PHE issues coronavirus guidance for primary care

Public Health England (PHE) has issued guidance for primary care professionals dealing with a suspected case of the Wuhan novel coronavirus (WN-CoV).

PHE says that if the infection does present in the UK, it is most likely to occur in travellers who have recently returned from Wuhan and advises clinicians to take an accurate travel history. | GETTY IMAGES
PHE says that if the infection does present in the UK, it is most likely to occur in travellers who have recently returned from Wuhan and advises clinicians to take an accurate travel history. | GETTY IMAGES

The new guidance comes as the government introduced enhanced monitoring of direct flights into the UK from the city of Wuhan in eastern China, where the virus originated.

PHE said that the measures are precautionary; there are no confirmed cases of the virus in the UK and based on available evidence the current risk to the UK population is considered low.  

Interim guidance

Initial clinical findings shared by China and WHO suggest that fever, cough or chest tightness, and dyspnoea are the main symptoms reported by affected patients. The guidance states that WN-CoV may cause mild to moderate illness as well as pneumonia or severe acute respiratory infection, so patients could potentially present to primary care.

Patients with a relevant travel history who are suspected of having the virus should be identified when they book in at reception and isolated as quickly as possible, avoiding use of any communal toilet facilities.

If clinicians suspect a possible case of WN-CoV during a consultation they should leave the room and conduct the remainder of the consultation by phone if necessary. Anyone who comes into contact with the patient should wash their hands thoroughly with soap and water.

Healthcare professionals should seek specialist advice from a local microbiologist, virologist or infectious diseases physician and inform their local Health Protection Team.

Transferring patients

If a patient is critically ill and requires urgent ambulance transfer to a hospital, the call handler should be informed of the concerns about WN-CoV infection. In all other instances, the transfer must be discussed with the hospital and patients should be instructed not to use public transport or taxis. 

Following the patient transfer, the room they were isolated in should not be used until further advice is provided by the local Health Protection Team. 

The government has issued separate guidance on investigation and initial clinical management of WN-CoV, which provides an interim definition of possible cases.

Dr Nick Phin, deputy director of the National Infection Service at PHE, said: 'This is a new and rapidly evolving situation where information on cases and the virus is being gathered and assessed daily. Based on the available evidence, the current risk to the UK is considered low. We are working with the WHO and other international partners, have issued advice to the NHS and are keeping the situation under constant review.' 

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