesame oil for prevention of 2019-nCoV (COVID-19 coronavirus) from the perspective of colloid and interface science

Authors:
Preprints and early-stage research may not have been peer reviewed yet.

Abstract and Figures

Due to the spread of 2019-nCoV (COVID-19 coronavirus), 9 million people are being isolated in the city of Wuhan in China, and more than thirty-four thousand people have been infected by the coronavirus up to February 8, 2020. The coronavirus is airborne and highly infectious at short contact distances. The use of high-efficiency respirators or masks (eg, N95 respirators) can protect people against the coronavirus, but the protective effect may be insufficient when the filtration efficiency of masks is not high enough or the wearing of masks is inappropriate. A folk method states that the adding of sesame oil in nostrils can prevent the spread of plague, but the validity and mechanism of this method still remains uncertain. Based on our previous studies on colloid and interface science, we think there are some theoretical reasons to support the sesame oil method for preventing viral infection by considering the physical-chemical properties of sesame oil, such as low surface tension, high-boiling point, high viscosity, immiscible with water and antivirus activity. This manuscript mainly discusses the possible physical-chemical mechanisms involved in the sesame oil method, and also proposes some potential methods for preventing the virus infection if the mechanisms of the sesame oil method can be confirmed by further experimental and clinical results, and may finally contribute to prevent the spread of the coronavirus as soon as possible.
Content may be subject to copyright.
A theoretical discussion of the possibility and possible mechanisms of using
sesame oil for prevention of 2019-nCoV (Wuhan coronavirus) from the
perspective of colloid and interface science
Wen Fan1, Jing Zeng2, Yunfeng Xu1
1School of Materials Science and Engineering, Ministry of Education Key Laboratory
for the Green Preparation and Application of Functional Materials, Hubei University,
Wuhan, Hubei, 430062, China
2Department of Materials Science, Fudan University, Shanghai 200433, China
Email: fanwen@hubu.edu.cn
Abstract: Due to the spread of 2019-nCoV (Wuhan coronavirus), 9 million people
are being isolated in the city of Wuhan in China, and more than thirty-four thousand
people have been infected by the coronavirus up to February 8, 2020. The coronavirus
is airborne and highly infectious at short contact distances. The use of high-efficiency
respirators or masks (eg, N95 respirators) can protect people against the coronavirus,
but the protective effect may be insufficient when the filtration efficiency of masks is
not high enough or the wearing of masks is inappropriate. A folk method states that
the adding of sesame oil in nostrils can prevent the spread of plague, but the validity
and mechanism of this method still remains uncertain. Based on our previous studies
on colloid and interface science, we think there are some theoretical reasons to
support the sesame oil method for preventing viral infection by considering the
physical-chemical properties of sesame oil, such as low surface tension, high-boiling
point, high viscosity, immiscible with water and antivirus activity. This manuscript
mainly discusses the possible physical-chemical mechanisms involved in the sesame
oil method, and also proposes some potential methods for preventing the virus
infection if the mechanisms of the sesame oil method can be confirmed by further
experimental and clinical results, and may finally contribute to prevent the spread of
the coronavirus as soon as possible.
Keywords: 2019-nCoV, sesame oil, colloid, interface, surface tension, antivirus
activity
Introduction
In December 2019, the novel coronavirus (2019-nCoV or so-called Wuhan
coronavirus) was first found in pneumonia patients living in Wuhan, China. The
2019-nCoV is the seventh coronaviruses known to infect humans, and is capable of
human-to-human transmission. The viruses can cause respiratory infection symptoms
including fever, dry cough, shortness of breath and respiratory distress[1-4].
Morphologically, the 2019-nCoV is a spherical particle with a size ranging from
60 nm to 140 nm under the observation of transmission electron microscope (TEM).
The virus is surrounded by 9-12 nm long club-shaped viral spike peplomers, which
are proteins (S-proteins) that are located on virus envelope and determine host tropism,
and also leading to a corona-like appearance[1].
The S-proteins on 2019-nCoV are regarded to have strong binding affinity to
human Angiotensin converting enzyme 2 (ACE2), although the binding free energy
between the 2019-nCoV S-protein and ACE2 (-50.6 kcal mol–1) is calculated to be u
than that between the severe acute respiratory syndrome coronavirus (SARS-CoV)
S-protein and ACE2 (-78.6 kcal mol–1)[5]. Thus, when the S-proteins can bind to the
surface receptors of sensitive cells, the virus will entry into the target cells for further
replication[5-7].
Recent research indicates that the ACE2 virus receptor expression is
concentrated in a small population of type Ⅱ alveolar cells (AT2) in human lungs,
which expresses many other genes favoring the viral process. The abundant
expression of ACE2 in a population of AT2 leads to the severe alveolar damage after
infection, namely pneumonia. The cell-type-specific expression pattern of ACE2
indicates that the ACE2 is also sparsely expressed in type alveolar cells (ATⅠ),
airway epithelial cells, fibroblasts and endothelial cells[6].
The 2019-nCoV is now rapidly spreading in Wuhan, which is the capital of
Hubei province and also the largest city in central China. In order to prevent the
spread of the virus to other areas in Hubei, China and even the world, Wuhan and
Hubei have restricted their public transportation to each other areas. At present, 9
million people are being isolated in Wuhan, 34,598 people have been infected by the
2019-nCoV, and 27,657 people are suspected to be infected up to February 8, 2020.
Currently, the isolation of people is very necessary, but a long time isolation of many
people can cause considerable economic losses to people and society.
In the following, we first investigate the epidemiological features of 2019-nCoV,
and then give some theoretical discussion on the possibility and possible mechanisms
of using sesame oil for prevention of 2019-nCoV from the perspective of colloid and
interface science.
Epidemiological analysis
Up to now, the epidemiological characteristics found in the 2019-nCoV include:
1. The outbreak of the 2019-nCoV happened in winter (that is, December 2019 to
January, 2020), the same months as SARS-CoV (December 2002 to January,
2003)[3,8];
2. There were strong evidences of human-to-human transmission of 2019-nCoV
among the close contacts of infected patients[9];
3. Among the first 425 patients, the median age was 59 years and 56% were male.
The mean incubation period was 5.2 days with the 95th percentile of the distribution
at 12.5 days, and the basic reproductive number was estimated to be 2.2[9];
4. Importantly, there were 2019-nCoV-infected people with no obvious clinical
symptoms or long incubation period but were still capable of infecting other people in
close contact[10-12]. These asymptomatic infected people may pose a serious risk for
the transmission of infection to healthy population.
