NORMAN SWAN:
Health authorities remain on alert after a man in Brisbane became the first suspected Australian case of a deadly new coronavirus that's killed six people in China. The man was released from home isolation late yesterday after having a series of tests, he's recently returned from Wuhan in China with flu-like symptoms. Queensland Health now says that he has no symptoms of the virus but they're waiting on the results of additional blood tests which could take some time.
Professor Brendan Murphy is Australia's Chief Medical Officer and he's responsible for the Office of Health Protection. Welcome back to Breakfast Brendan.
PROFESSOR BRENDAN MURPHY:
Good morning Norman.
NORMAN SWAN:
How soon do these DNA tests take to come back?
PROFESSOR BRENDAN MURPHY:
Well the tests, they're just being fully developed in Australia, we had to get the primers. The VIDRL lab in Melbourne has developed a test so they could take a day or so before we're absolutely sure with a confirmatory test. But we're gearing up across the country to get much more rapid testing over the next few days.
NORMAN SWAN:
And that's, I'm assuming that's a blood test rather than a test of the sputum or what have you?
PROFESSOR BRENDAN MURPHY:
Well yeah, we can, you can actually do PCR on the biological sample, the respiratory sample - that's the main test to confirm the presence of the virus. Serology is not yet being developed.
NORMAN SWAN:
So PCR is where you take a tiny genetic sample of RNA or DNA and then you amplify it up to see whether it's got the sequence of the virus?
PROFESSOR BRENDAN MURPHY:
Correct.
NORMAN SWAN:
Now, given that there are more and more cases, people coming down with this coronavirus - by the way does it have a name yet?
PROFESSOR BRENDAN MURPHY:
It's still just called novel coronavirus with a number. It hasn't been given a popular name as yet.
NORMAN SWAN:
Popular being moot, but what are the symptoms? As more and more people come down with it are we getting a fuller picture of the symptoms or is it just pneumonia?
PROFESSOR BRENDAN MURPHY:
So the most prominent symptom is fever, nearly every person has developed a significant fever, and then associated with that are a range of upper respiratory type symptoms very similar to flu or colds - so sore throat, cough and the more severe cases seen do develop pneumonia and respiratory symptoms. But there clearly seem to be a number of mild cases that just have a fever, a bit like a common cold.
NORMAN SWAN:
And the people who are dying are they very old, very sick with other problems? Or it’s out of the blue, anybody can die of it?
PROFESSOR BRENDAN MURPHY:
We don't yet have good information about that. We know that the first two confirmed deaths, both, one had a lot of comorbidities and other illnesses and one was quite elderly. We don't yet have clinical information about the other four reported deaths.
NORMAN SWAN:
And do we have any sense of what's called a prodrome, in other words this is what goes on before you get the symptoms when you could be quite infectious and spreading it around on, you know, quite innocently?
PROFESSOR BRENDAN MURPHY:
We don't yet, no.
NORMAN SWAN:
And if you were to extrapolate from the Middle-Eastern respiratory sydnrome- the coronavirus that causes that MERS or SARS what would you expect the prodrome to be? Or am I stretching a kidney specialist's knowledge of respiratory medical here?
PROFESSOR BRENDAN MURPHY:
Well I think what's pretty, what seems to be clear is that there is an incubation period that, of up to seven days in which people are pretty asymptomatic and that's, it’s obviously one of the concerns is that you can't tell when people might be infectious, particularly when they're travelling. So generally speaking once you start developing a fever is when the symptoms start. But we really haven't got clear clinical picture of this at the moment.
NORMAN SWAN:
And given it's a virus antibiotics aren't going to help. Do any of the current antivirals help coronavirus [indistinct]-?
PROFESSOR BRENDAN MURPHY:
[Talks over] Not that we know of, no.
NORMAN SWAN:
So it's essentially keeping people as well as they possibly can until they get over it?
PROFESSOR BRENDAN MURPHY:
Correct, supported treatment. And again there does seem to be suggestion that a lot of cases are quite mild and people, some of the data from Wuhan suggest people looking retrospectively might have had this infection and they've now recovered. So we don't yet have a good sense of the severity of this virus.
NORMAN SWAN:
Or indeed its infectivity.
PROFESSOR BRENDAN MURPHY:
Correct, or its potential for human-to-human transmission - that is now proven but we- the initial cases were thought mainly to have come from an animal host in Wuhan but there's now over the last four or five days pretty clear evidence of human-to-human transmission but we don't know just how high the human-to-human transmission risk is yet.
