A new coronavirus virus, likely first transmitted to people from animals at a market in the Chinese city of Wuhan, is making international headlines.

Death toll in China raises to 259 and So far, about 124 positive cases have been reported in a host of countries, including India where the first case was confirmed in Kerala. The WHO now agreed that the outbreak meets the criteria for a Public Health Emergency of International Concern.

Coronaviruses are a group of viruses that cause diseases in mammals and birds. In humans, the viruses cause respiratory infections which are typically mild, including the common cold; however, rarer forms such as SARS, MERS and the novel coronavirus causing the current outbreak are lethal. In cows and pigs, they may cause diarrhea, while in chickens they can cause an upper respiratory disease. There are no vaccines or antiviral drugs that are approved for prevention or treatment.

Coronaviruses are viruses in the subfamily Orthocoronavirinae in the family Coronaviridae, in the order Nidovirales. Coronaviruses are enveloped viruses with a positive-sense single-stranded RNA genome and with a nucleocapsid of helical symmetry. The genomic size of coronaviruses ranges from approximately 26 to 32 kilobases, the largest for an RNA virus.

The name “coronavirus” is derived from the Latin corona, meaning crown or halo, which refers to the characteristic appearance of the virus particles (virions): they have a fringe reminiscent of a royal crown or of the solar corona.

Coronaviruses were discovered in the 1960s; the earliest ones discovered were infectious bronchitis virus in chickens and two viruses from the nasal cavities of human patients with the common cold that were subsequently named human coronavirus 229E and human coronavirus OC43. Other members of this family have since been identified, including SARS-CoV in 2003, HCoV NL63 in 2004, HKU1 in 2005, MERS-CoV in 2012, and 2019-nCoV in 2019; most of these have been involved in serious respiratory tract infections.

Cross-sectional model of a coronavirus

There are so far seven strains of human coronaviruses:

1. Human coronavirus 229E(HCoV-229E)
2. Human coronavirus OC43(HCoV-OC43)
3. SARS-CoV
4. Human coronavirus NL63(HCoV-NL63, New Haven coronavirus)
5. Human coronavirus HKU1
6. Middle East respiratory syndrome coronavirus(MERS-CoV), previously known as novel coronavirus 2012 and HCoV-EMC.
7. Novel coronavirus (2019-nCoV),also known as Wuhan pneumonia or Wuhan coronavirus. (‘Novel’ in this case means newly discovered, or newly originated, and is a placeholder name.)

The coronaviruses HCoV-229E, -NL63, -OC43, and -HKU1 continually circulate in the human population and cause respiratory infections in adults and children world-wide.

Symptoms

Common human coronaviruses, including types 229E, NL63, OC43, and HKU1, usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. Most people get infected with these viruses at some point in their lives. These illnesses usually only last for a short amount of time. Symptoms may include

• runny nose
• headache
• cough
• sore throat
• fever
• a general feeling of being unwell

Human coronaviruses can sometimes cause lower-respiratory tract illnesses, such as pneumonia or bronchitis. This is more common in people with cardiopulmonary disease, people with weakened immune systems, infants, and older adults.

Other human coronaviruses

Two other human coronaviruses, MERS-CoV and SARS-CoV have been known to frequently cause severe symptoms. MERS symptoms usually include fever, cough, and shortness of breath which often progress to pneumonia. About 3 or 4 out of every 10 patients reported with MERS have died. MERS cases continue to occur, primarily in the Arabian Peninsula. SARS symptoms often included fever, chills, and body aches which usually progressed to pneumonia. No human cases of SARS have been reported anywhere in the world since 2004.