Here, we discuss possible mechanisms to explain the above phenomena:
1. In winter, the temperature decreases and the air becomes cold and dry. The
breathing of cold dry air can lead to unfavorable changes in the upper respiratory
system (the nasal cavity, pharynx and larynx)[13-15]. For example, in nasal mucosa, the
cold air may cause a vasoconstriction of the nasal mucosa and thereby an inadequate
supply of blood and nutrients to support the anti-virus functions of the nasal
mucosa[13-15]. For instance, the cold air-induced slowing of mucociliary clearance of
the nasal passage can encourage viral spread into the respiratory tract[13-15]. In addition,
exposure to dry air can also impair host defense against viral infection and reduce
tissue repair[16]. Thus, the climatic conditions in winter can reduce the protective
immunity of the population, and infections occur and spread more commonly during
the winter[17-21], and this may explain both the outbreak of SARS-CoV and
2019-nCoV in the winter.
The statistical data on SARS indicates that the number of infected people
reached a maximum value around May 2003, then gradually reduced to zero around
July 2003. This may be related to better climatic conditions (eg, high temperature and
high relative humidity environment) could lead to an increased protective immunity
against virus infection[22].
2. Similar to SARS-CoV, the transmission of 2019-nCoV may occur
predominantly through direct mucous membrane (nose, mouth or eye) contact with
infectious respiratory droplets within close vicinity of an infected person, and/or
through exposure to fomites, such as hand-to-mouth (or hand-to-nose and hand-to-eye)
contact with fomites, and inhalation of virus-containing aerosols generated from the
evaporation of respiratory droplets produced by patients during coughing, sneezing or
even talking[23-28]. Research on SARS-CoV indicates that the aerosol should not be
distributed evenly in an enclosed space, that is, the aerosol concentration decays as
one moves away from the source[29]. Thus, close or long-term contact with an infected
patient is considered to be a major risk factor for infection.
3. The 2019-nCoV can have a long incubation period of up to 14 days, and a
more worrying feature of the 2019-nCoV is that asymptomatic or mild cases could
transmit the virus to other healthy people[10,30-32]. There are also 2019-nCoV infected
patients that have developed respiratory failure and severe pneumonia after infection
of 2019-nCoV, many of them are older patients with underlying diseases[33-35].
Based on the discussion above, we guess there is a possibility to explain these
phenomena:
For asymptomatic infected people, they may have a strong protective immunity
in their upper respiratory tract system even in the winter, thus the 2019-nCoV cannot
enter the lower respiratory tract. Because it has been demonstrated that tissues of the
upper respiratory tract, such as oral and nasal mucosa and nasopharynx, did not show
ACE2 expression on the surface of epithelial cells[36,37], the 2019-nCoV can be treated
as “a common virus” by the body, and the virus only stays and replicates in the
invasion site of upper respiratory tract. These asymptomatic infected people may
produce infectious respiratory droplets and virus-containing aerosols by talking or
even breathing and become virus spreaders.
A Statistical analysis on SARS showed that SARS occurred more frequently at
7-12 days later after a sudden drop in air temperature from a gradually rising air
temperature[38,39]. This indicates that sometimes the SARS-nCoV may be already
present and “living” in the upper respiratory tract of people, but is blocked from
entering the lower respiratory tract due to the better protective immunity in upper
respiratory tract during higher air temperature. While a sudden drop in temperature
will reduce the protective immunity of upper respiratory tract, thus the virus has
increased opportunities to infect the lower respiratory tract.
For some infected people, their protective immunity in upper respiratory tract
system is weaker (especially those older or frail people) and the 2019-nCoV has more
opportunities to invade the lower respiratory tract. After the entry of virus in the lower
respiratory tract, the S-proteins on the surface of the 2019-nCoV can bind to the
surface receptors (ACE2) of sensitive cells (AT2), then leading to the development of
pneumonia.
A possible approach may help to prevent 2019-nCoV
Currently, the use of personal protective equipments, such as N95 respirators,
surgical masks, gloves and goggles can offer a level of protection against the
transmission of the coronavirus[40-43]. N95 respirators or surgical masks are especially
necessary to prevent droplet-spread and airborne transmission of infectious agents
because of their high filtration efficiency[41]. A study on SARS-nCoV indicates that
N95 respirators may offer more protection than surgical masks[40]. While some other
studies indicate that there is no significant difference in protection between them[41,43].
The main risk factors for 2019-nCoV infection may be the inappropriate use of
respirators or masks, or the use of masks with lower filtration efficiency when people
are in direct contact or close proximity to infected patients[43,44].
The development of the protective drugs or vaccines for 2019-nCoV is in the
process[45]. A potential problem is that if the production of drugs can meet the needs of
a large number of people in a short period[46,47].
Some people are afraid of the 2019-nCoV and propose to use some folk methods
for preventing the infection of the virus. For example, some people tend to use sesame
oil. Because a Chinese medicine book named <串雅内外编> (1759 AD) says that if
sesame oil is added and coated to a person's nostrils, the person will not be infected by
plague when the person go to a plague patient's home[48-50]. Recently, the Indian
government gave similar recommendations that instilling two drops of sesame oil in
each nostril every morning can be used to prevent the new coronavirus, according to
their ancient ayurvedic medicine[51]. However, many news reports claim that the
sesame oil method is useless and sesame oil could not protect people from viral
infection[52,53].
At present, we think there is no clinical or theoretical evidence to show that the
sesame oil method is invalid or valid. Many Chinese folk medical methods were the
life experiences accumulated by the ancient Chinese people, although they may not
know the mechanism. Some folk medical methods may have high value. For example,
inspired by traditional Chinese medicine book named < 肘 后 备 急 方 > (340 AD),
Youyou Tu discovered artemisinin and dihydroartemisinin and used them to treat
malaria, saving millions of lives across the globe[54-56]. Thus, we need to pay more
scientific attention to the potential useful clues from the folk medical methods.
We think, from the perspective of colloid and interface science, there may be
some reasons to consider that the sesame oil method may have the potential to protect
people from infection of virus. The following is a theoretical analysis and assumption
of the possibility and possible mechanism of using sesame oil to prevent infection of
virus:
First, sesame oil is an edible vegetable oil derived from sesame seeds[57]. Pure
sesame oil has a relatively low surface tension (about 28 mN/m at 28°C) and is
incompatible with water[58,59]. Thus, because the relatively low intermolecular
attraction between adjacent sesame oil molecules, pure sesame oil has a good
wettability and can readily wet the surface of various solid and aqueous phases. For
example, Figure 1 shows that when pure sesame oil was dropped onto the surface of
water, the sesame oil was readily and rapidly spread out on the water surface. Our
previous study published in Science Advances indicates that a low surface tension oil,
such as hexane (18.4 mN/m at 25°C) or silicone oil (about 16-21 mN/m at 25°C) can
sufficiently wet the surface nanostructure of various solids[60]. Thus, when sesame oil
is added and coated to a person's two nostrils, the sesame oil may wet the nasal
mucosa and act as a large area of protective layer. In addition, sesame oil has a high
boiling point of about 215 °C, thus the protective layer may remain for a longtime.
