Interim Guidance on Novel Coronavirus for Travellers

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This document provides information on Novel Coronavirus (nCoV) prevention and preparedness for travellers coming to the Caribbean, travellers going to an nCoV affected country and travellers returning to the Caribbean from an nCoV affected country. This information is based on currently available scientific evidence and expert opinion and is subject to change as any new information becomes available. It should be read in conjunction with relevant national legislation, regulations and policies. This document has been adapted for the Caribbean situation and therefore may differ from guidance developed by other agencies. 
 

Key Points  

• There is an outbreak of pneumonia in Wuhan, China, caused by a novel (new) coronavirus, which is a family of viruses that includes the common cold, and temporarily named “2019-nCoV.” 

• Initially, most patients were linked to a large seafood and live animal market, which was closed by Health officials on January 1, 2020, for cleaning and disinfection.  

• Person-to-person spread is occurring in the Wuhan community, increasing the risk of international spread by travellers.

• The immediate health risk from 2019-nCoV to the general public in the Caribbean remains LOW.

 • Travellers to Wuhan, China, should avoid animals (alive or dead), animal markets, and contact with sick people.  

• Travellers from Wuhan to Caribbean Countries may be asked questions about their health and travel history upon arrival, but entrance temperature screening is not recommended.  

• This notice will be updated as more information becomes available on the outbreak.
 

Background 

The Caribbean Public Health Agency (CARPHA) is closely monitoring the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan City, Hubei Province, China. The outbreak which started in December 2019 is reported to have affected more than 500 persons up to 22 January. CARPHA has activated its Incident Management Team for Emergency Response and is working closely with its international health partners to respond to this health threat and provide timely advice and assistance to Caribbean Countries. 
 

What is Novel coronavirus? 

Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS). 

What are the common signs and symptoms of infection? 

Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. This 2019 virus is a new strain of coronavirus that has not been previously identified in humans. The cases in the Wuhan pneumonia outbreak have tested negative for both SARS and MERS-CoV. (1,2)

How is it transmitted? 
 
Currently, the source of the outbreak is yet to be identified. Early information found samples from the environment in the Huanan Seafood Wholesale Market in Wuhan City, but several of those infected did not visit the market. The virus has also been detected in health care workers caring for ill cases. The available information indicates that a person-to-person transmission is taking place 2,3. Precautions must therefore be taken to prevent human-to-human transmission of the disease.  

While we don’t know the routes of transmission of 2019-nCoV, from what we know about other coronaviruses, they are mainly transmitted by (3):

• large respiratory droplets and direct or indirect contact with infected secretions 

• other coronaviruses have been detected in blood, faeces and urine; and 

• there have been some instances when airborne transmission of other coronaviruses was thought to have taken place through exposure to aerosols of respiratory secretions and sometimes faecal material.

Since this is a newly discovered virus, this information will be updated as more information becomes available.
 

Section I. Guidance for Travellers coming to the Caribbean 

To date, there have been NO reported cases of nCoV in the Caribbean region. The risk of a case being imported to the Caribbean remains low. However, the report of the first case of 2019-nCoV in the USA on 21 January, emphasizes the potential for international dissemination of the virus via commercial air travel. Travellers must therefore take all necessary precautions when travelling. Since there have been no cases of nCoV in the Caribbean, there are no special precautions travellers need to take when travelling to the Caribbean.  ​

Travellers are advised to: 
 
• Stay informed about the nCoV situation in any countries they are travelling to.

• Practice general infection control measures, such as frequent hand washing with soap and water or an alcohol-based hand sanitizer. 
 

Travellers coming to the Caribbean from a nCoV affected country may undergo entrance screening if travelling through certain ports in the United States and in some Caribbean countries (see Section II below).