HISTORY

• Outbreaks of viral diseases such as influenza, flu, coronavirus with similar symptoms are causing havoc time to time since 400 BCE. The symptoms of viral human influenza are described by Hippocrates in 400 BCE.
• First epidemic, where symptoms are probably influenza, was reported in 1173 in Europe. Influenza-like illness epidemic develops in Europe, preferentially killing elderly and debilitating persons.
• Epidemic of coughing disease associated with spontaneous abortions is noted in Paris in 1411.
• Influenza pandemic develops in Africa in the summer of 1510 and proceedes northward to involve all of Europe and then the Baltic States. Attack rates are extremely high, but fatality is low and said to be restricted to young children.
• The first influenza pandemic in which global involvement and westward spread from Asia to Europe is documented in 1557–1558. Unlike the previous pandemic from 1510, this one is highly fatal, with deaths recorded as being due to “pleurisy and fatal peripneumony”. High mortality in pregnant women is also recorded.
• Influenza pandemic originates in Asia during the summer, spreading to Africa, and then to Europe along two corridors from Asia Minor and North-West Africa in 1580. Illness rates are high. 8000 deaths are reported in Rome, and some Spanish cities are decimated.
• Influenza pandemic originates in Russia in 1729, spreading westwards in expanding waves to embrace all Europe within six months. High death rates are reported.
• Influenza pandemic originates in the Americas in the spring of 1761 and spreads from there to Europe and around the globe in 1762. It is the first pandemic to be studied by multiple observers who communicate with each other in learned societies and through medical journalsand books. Influenza is characterized clinically to a greater degree than it has been previously, as physicians carefully record observations on series of patients and attempt to understand what would later be called the pathophysiology of the disease.
• Influenza pandemic originates in Southeast Asiain 1780 and spreads to Russia and eastward into Europe. It is remarkable for extremely high attack rates but negligible mortality. It appears that in this pandemic the concept of influenza as a distinct entity with characteristic epidemiological features is first appreciated.
• Influenza pandemic breaks out in the winter of 1830 in China, further spreading southwards by sea to reach the Philippines, India and Indonesia, and across Russiainto Europe. By 1831, the epidemic reaches the Americas. Overall the attack rate is estimated at 20–25% of the population, but the mortality rate is not exceptionally high.
• In 1889-90, “Russian pandemic”. Attack rates are reported in 408 geographic entities from 14 European countries and in the United States. Rapidly spreading, the pandemic would take only 4 months to circumnavigate the planet, reaching the United States 70 days after the original outbreak in Saint Petersburg. Following this pandemic, interest is renewed in examining the recurrence patterns of influenza.
• The Spanish flu(H1N1) pandemic is considered one of the deadliest natural disasters ever, infecting an estimated 500 million people across the globe and claiming between 50 and 100 million lives. This pandemic would be described as “the greatest medical holocaust in history” and is estimated to have killed in a single year more people than the Black Death bubonic plaguekilled in four years from 1347 to 1351.
• New, virulent influenza A virus subtype H2N2breaks out in Guizhou (China) in 1957. It would turn into pandemic (category 2) and kill 1 to 4 million people.^[28] It is considered the second major influenza pandemic to occur in the 20th century, after the Spanish flu.
• Hong Kong flu(H3N2) pandemic breaks out in 1968-69, caused by a virus that has been “updated” from the previously circulating virus by reassortment of avian genes.
• Swine flu outbreakin 1976 is identified at U.S. army base in Fort Dix, New Jersey. Four soldiers infected resulting in one death. To prevent a major pandemic, the United States launches a vaccination campaign.
• Russian flu(H1N1) epidemic in 1977. New influenza strain in humans. Isolated in northern China. A similar strain prevalent in 1947–57 causes most adults to have substantial immunity. This outbreak is not considered a pandemic because most patients are children.
• Highly pathogenic avian influenza (HPAI) H5N1(also known as bird flu) is discovered in humans in 1997. The first time an influenza virus is found to be transmitted directly from birds to people. Eighteen people hospitalized, six of whom die. Hong Kong kills its entire poultry population of about 1.5 million birds. No pandemic develops.
• In 2009, New flu virus (H1N1) pandemic, first recognized in the state of Veracruz, Mexico, spreads quickly across the United States and the world, prompting a strong global public reaction. Overseas flights are discouraged from government health bodies.^[57]Worldwide, nearly 1 billion doses of H1N1 vaccine are ordered.^[58] A total of 74 countries are affected. 18,500 deaths.
• In 2013, Avian Influenza A virus subtype H7N9strain, a low pathogenic AI virus, breaks out in China. As of April 11, 2014, the outbreak’s overall total would reach 419 people, including 7 in Hong Kong, with the unofficial death toll at 127.
• In 2019-2020, Coronavirus outbreak: Death toll in China rises to 259

These highly contagious viral infection that mainly affects the respiratory system. It’s usually a seasonal illness, with yearly outbreaks killing hundreds of thousands of people around the world. Though rare, completely new versions of the virus may infect people and spread quickly, resulting in pandemics (an infection that spreads throughout the world) with death tolls in the millions. These disease have plagued humankind for centuries and, given its highly variable nature, may continue to do so for centuries to come.