Figure 1. The spreading out of pure sesame oil onto the surface of water indicates that
sesame oil has a low surface tension.
Second, the protective layer of sesame oil onto the nasal mucosa may has a
suitable surface tension, viscosity, adhesion and thickness to catch and trap the virus
particles when a person is breathing with his nose, and thus preventing the direct
contact and binding of virus onto the surface of nasal mucosa, as shown in Figure 2.
Figure 2. (A) The catching and trapping of virus particles by the sesame oil protective
layer onto the nasal mucosa. (B) The sesame oil layer may block the physical contact
between the virus nanoparticles and the nasal mucosa surface.
Figure 3 shows the schematic diagram of possible interface behavior of
virus-containing aerosols or virus-containing aqueous droplets at the air/sesame oil
interface. Generally, the adsorption behavior of dried particles at an air/oil interface
can be determined by the combined contributions of various effects, including the
hydrophilic and hydrophobic properties of particles, particle surface morphology,
particle size, air/oil surface tension, three-phase contact angle, oil viscosity and oil
density, etc[61-63]. Overall, a lower air/oil surface tension will facilitate the adsorption
and entrance of dried particles at the air/oil interface. For submicron-sized or
micron-sized aqueous droplets containing virus nanoparticles, the droplets could be
absorbed at the air/oil interface[61]. Because water has slight solubility in sesame oil,
the virus nanoparticles could enter into the oil phase after the solution of water in
sesame oil.
Figure 3. Schematic diagram of the possible adsorption process of virus-containing
aerosols or virus-containing aqueous droplets at the air/sesame oil interface.
A recent study suggests that compared to the SARS-nCoV, the S-protein on the
2019-nCoV has additional hydrophilicity in the protein structure, thus may provide an
enhanced affinity towards host cell receptors and might have also increased the range
of host cells that 2019-nCoV can infect, thereby may increase the infectivity of
2019-nCoV[64].
Thus, the coating of sesame oil onto mucosal surface may increase the surface
hydrophobicity of mucosal surface, and thereby decreasing the binding ability of
2019-nCoV S-protein to mucosal cells.
Figure 4. The envisaged protective layer of sesame oil coated onto the surface of
nasal cavity, oral cavity and throat.
To achieve better protection effect, a person could also slowly drink some
sesame oil and keep some sesame oil in the mouth, and thus let the sesame oil cover
the mucosal surface of oral cavity and throat, as shown in Figure 4. This may further
increase the protected area and thus reduce the chance of infection by virus during
talking or mouth breathing, and may be especially useful in high-risk areas, such as
hospital environments or family environments with patients.
Third, generally, dried SARS-CoV can retain its infectivity for as long as six
days[65], but SARS-CoV and 2019-nCoV are also sensitive to various disinfectants,
including diethyl ether, 75% (v/v) ethanol solution, chlorinated disinfectants, fatty
solvents such as peracetic acid and chloroform[66,67].
At present, there is little experimental or theoretical investigation on the
inactivation ability of sesame oil to coronavirus, but we think that there is a
potentiality. Because the sesame oil has a low surface tension similar to that of 75%
ethanol solution (about 25 mN/m at 20 °C)[68], which may help to disrupt the surface
structures and functions of the virus. Moreover, sesame oil is composed of various
saturated or unsaturated fatty acids, including linoleic acid (41% of total fatty acids),
oleic acid (39%), palmitic acid (8%) and stearic acid (5%)[57,69]. Some fatty acids,
especially the unsaturated fatty acids, have been proven to be active against some
enveloped viruses[70-75].
For example, it has been demonstrated that incubation of vesicular stomatitis
virus with linoleic acid (a type of unsaturated fatty acid) can lead to leakage of viral
envelopes. This effect was far more pronounced with a higher linoleic acid
concentration, causing disintegration of viral particles. It was suggested that the
antiviral mechanism is due to the fatty acids can be incorporated into the lipid
membrane of viral envelopes, causing destabilization of the bilayer of viral
envelopes[70]. Interestingly, a recent study revealed that exogenous supplement of
linoleic acid or arachidonic acid in human coronavirus 229E-infected cells was
capable of significantly suppressing the coronavirus replication. This inhibitory effect
was also observed in the highly virulent Middle East respiratory syndrome
coronavirus[75].
Thus, if the structures and functions of the 2019-nCoV S-protein or the viral
envelope could be disrupted by sesame oil, the 2019-nCoV would be considered
harmless to human body, even if the viral RNA cannot be damaged.
Fourth, very importantly, sesame oil is a non-toxic and harmless cooking oil, and
can be easily found in most Chinese kitchens, and people can buy it everywhere. If
the sesame oil method can really work, every people can quickly and easily protect
themselves in various indoor and outdoor environments, and the combined use of a
mask and the protective layer of sesame oil may well prevent the further development
of the epidemic.
Moreover, commonly used disinfectants, such as 75% ethanol solution and
chlorinated disinfectants, cannot be used into human body because of their stimulation
or toxicity to body. While sesame was cultivated more than 5000 years ago, and
sesame seeds were one of the first crops processed for oil as well as one of the earliest
condiments. In industry, sesame oil can be used as a solvent in injected drugs,
intravenous drip solutions or a cosmetics carrier oil[57,77]. Thus, the safety of sesame
oil is well appreciated.
The first author of this manuscript had added two drops of sesame oil to each
nostril and added 1 mL sesame oil to mouth every morning for seven days, most of
the time there was no discomfort. A few times there was a sore throat similar to that of
a common cold, but the sore throat usually disappeared after several minutes. This
sore throat may be caused by an immune response in the upper respiratory tract due to
unknown reason at present.
Thus, we think some experimental and clinical studies can be carried out for this
sesame oil method, and to find out if the method is valid or not. For example, we can
examine if the 2019-nCoV can still invade the cultured sensitive cells after coating a
sesame oil layer onto the cells. If the sesame oil method can really work, we may
prevent the spread of virus as soon as possible. If the sesame oil method is invalid and
even harmful, no one will use the method in the future.
If the sesame oil method can really work, that is, sesame oil can inactivate the
2019-nCoV or prevent the infection of 2019-nCoV, there are also some helpful
suggestions:
1. For the asymptomatic infected people, we can examine if it is possible to
inactivate the 2019-nCoV in their bodies (or upper respiratory tracts) by adding
sesame oil to their nostrils and mouth, since sesame oil is capable of
permeating and entering the blood stream through the capillaries[77].
2. We can apply sesame oil to the surface of frequently contacted objects, such
as tables, door handles, our hands and faces. Because sesame oil has a low surface
tension and a high boiling point, sesame oil can wet the surface of various objects and
can also maintain for a longer time. While 75% ethanol solution is easily volatilized
and lose its disinfection capacity due to the low boiling point of ethanol (78 °C).