Section II. Guidance for Travellers arriving from or returning to the Caribbean from a Novel Coronavirus affected country

Travelers arriving from or returning to the Caribbean from a nCoV affected country may face special screening measures in Caribbean countries. Travelers are advised to: 

 • Seek information about the current nCoV situation and remain aware of up-to-date information from the WHO or the Ministry of Health in the destination country. 

 • When leaving the affected area, you may be screened by airport officials and again at airports in the USA and other countries. They may take your temperature and ask about your  activities to assess the likelihood of you acquiring the infection.   

• Some Caribbean countries also may be screening passengers from affected areas. They may take your temperature and ask about your activities to assess the likelihood of you    acquiring the infection and may ask you to complete a survey with your travel history.

When travelling from a country with reported cases of nCoV travellers should: 

a) Seek medical attention if you develop symptoms of nCoV during travel and state your travel history. 

b) If you have symptoms during travel or upon arrival into a Caribbean country or territory, tell a flight attendant immediately, OR a port health officer or a border services officer when you arrive. They will determine whether you need further medical assessment. 

c) Monitor your health upon your return or entry into the Caribbean from a country affected by the Novel Coronavirus. 

d) Seek medical attention if notice any of the symptoms within 14 days after your arrival in the Caribbean: fever, headache, fatigue, severe and nonproductive cough, difficulty breathing, vomiting, diarrhea or any other severe symptoms. 

e) Be sure to tell your healthcare provider that you have travelled to a region where Novel coronavirus was present. Make sure to tell them about the activities or work you participated in and whether there was contact with a person known or suspected to have been infected by the nCoV.
 

Section III. Guidance for Travellers going to a 2019 novel coronavirus affected Area

CARPHA advises anyone travelling to an area affected by novel coronavirus should pay attention to health alerts and take necessary precautions. 

If you are traveling to an area affected by Novel Coronavirus, the following preventive measures will help to reduce your risk of getting infected (see Appendix A for a useful infographic prepared by the WHO). 
 
Before you travel: 

• Seek information about the current nCOV situation and remain aware of up-to-date information. 
 
• Assemble a travel health kit including a thermometer and know where you can seek medical care in case you start to feel ill.

While you are in an area with reported cases of nCOV:  
 
1. Avoid areas with outbreaks. Follow directives issued by the local Ministry of Health and/or World Health Organization. 

2. The virus can spread through person to person contact 
     a. Avoid direct contact with people that are visibly sick. 
     b. Avoid contact with blood and other bodily fluids especially of a person you think is sick. 
 
3. Avoid close contact with or handling of animals.   
     a. Avoid live or dead animals, as both may spread the virus. Avoid animal or fresh meat markets. 
     b. Avoid handling or eating raw or undercooked meat. 
 
4. Practice strict and frequent hand washing routines with soap and water. 
 
5. Know the symptoms of Novel Coronavirus and seek medical care if you develop flu like symptoms: fever, headache, fatigue, severe and nonproductive cough, difficulty breathing, vomiting, diarrhoea, or any other severe symptoms. 
 
6. Symptoms may start up to 2 weeks after exposure to the virus. Monitor your health and that of your traveling partners. If you need to seek medical care, let your healthcare provider know that you traveled to an area affected by the Novel Coronavirus. 
 
 7. When leaving the affected area, you may be screened by airport officials. They may take your temperature and ask about your activities to assess the likelihood of you acquiring the infection.  ​


Appendix A ​

Coronavirus Infographic WHO
Available from: https://www.who.int/images/default-source/healthtopics/coronavirus/1over...  


References


1 CDC, 2020. Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV) in Wuhan, China available at https://emergency.cdc.gov/han/han00426.asp 

2 The 2019-nCoV Outbreak Joint Field Epidemiology Investigation Team, Qun Li. An Outbreak of NCIP (2019-nCoV) Infection in China — Wuhan, Hubei Province, 2019−2020[J]. China CDC Weekly, 2020,2(5): 79-80.   

3 Public Health England, 2020. Wuhan novel coronavirus: epidemiology, virology and clinical features ​

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