Treatments

Only treatment suggested for such diseases is vaccination. After the Asian flu pandemic arose in 1957, a new vaccine protecting against H2N2 was developed. During the 1978 pandemic, scientists developed the first trivalent flu vaccine, which protected against one strain of influenza A/H1N1, one strain of influenza virus A/H3N2 and a type B virus. Most U.S.-licensed seasonal flu vaccines since then have been trivalent.

However, problem for developing vaccines that can be effective against all the available strains is continued to be a challenge. As well as effectiveness of vaccine can vary widely—the 2004–2005 vaccine was only 10 percent effective in the United States, while the 2010-2011 vaccine was 60 percent effective, according to the CDC.

The 2017–2018 flu vaccine was only 10 percent effective in Australia and about 25 percent effective in the United States against the H3N2 strain that caused most illnesses and deaths.

In the UK, an acute respiratory infection is the commonest reason for a patient to consult a general practitioner. Thirty million courses of antibiotics are prescribed per year for the treatment of acute respiratory infections despite evidence that they neither shorten the course of acute viral infections nor prevent secondary bacterial infections. The overuse of antimicrobial drugs for the management of respiratory infections has important implications for healthcare costs and the potential for emergence of antimicrobial resistance.

What should we do in India?

In light of the continued popularity of herbal medicine, an effective and well-tolerated herbal medication for the prevention and treatment of acute respiratory infections would be a welcome addition to the therapeutic repertoire. The leaves of Andrographis paniculata, popular in India as Kalmegh and as a cold and influenza remedy, are used traditionally in Ayurvedic.  Pharmacological studies have confirmed its  anti-inflammatory, antipyretic, antiviral and immunostimulatory properties.

Andrographis paniculate

Introduction

Andrographis paniculata (Burm. F) Nees, commonly known as the “king of bitters,” is an herbaceous plant belonging to the Acanthaceae and is found throughout tropical and subtropical Asia, Southeast Asia, and India. In India, A. paniculata is known as “Kalmegh”; in China it is known as “Chuan-Xin-Lian”; in Thailand it is known as “Fah Tha Lai”; in Malaysia it is known as “Hempedu bumi”; in Japan it is known as “Senshinren”; and in Scandinavian countries it is known as “green chiretta”. Extracts of this plant and andrographolide exhibit pharmacological activities such as those that are immunostimulatory, antiviral, and antibacterial. As major active constituent, andrographolide exhibits a broad range of biological activities, such as anti-inflammatory, antibacterial, antitumor, antidiabetic, antimalarial, and hepatoprotective.

 Chemical Structure

Andrographolide is a major bioactive phytoconstituent found in various parts of A. paniculata, but particularly in the leaves. The chemical name of andrographolide is 3α, 14, 15, 18-tetrahydroxy-5β, 9βH, 10α-labda-8, 12-dien-16-oic acid γ-lactone, and its molecular formula and weight are C₂₀H₃₀O₅ and 350.4 (C 68.54%, H 8.63%, and O 22.83%), respectively.

Antiviral Effects

The antiviral activities of plant extracts have been renewed and have been the topic of passionate scientific investigation. Several medicinal plant extracts have shown antiviral activities against some RNA and DNA viruses.

How to use this herb

Soak 10-15 g dried leaves and stems in water for overnight (water will be tea colour) and take in the morning empty stomach. If  fever persists,  take two three times in a day. For improving immunity against the virus, continue drinking for 7-10 days in the morning even if you are not infected with the virus. This will help you to prevent the disease. However, you are advised that you may consult a doctor if symptoms persist.

Disclaimer: This article has been prepared with information drawing from various sources: research papers, websites and no part of this is claimed by the author as his original work.  

References:

https://www.uchicagomedicine.org/forefront/prevention-and-screening-articles/wuhan-coronavirus

https://www.ynhhs.org/patient-care/urgent-care/flu-or-coronavirus

https://en.wikipedia.org/wiki/Coronavirus