4. We can spray sesame oil into the air, for example, spraying sesame oil around
infected patients and to inactivate the virus aerosols around patients. The inhalation of
sesame oil molecules to patients' nostrils and lungs could be non-toxic and perhaps
even beneficial. While an excessive use of some other disinfectants, such as
chlorinated disinfectants, are potentially harmful to human health and the
environment.
5. Preventing the transmission of infectious diseases spread by airborne virus
poses a significant challenge[41]. We can use a napkin containing sesame oil to cover
the nose and mouth before the wearing of a mask. In this combination, the mask can
be used to block the larger virus-containing droplets, while the napkin can be used to
adsorb, trap and inactivate the virus in aerosols that is capable of passing through the
mask. This may be useful when a high protection level N95 respirators or surgical
masks are not available.
6. We can also investigate the antiviral effects of other edible oils that have a low
surface tension, a high boiling point and contain a high proportion of unsaturated fatty
acid, such as olive oil, linseed oil and tea seed oil.
In summary, the above discussion provides some possible mechanisms and
thinking of using sesame oil to prevent the infection of the 2019-nCoV from the point
of view of colloid and interface science. Nevertheless, this sesame oil method should
not be used until it has been verified and approved by future experimental and clinical
studies.
References
[1] Zhu, Na, et al. "A Novel Coronavirus from Patients with Pneumonia in China,
2019." New England Journal of Medicine (2020).
[2] Hui, David S., et al. "The continuing 2019-nCoV epidemic threat of novel
coronaviruses to global health-The latest 2019 novel coronavirus outbreak in
Wuhan, China." International journal of infectious diseases: IJID: official
publication of the International Society for Infectious Diseases 91 (2020): 264.
[3] Wang, Chen, et al. "A novel coronavirus outbreak of global health concern." The
Lancet (2020).
[4] Fan, Wu, et al. “A new coronavirus associated with human respiratory disease in
China.” Nature (2020).
[5] Xu, Xintian, et al. "Evolution of the novel coronavirus from the ongoing Wuhan
outbreak and modeling of its spike protein for risk of human transmission."
SCIENCE CHINA Life Sciences (2020).
[6] Zhao, Yu, et al. "Single-cell RNA expression profiling of ACE2, the putative
receptor of Wuhan 2019-nCov." BioRxiv (2020).
[7] Zhou, Peng, et al. "Discovery of a novel coronavirus associated with the recent
pneumonia outbreak in humans and its potential bat origin." bioRxiv (2020).
[8] Du Toit, Andrea. "Outbreak of a novel coronavirus." Nature Reviews
Microbiology (2020): 1-1.
[9] Li, Qun, et al. "Early Transmission Dynamics in Wuhan, China, of Novel
Coronavirus–Infected Pneumonia." New England Journal of Medicine (2020).
[10] Rothe, Camilla, et al. "Transmission of 2019-nCoV Infection from an
Asymptomatic Contact in Germany." New England Journal of Medicine (2020).
[11] http://news.ifeng.com/c/7tg6pV2ymEE
[12] https://tech.sina.com.cn/roll/2020-01-30/doc-iimxyqvy9139586.shtml
[13] Cauna, Nikolajs, and Kenneth H. Hinderer. "LXXVI Fine Structure of Blood
Vessels of the Human Nasal Respiratory Mucosa." Annals of Otology, Rhinology
& Laryngology 78.4 (1969): 865-879.
[14] Eccles, Ronald. "Acute cooling of the body surface and the common cold."
Rhinology 40.3 (2002): 109-114.
[15] Watanabe, K. "The ultrastructural characteristics of the capillary walls in human
nasal mucosa." (1980).
[16] Kudo, Eriko, et al. "Low ambient humidity impairs barrier function and innate
resistance against influenza infection." Proceedings of the National Academy of
Sciences 116.22 (2019): 10905-10910.
[17] Lowen, Anice C., et al. "Influenza virus transmission is dependent on relative
humidity and temperature." PLoS Pathog 3.10 (2007): e151.
[18] Fuhrmann, Christopher M., et al. "Jet Stream or Jet Plane? The Effects of
Climate on Influenza in the United States."
[19] Chu, Yueng-Hsiang, Da-Wen Lu, and Hsing-Won Wang. "Ambient cold air
decreased nasal mucosa blood flow measured by laser Doppler flowmeter."
Rhinology 48.2 (2010): 160.
[20] Le Merre, Charles, et al. "Effects of cold dry air nasal stimulation on airway
mucosal blood flow in humans." Archives of physiology and biochemistry 111.4
(2003): 327-329.
[21] Iwasaki, Akiko, Ellen F. Foxman, and Ryan D. Molony. "Early local immune
defences in the respiratory tract." Nature Reviews Immunology 17.1 (2017): 7.
[22] Chan, K. H., et al. "The effects of temperature and relative humidity on the
viability of the SARS coronavirus." Advances in virology 2011 (2011).
[23] Li, Y., et al. "In vivo protective performance of N95 respirator and surgical
facemask." American journal of industrial medicine 49.12 (2006): 1056-1065.
[24] Tsui, Kin-Lam, et al. "Preparadeness of the cardiac catheterization laboratory for
severe acute respiratory syndrome (SARS) and other epidemics." J Invas Cardiol
17 (2005): 149-152.
[25] Rutledge, Tim, Rick Penciner, and Karyn Popovich. "SARS assessment clinic: a
rapid response to an infectious outbreak." Canadian Journal of Emergency
Medicine 7.3 (2005): 162-167.
[26] Stanley, Perlman. "Another Decade, Another Coronavirus." New England
Journal of Medicine (2020).
[27] Lo, Janice YC, et al. "Respiratory infections during SARS outbreak, Hong Kong,
2003." Emerging infectious diseases 11.11 (2005): 1738.
[28] Fung, Isaac Chun‐Hai, and Sandy Cairncross. "Effectiveness of handwashing in
preventing SARS: a review." Tropical medicine & international health 11.11
(2006): 1749-1758.
[29] Li, Y., et al. "Role of air distribution in SARS transmission during the largest
nosocomial outbreak in Hong Kong." Indoor air 15.2 (2005): 83-95.
[30] Liu, Tao, et al. "Transmission dynamics of 2019 novel coronavirus
(2019-nCoV)." bioRxiv (2020).
[31] Gostic, Katelyn, et al. "Estimated effectiveness of traveller screening to prevent
international spread of 2019 novel coronavirus (2019-nCoV)." medRxiv (2020).
[32] Wu, Joseph T., Kathy Leung, and Gabriel M. Leung. "Nowcasting and
forecasting the potential domestic and international spread of the 2019-nCoV
outbreak originating in Wuhan, China: a modelling study." The Lancet (2020).