NORMAN SWAN:
SARS faded after, it really was quite formanent [sic] - you can catch it from the end of the bed. It was very, very scary, it kind of faded. MERS keeps on going. Presumably it's too early to say because the early stages of any new virus is that it's pretty nasty but then tends to get a bit, as human populations gets used to it, it gets a bit easier; - we just don't know that yet.
PROFESSOR BRENDAN MURPHY:
We don't know yet. I mean I think we don't- there are reports of 14 healthcare workers infected but SARS had a much, much higher rate of infection of healthcare workers; MERS had high rates. So that's slightly positive early data but it's just too early to tell Norman, 'til we get the full picture.
NORMAN SWAN:
Reports today of, that Australia has some technology for rapid vaccine development. How promising is that?
PROFESSOR BRENDAN MURPHY:
That's interesting stuff. That's been funded by CEPI, Coalition for Epidemic Preparedness and by the Australian Government. They've developed technology using recombinant DNA technology to create vaccines. They're obviously very enthusiastic about it and that's certainly something that WHO and we could be looking at.
WHO is currently about to meet to consider whether to declare this virus a public health emergency of international concern, and I suspect that they will.
NORMAN SWAN:
And if they do then that kicks in some vaccine development if it is possible?
PROFESSOR BRENDAN MURPHY:
It could well do.
NORMAN SWAN:
What's the best then- what's the best approach for avoiding infection should it [indistinct]-?
PROFESSOR BRENDAN MURPHY:
[Talks over] Well I think there is no evidence of transmission in Australia at the moment. So we're focusing on people who have come from China, particularly from the city of Wuhan, and that's why we're targeting those three direct flights a week with border measures. So if someone has come from Wuhan or has been in contact with someone from Wuhan who's been unwell and they develop the flu-like symptoms they should seek medical attention. We're providing good advice to all of the health professionals around the country so that they know how to test and isolate if appropriate.
NORMAN SWAN:
And this is just physically taking people's temperature when they arrive off the plane?
PROFESSOR BRENDAN MURPHY:
No. No. What we're doing the- we are meeting every one of these flights with biosecurity officers providing information to every passenger asking them to identify themselves to biosecurity officers and New South Wales Health will also have some staff because the flights all come to Sydney. The important thing is to provide information because many of these people may be well when they come and they may develop symptoms after they've landed. The airlines are also required to notify if there's an unwell passenger on-board and then they're met by biosecurity officers.
NORMAN SWAN:
Is it inevitable that a case will come?
PROFESSOR BRENDAN MURPHY:
I wouldn't say it's inevitable but we do know that there has been a confirmed case in the US; that's just been confirmed overnight. We do have a lot of traffic from China and I think it's quite likely that we will get some cases here but I'm very confident that we're well prepared to respond if we do.
NORMAN SWAN:
Given past- I mean it's very hard to predict from past outbreaks and epidemics, has it got the potential to become worse? Or is this the worst we're going to see in terms of human transmission?
PROFESSOR BRENDAN MURPHY:
I just don't think we know, Norman. I think we just have to wait and see as the epidemiology's becomes clear, as the WHO and the Chinese authorities provide more and more information - I think it's hard to speculate. At the moment I think the Chinese are responding incredibly appropriately and we just have to wait and see how it develops.
NORMAN SWAN:
So you're happy with the information provided by China because they've been criticised heavily in the past particularly for SARS.
PROFESSOR BRENDAN MURPHY:
I think China is completely different in this. They're being open; they're being transparent; they shared the virus sequence and they're now providing information updates on a regular basis. I think it's a wonderful transparency and openness that we're now seeing with China.
NORMAN SWAN:
Of course the stakes are high. I mean the Nikkei in Tokyo's down nearly a per cent, Shanghai tops the stock market off of 1.5 per cent. I mean it has knock on effects.
PROFESSOR BRENDAN MURPHY:
Yes. It does.
NORMAN SWAN:
I mean I'm asking the Chief Medical Officer about wider economic impacts but presumably there's pressure on in terms of what you see about it so that you don't frighten the horses.
PROFESSOR BRENDAN MURPHY:
Well I don't- there's a basis for us to say that the Australian public should be reassured. I don't think we should be panicking. I think we have good mechanisms to deal with new infectious diseases. We're watching closely and we're, we'll providing new information as it comes to hand but I don't think there's currently any reason for significant public concern. We just need to watch.
NORMAN SWAN:
Brendan Murphy, thanks for joining us.
PROFESSOR BRENDAN MURPHY:
Pleasure.
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