[33] Chan, Jasper Fuk-Woo, et al. "A familial cluster of pneumonia associated with
the 2019 novel coronavirus indicating person-to-person transmission: a study of
a family cluster." The Lancet (2020).
[34] Paules, Catharine I., Hilary D. Marston, and Anthony S. Fauci. "Coronavirus
Infections—More Than Just the Common Cold." JAMA (2020).
[35] Heymann, David L. "Data sharing and outbreaks: best practice exemplified." The
Lancet (2020).
[36] Hamming, Inge, et al. "Tissue distribution of ACE2 protein, the functional
receptor for SARS coronavirus. A first step in understanding SARS
pathogenesis." The Journal of Pathology: A Journal of the Pathological Society
of Great Britain and Ireland 203.2 (2004): 631-637.
[37] Paules, Catharine I., Hilary D. Marston, and Anthony S. Fauci. "Coronavirus
Infections—More Than Just the Common Cold." JAMA.
[38] http://www.china.com.cn/chinese/zhuanti/sars/553753.htm
[39] Ye, Dianxiu, et al. “Analysis on the Relationship between Meteorological
Conditions and SARS Occurring.” Climatic and Environmental Research (2004).
[40] Loeb, Mark, et al. "SARS among critical care nurses, Toronto." Emerging
infectious diseases 10.2 (2004): 251.
[41] Gamage, Bruce, et al. "Protecting health care workers from SARS and other
respiratory pathogens: a review of the infection control literature." American
Journal of Infection Control 33.2 (2005): 114-121.
[42] Le Dang Ha, Sharon A. Bloom, et al. "Lack of SARS transmission among public
hospital workers, Vietnam." Emerging infectious diseases 10.2 (2004): 265.
[43] Lau, Joseph TF, et al. "SARS transmission among hospital workers in Hong
Kong." Emerging infectious diseases 10.2 (2004): 280.
[44] Derrick, J. L., and C. D. Gomersall. "Protecting healthcare staff from severe
acute respiratory syndrome: filtration capacity of multiple surgical masks."
Journal of Hospital Infection 59.4 (2005): 365-368.
[45] http://news.sina.com.cn/c/2020-01-26/doc-iihnzhha4771111.shtml
[46] http://news.dayoo.com/gzrbyc/202002/04/158752_53076829.htm
[47] http://news.sina.com.cn/c/2020-02-02/doc-iimxxste8215056.shtml
[48] 张峻屹. "民间方剂学专著《 串雅内编》." 中国民族民间医药杂志 32 (1998):
45.
[49] 李艳艳. "赵学敏与《 串雅内编》." 中医研究 26.9 (2013): 59-60.
[50] https://www.2345daohang.com/dianji/64113/item_4521.htm
[51] https://pib.gov.in/PressReleasePage.aspx?PRID=1600895
[52] http://tech.163.com/20/0127/10/F3T0ULVT000999LD.html
[53] https://new.qq.com/omn/20200126/20200126A08FRM00
[54] Miller, Louis H., and Xinzhuan Su. "Artemisinin: discovery from the Chinese
herbal garden." Cell 146.6 (2011): 855-858.
[55] https://en.wikipedia.org/wiki/Tu_Youyou
[56] 屠呦呦, et al. "中药青蒿化学成分的研究 Ⅰ." 药学学报 16.5 (1981): 366r370.
[57] https://en.wikipedia.org/wiki/Sesame_oil
[58] Siddiqui, Nazima, and Adeel Ahmad. "A study on viscosity, surface tension and
volume flow rate of some edible and medicinal oils." Int. J. Sci. Environ.
Technol 2.6 (2013): 1318-1326.
[59] http://www.kino17.com/html/zh-detail-214.html
[60] Fan, Wen, et al. "Three-dimensional all-dielectric metamaterial solid immersion
lens for subwavelength imaging at visible frequencies." Science Advances 2.8
(2016): e1600901
[61] Binks, Bernard P., and Tommy S. Horozov, eds. Colloidal particles at liquid
interfaces. Cambridge University Press, 2006.
[62] Fan, Wen, et al. "Centrifugation-assisted assembly of colloidal silica into
crack-free and transferrable films with tunable crystalline structures." Scientific
reports 5 (2015): 12100.
[63] Weian, Huang, Lan Qiang, and Zhang Yan. "Colloid particles adsorption and
interfacial assembly at the fluids interface." Progress in Chemistry 19.2-3 (2007):
214-219.
[64] Pradhan, Prashant, et al. "Uncanny similarity of unique inserts in the 2019-nCoV
spike protein to HIV-1 gp120 and Gag." bioRxiv (2020).
[65] Rabenau, H. F., et al. "Stability and inactivation of SARS coronavirus." Medical
microbiology and immunology 194.1-2 (2005): 1-6.
[66] http://www.xinhuanet.com/2020-01/28/c_1125506707.htm
[67] Rabenau, H. F., et al. "Efficacy of various disinfectants against SARS
coronavirus." Journal of Hospital Infection 61.2 (2005): 107-111.
[68] Vazquez, Gonzalo, Estrella Alvarez, and Jose M. Navaza. "Surface tension of
alcohol water+ water from 20 to 50. degree. C." Journal of chemical and
engineering data 40.3 (1995): 611-614.
[69] 曹梦晔,巩江,高昂,.芝麻油药学研究概况[D]. , 2011.
[69] Kapadia, Govind J., et al. "Chemopreventive effect of resveratrol, sesamol,
sesame oil and sunflower oil in the Epstein–Barr virus early antigen activation
assay and the mouse skin two-stage carcinogenesis." Pharmacological Research
45.6 (2002): 499-505.
[70] Thormar, Halldor, et al. "Inactivation of enveloped viruses and killing of cells by
fatty acids and monoglycerides." Antimicrobial agents and chemotherapy 31.1
(1987): 27-31.
[71] Kohn, A., J. Gitelman, and M. Inbar. "Unsaturated free fatty acids inactivate
animal enveloped viruses." Archives of virology 66.4 (1980): 301-307.
[72] Liu, Kelly. "Influenza Virus Infection--Can Fatty Acids Change Infectivity?."
(2018).
[73] Li, Chuyuan, et al. Unsaturated fatty acid is for suppressing the purposes of virus
replication and/or infection. Patent No. CN103096885B (2010).
[74] Yan, Bingpeng, et al. "Lipidomic Profiling Reveals Significant Perturbations of
Intracellular Lipid Homeostasis in Enterovirus-Infected Cells." International
journal of molecular sciences 20.23 (2019): 5952.
[75] Yan, Bingpeng, et al. "Characterization of the lipidomic profile of human
coronavirus-infected cells: Implications for lipid metabolism remodeling upon
coronavirus replication." Viruses 11.1 (2019): 73.
[77] https://www.agmrc.org/commodities-products/grains-oilseeds/sesame-profile
[78] Judson, Seth D., and Vincent J. Munster. "Nosocomial Transmission of
Emerging Viruses via Aerosol-Generating Medical Procedures." Viruses 11.10
(2019): 940.
... Recently, the Indian government gave similar recommendations that instilling two drops of sesame oil in each nostril every morning can be used to prevent the new coronavirus [81] . Different studies suggested that applying oil on to the nostrils prevent direct contact and binding of virus onto the surface of nasal mucosa [82] , causing destabilization of the bilayer of viral envelopes [83] and capable of significantly suppressing the coronavirus replication due to the fatty acids [84] . Thus this may prevent human-to-human transmission and to the lower respiratory tract as well [82] . ...
... Different studies suggested that applying oil on to the nostrils prevent direct contact and binding of virus onto the surface of nasal mucosa [82] , causing destabilization of the bilayer of viral envelopes [83] and capable of significantly suppressing the coronavirus replication due to the fatty acids [84] . Thus this may prevent human-to-human transmission and to the lower respiratory tract as well [82] . It is also reported that coconut oil and its derivatives lauric acid (a fatty acid) and monolaurin (a metabolite) having antiviral activity against the novel coronavirus [85] . ...
... Coronavirus is sensitive to various disinfectants, including diethyl ether, 75% (v/v) ethanol solution, chlorinated disinfectants, fatty solvents such as peracetic acid and chloroform [82] . Bhootopaghata (invasion of organism) is described one of the causes of Ojas-kshaya (loss of immunity) [97] . ...
Article
Full-text available
The novel coronavirus disease 2019 (COVID-19) is a pandemic health emergency, caused by the severe acute respiratory syndrome corona virus-2 (SARS-CoV-2). Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying some medical problems are more likely to develop serious illness. Considering different classical and contemporary viewpoints, the newly identified COVID-19 can be categorized under agantuja vyadhi (exogenous disease) by inception, caused by bhoota (organisms), and transforming to nija (endogenous) leading to disequilibrium of kapha, vata, and pitta doshas and manifestation of clinical features of mainly pranavaha (cardio-pulmonary system), rasavaha (cardio-vascular system) and raktavaha (vascular and RES) srotas dushti (vitiation of channels). In Ayurveda, for a new disease, the treatment principle is designed on the basis of the nature of the disorder, etiology and location. Hence rasayana drugs for epidemic disease, disinfectants for microorganism, dosha (mainly kapha and vata) pacifying drugs and disease-location specific treatment i.e deepana (stomachic), pachana (digestive), shwasahara (anti-dyspnea) and kasahara (anti-cough) are being discussed in this paper. Apart from this, potential of mukhavaishadyakara (mouth cleansing agent), patimarsha-nasya (nasal smearing), krimighna (anti-viral), vishaghna (anti-toxic) and kshara (alkali) dravya (medicinal plants) are being highlighted as these groups of drugs are effective in subsiding kapha, vata, killing microorganism and protecting ojas (immunity) by virtue of their broad spectrum pharmacodynamic properties.
... [5]. Sin embargo, el uso continuo y excesivo de etanol y sustancias desinfectantes que contienen cloro pueden causar problemas en la salud de las personas y daños al medio ambiente [5], [12]. Por otro lado, los ácidos grasos insaturados, tales como; el ácido araquidónico, linoleico, oleico y palmitoleico han demostrado actividad antimicrobiana, induciendo la lisis de las membranas celulares de varios or-π C. E. Aristizábal-Alzate & J. L. González-Monsalva ganismos infecciosos [13]- [15]. ...
... C. Mecanismos de protección de la infección con 2019-nCovid La transmisión de 2019-nCoV puede ocurrir predominantemente a través del contacto directo de las membranas mucosas (nariz, boca u ojos) con gotitas respiratorias infecciosas cerca de una persona infectada, y / o mediante la exposición a fómites, como la mano a la boca (o la mano a la nariz y la mano al contacto ocular) con fómites e inhalación de aerosoles que contienen virus generados por la evaporación de las gotas respiratorias producidas por los pacientes al toser, estornudar o incluso hablar [2], [12]. Además, El 2019-nCoV posee hidrofilicidad en la estructura de la proteína gracias a los glucósidos enlazados a esta, por lo tanto, puede proporcionar una mayor afinidad hacia los receptores y también aumentar el rango del tipo células huésped que el 2019-nCoV puede infectar. ...
... Además, El 2019-nCoV posee hidrofilicidad en la estructura de la proteína gracias a los glucósidos enlazados a esta, por lo tanto, puede proporcionar una mayor afinidad hacia los receptores y también aumentar el rango del tipo células huésped que el 2019-nCoV puede infectar. Por ende, se proponen en este apartado diferentes compuestos, tales como el aceite de sésamo y otros aceites vegetales comestibles que tengan baja tensión superficial, para aprovechar su incompatibilidad con el agua, ya que las mucosas por lo general son soluciones acuosas que constan de un 99 % agua y electrolitos [16] y que se mantienen un mayor tiempo sobre las superficies debido a su alto punto de ebullición y baja volatilidad, si se les compara con otros agentes microbianos como lo es el alcohol etílico [12]. En la Figura 3, se ilustra como los aceites con altos contenidos de ácidos grasos insaturados pueden actuar como una capa protectora sobre las mucosas. ...
Article
Full-text available
Las enfermedades respiratorias virales, como el nuevo coronavirus (2019-nCoV), el cual se ha extendido a muchos otros países alrededor del mundo, causan muertes, problemas económicos y sociales. En el presente artículo se estudian y abordan compuestos no convencionales que actúan como agentes de protección y desinfección eficaces en contra del 2019-nCoV. Los compuestos seleccionados se basan en la capacidad de destruir las proteínas estructurales de este virus e inhibir sus mecanismos de propagación e invasión de las células sanas. Por lo tanto, varios aceites vegetales y comestibles fueron propuestos, de acuerdo con su capacidad de disolución de las proteínas (GP120), su tensión superficial y su composición de ácidos grasos.
... To inhibit the virus attack through nose application of sesame oil into the nostrils is advised under Table 1. Though mechanism of action is not mentioned, but in chemistry point of view low surface tension of sesame oil and hydrophobic nature [90]. Viscous nature of oil make the flow of virus droplet typical and due to hydrophobicity, droplets capture in the nostrils. ...
... Application of oil prepared in Ficus religiosa leaves through nostrils may reduce the transmission of virus. This is the hypothetical concept and more research is required to establish the mode of action of sesame oil, coconut oil, anu taila etc. into the nostrils [90]. Recently, it has been reported that transmission through nose is the major way of virus transmission and in future administration of drug or vaccine through nose will be more effective [87]. ...
Article
The COVID-19 outbreak has came in existence in late December 2019 at Wuhan, China. It is declared as an epidemic by WHO. The rationale of this study is to provide the details regarding prevention, environment concern, social economic consequences, and medicines for COVID-19. Social distancing, screening, lockdown, use of mask and application of sanitizer or soap at regular time interval is the best prevention against COVID-19. The “oral-feces” transmission of COVID-19 is threat to environment. Improper disposal of medical/biomedical and human waste may harm the total environment. Nitrifying-enriched activated sludge i.e. NAS approach can play important role to clean the environment compartments like sludge and waste. COVID-19 has shown impact on social and economic life, but there is no alternate until the drug discovery. In medicine or treatment of COVID-19 point of views, an integrated approach between modern and traditional medicine system may ensure an early prevention of further viral spread. Based on the symptoms of COVID-19, list of herbs and drugs of Indian Medicine System has been searched and reported. To develop the potential drug against COVID-19, the detailed experimentation and clinical trials to be performed for future prospective.
... Due to lipoid in nature Nasya karma may interfere to the cell membrane of virus and it check the replication of virus at nasal site and thus reduces viral load and severity of infection. Researchers of Traditional Chinese Medicine have already proposed the use of nasal58 oil application for preventing SARS-COV-2 infection . ...
Article
Full-text available
The world community is facing a pandemic of COVID -19, which is caused by infection of novel corona virus-2. The disease has spread globally with a total of 27.2 Cr conrmed cases, 53.3 L deaths and 24.3 Cr recovered as of December 13. Primarily; it involves the respiratory system and in due course of time affects the other systems too. The pathophysiology and management are still evolving in modern medicine, while developments of vaccine are under the way. As per Ayurveda, it is type of Aupasargikaroga (infectious disease) that is Sankramakaroga (communicable disease) in nature and later on it may derange the basic matrix of bio-humours and alter the status of Agnis (bio-res) and Ojas (immune strength). In view of this, different treatments guidelines have been recommended in the classics of Ayurveda by considering the genetic constitution (Prakriti), kala, bala and other epigenetic factors of the patient. Besides, specic recommendations for Ahara (diet), Nidra (sleep) and Brahmacharya (code of conduct related to mental and physical activities) have also been mentioned to target physical, mental, social and spiritual health. In this context authors have tried to explore the preventive aspects which are feasible for general public to become free from COVID-19 through Ayurveda.
... It increases blood circulation, affects the lymphatic system, supplies nourishment to the blood and skin, and soothes the nervous system [87] • Nasya, i.e., applying oil in the nostrils, [88] either medicated oils formulated from ghrita (clarified butter) or natural oils obtained from plants such as sesame or coconuts, might protect the respiratory tract from pathogen entry. [89,90] concLusIons Immunity gets worse affected by lack of nutrition, lack of physical activity, chronic mental and emotional stress, and presence of comorbidities. All these, in addition to Immunosenescence, can create havoc for the elderly, making it important to address these to achieve good health and strengthen one's immunity. ...
Article
Coronavirus disease 2019 has had a devastating impact on global health‐care systems and the economy. Scientists and medical professionals worldwide are striving to provide for vaccine cures, while the deadly virus continuously mutates and thrives. Immunity being directly co‐related to multiple factors such as diet, sleep, lifestyle, and stress; elderly people are at high risk due to factors such as immunosenescence, weakened metabolism, micro‐nutrient deficiency, immobility, chronic stress, and comorbidities. The elderly has had the highest morbidity and mortality rates during the pandemic and is the most neglected in general. Holistic and integrative approaches need to be researched for finding safe and risk‐free ways that may help counter immune suppression and prevent the vulnerable from getting infected. Yoga and Ayurveda have shown promising results in this regard, although among populations varying in age and health status. However, good‐quality clinical trials are needed to strengthen the evidence of yoga for geriatric immunity as online databases of PubMed, Cochrane Library, and Embase showed a paucity of studies when searched for related keywords. Similarly, several aspects of Ayurveda, especially Ahara/food, have vast yet unexplored applications in immune strengthening and developing physical and mental resilience. Primary care physicians can utilize these time‐tested techniques as lifestyle modifications along with the standard pharmacological treatment for fulfilling the health‐care needs of their patients, especially for the vulnerable elderly, which is the pressing need during this pandemic.
... It helps to cleanse, disinfect, and strengthen the nasal passages [112]. A recent study suggests that compared to the SARS-nCoV, the S-protein on the 2019-nCoV has additional hydrophilicity in the protein structure, thus may provide an enhanced affinity towards host cell receptors and might have also increased the range of host cells that 2019-nCoV can infect, thereby may increase the infectivity of 2019-nCoV [] Thus, the coating of sesame oil on the mucosal surface of the nasal passage may result in its hydrophobicity which decreases the binding ability of 2019-nCoV S-protein to mucosal cells [113]. Sars Cov-2 virus present in the air always finds good nidus to settle and breed in the congested mucus membrane of the nose. ...
Article
The ongoing coronavirus pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) and unique in various facets. The earlier experience from the past severe acute respiratory syndrome (SARS) epidemics seem to be insufficient and there is need for better strategies in public health and medical care. Ayurved & Yog are well known for their preventive and therapeutic aspect, but not getting utilized properly for prevention of Covid 19 crisis which may also be helpful as supportive therapy along with current line of management. This paper is aimed at unrevealing the role of Ayurved and Yoga guidelines established by Department of AYUSH for prevention from SARS-CoV-2 by providing help to improving the quality of supportive/prophylactic therapy in relation with their immunity.
... In the pharmaceutical industry, sesame oil is used as an emollient, carrier oil for other essential oils and fatsoluble compounds.Sesame oil is reported to have significant antineoplastic, neuroprotective, antioxidant, anti-inflammatory and lipid-lowering activities (Deme et al., 2018;Majdalawiehet al.,2019;Mekkyet al., 2019;Ruankham et al., 2019). Recently a researcher hypothesized that adding sesame oil in the nostril can prevent the spreading of coronaviruses (Wen Fan et al., 2020). Sesame oil has high concentrations of unsaturated fatty acids such as linoleic and oleic acid that contribute the potential in prophylaxis and treatment against many bacterial infections (Dilika et al., 2000;Uzun et al., 2008).A bacterial infection is a serious health issue affecting millions of people worldwide every year. ...
Article
Full-text available
Bacterial infection and its resistance is a major health issue that affects millions of people throughout the world. There is always a need to search forth new and safest drug from natural resources to fight these challenges. Sesame seed essential oil is a rich source of protein with high medicinal value since the ancient time peoples are using for several remedies in Saudi Arabia.Therefore, the current study is aimed to discover the potential activity of the locally available sesame oil for antibacterial action based on ethnobotanical knowledge and traditional utilization as a therapeutic agent to treat several kinds of health problem in Saudi culture. Gas chromatography / mass spectrometry (GC/MS) analysis of sesame essential oil extracted from locally available sesame seeds represented 39 different chemical compounds. Sesamin and sesamol were the principal components alongwith fatty acids and triglycerides. Results indicated that the locally available sesame oil was found rich in sesamin contents (24.45%). The spectrum of antibacterial effect of sesame seed essential oil was exhibited significantly against Escherichia coli followed by Staphylococcus aureus, Streptococcus pyogenes, Klebsiella pneumoniae and Pseudomonas aeruginosa respectively. The results indicate that sesame oil was found most effective against three bacteria i.e. E. coli, S. aureus and S. pyogenes.
Article
The outbreak of Corona virus disease (COVID-19) has been recently declared as Public Health Emergency of International Concern (PHEIC) by World Health Organization and the virus has now spread beyond the boundaries of countries and continents. At present, no specific antiviral treatment or vaccine is available or recommended to counter the COVID-19, and the potential therapy is still symptomatic. The outbreak of the Corona virus was begun in Wuhan, China in December 2019. The most common symptoms are fever, tiredness and dry cough. Some individuals also develop aches and pains, nasal congestion, runny nose, sore throat, or diarrhea. It was reported that traditional remedies may alleviate the symptoms of COVID19. Ayurveda is the world’s oldest medical system that can manage any disease without side effects. Ayurveda is equipped with varieties of treatment modalities to handle with any type of deadly diseases. However, a major drawback is a lack of adequate scientific basis. In recent time, a branch of modern medical science has developed and is known as Psycho- Neuro -Immunology. It deals with the phenomenon of how our thoughts and emotions can affect our immune system. Stress, fear and negative emotions are known to weaken our immune system while Yoga (including meditation), mindfulness, positive emotions, and relaxa-tion strengthen it. Yoga plays an important role to strengthen our immune system.
Article
The world is facing global pandemic coronavirus which causes severe acute respiratory syndrome (SARS-CoV-2) infection mainly affecting the immune system of the body. In a very short span of time it has become a global concern due to its high R0.Many countries are still endeavoring to prevent the disease. Researches are still underway to develop effective vaccine or drugs for COVID 19 disease. Unfortunately, there is no definite preventive or curative medicine available for coronavirus in allopathic system of medicine. As no specific drugs are available in mainstream medicine for treating symptoms of COVID-19, prevention seems to be the best strategy.The traditional health care system can prove to be successful for prophylaxis.Ayurveda is a medical science with well-established scientific principles, practiced in India for several thousands of years. AcharyaCharak has explained the concept of Janpadodwansa which has a direct correlation with COVID pandemic. This article is an attempt to interpret direct correlation between pandemics and Janpadodwansa and provide viable options for COVID-19prevention byAyurvedic medicines like Guduchi, Ashwagandha, Yashtimadhu, Chayavanprash, Suwarna prashan etc.andenhancing the immune system.
Article
Full-text available
Emerging infectious diseases, such as SARS and Zika, present a major threat to public health1–3. Despite intense research efforts, how, when and where new diseases appear are still the source of considerable uncertainly. A severe respiratory disease was recently reported in the city Wuhan, Hubei province, China. Up to 25th of January 2020, at least 1,975 cases have been reported since the first patient was hospitalized on the 12th of December 2019. Epidemiological investigation suggested that the outbreak was associated with a seafood market in Wuhan. We studied one patient who was a worker at the market, and who was admitted to Wuhan Central Hospital on 26th of December 2019 experiencing a severe respiratory syndrome including fever, dizziness and cough. Metagenomic RNA sequencing4 of a bronchoalveolar lavage fluid sample identified a novel RNA virus from the family Coronaviridae, designed here as WH-Human-1 coronavirus. Phylogenetic analysis of the complete viral genome (29,903 nucleotides) revealed that the virus was most closely related (89.1% nucleotide similarity) to a group of SARS-like coronaviruses (genus Betacoronavirus, subgenus Sarbecovirus) previously sampled from bats in China. This outbreak highlights the ongoing capacity of viral spill-over from animals to cause severe disease in humans.
Article
Full-text available
Background: The initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods: We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results: Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions: On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.).
Article
Full-text available
In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed another clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).
Article
Full-text available
Background: An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. Methods: In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. Findings: From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36-66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3-6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6-10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. Interpretation: Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. Funding: The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).
Article
Background: Since Dec 31, 2019, the Chinese city of Wuhan has reported an outbreak of atypical pneumonia caused by the 2019 novel coronavirus (2019-nCoV). Cases have been exported to other Chinese cities, as well as internationally, threatening to trigger a global outbreak. Here, we provide an estimate of the size of the epidemic in Wuhan on the basis of the number of cases exported from Wuhan to cities outside mainland China and forecast the extent of the domestic and global public health risks of epidemics, accounting for social and non-pharmaceutical prevention interventions. Methods: We used data from Dec 31, 2019, to Jan 28, 2020, on the number of cases exported from Wuhan internationally (known days of symptom onset from Dec 25, 2019, to Jan 19, 2020) to infer the number of infections in Wuhan from Dec 1, 2019, to Jan 25, 2020. Cases exported domestically were then estimated. We forecasted the national and global spread of 2019-nCoV, accounting for the effect of the metropolitan-wide quarantine of Wuhan and surrounding cities, which began Jan 23-24, 2020. We used data on monthly flight bookings from the Official Aviation Guide and data on human mobility across more than 300 prefecture-level cities in mainland China from the Tencent database. Data on confirmed cases were obtained from the reports published by the Chinese Center for Disease Control and Prevention. Serial interval estimates were based on previous studies of severe acute respiratory syndrome coronavirus (SARS-CoV). A susceptible-exposed-infectious-recovered metapopulation model was used to simulate the epidemics across all major cities in China. The basic reproductive number was estimated using Markov Chain Monte Carlo methods and presented using the resulting posterior mean and 95% credibile interval (CrI). Findings: In our baseline scenario, we estimated that the basic reproductive number for 2019-nCoV was 2·68 (95% CrI 2·47-2·86) and that 75 815 individuals (95% CrI 37 304-130 330) have been infected in Wuhan as of Jan 25, 2020. The epidemic doubling time was 6·4 days (95% CrI 5·8-7·1). We estimated that in the baseline scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (95% CrI 227-805), 113 (57-193), 98 (49-168), 111 (56-191), and 80 (40-139) infections from Wuhan, respectively. If the transmissibility of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1-2 weeks. Interpretation: Given that 2019-nCoV is no longer contained within Wuhan, other major Chinese cities are probably sustaining localised outbreaks. Large cities overseas with close transport links to China could also become outbreak epicentres, unless substantial public health interventions at both the population and personal levels are implemented immediately. Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally. Funding: Health and Medical Research Fund (Hong Kong, China).
Article
The emergence of a new coronavirus in China raises global alarm.