Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany TO THE EDITOR: The novel coronavirus (2019-nCoV) from Wuhan is currently causing concern in the medical community as the virus is spreading around the world.1 Since its identification in late December 2019, the number of cases from China that have been imported into other countries is on the rise, and the epidemiologic picture is changing on a daily basis. We are reporting a case of 2019-nCoV infection acquired outside of Asia in which transmission appears to have occurred during the incubation period in the index patient.
A 33-year-old otherwise healthy German businessman (Patient 1) became ill with a sore throat, chills, and myalgias on January 24, 2020. The following day, a fever of 39.1°C (102.4°F) developed, along with a productive cough. By the evening of the next day, he started feeling better and went back to work on January 27.
Figure 1.
Timeline of Exposure to Index Patient with Asymptomatic 2019-CoV Infection in Germany. Before the onset of symptoms, he had attended meetings with a Chinese business partner at his company near Munich on January 20 and 21. The business partner, a Shanghai resident, had visited Germany between Jan. 19 and 22. During her stay, she had been well with no signs or symptoms of infection but had become ill on her flight back to China, where she tested positive for 2019-nCoV on January 26 (index patient in Figure 1).
On January 27, she informed the company about her illness. Contact tracing was started, and the above-mentioned colleague was sent to the Division of Infectious Diseases and Tropical Medicine in Munich for further assessment. At presentation, he was afebrile and well. He reported no previous or chronic illnesses and had no history of foreign travel within 14 days before the onset of symptoms. Two nasopharyngeal swabs and one sputum sample were obtained and were found to be positive for 2019-nCoV on quantitative reverse-transcriptase–polymerase-chain-reaction (qRT-PCR) assay.2 Follow-up qRT- PCR assay revealed a high viral load of 108 copies per milliliter in his sputum during the following days, with the last available result on January 29.
On January 28, three additional employees at the company tested positive for 2019-nCoV (Patients 2 through 4 in Figure 1). Of these patients, only Patient 2 had contact with the index patient; the other two patients had contact only with Patient 1. In accordance with the health authorities, all the patients with confirmed 2019-nCoV infection were admitted to a Munich infectious diseases unit for clinical monitoring and isolation. So far, none of the four confirmed patients show signs of severe clinical illness.
This case of 2019-nCoV infection was diagnosed in Germany and transmitted outside of Asia. However, it is notable that the infection appears to have been transmitted during the incubation period of the index patient, in whom the illness was brief and nonspecific.3
The fact that asymptomatic persons are potential sources of 2019-nCoV infection may warrant a reassessment of transmission dynamics of the current outbreak. In this context, the detection of 2019-nCoV and a high sputum viral load in a convalescent patient (Patient 1) arouse concern about prolonged shedding of 2019-nCoV after recovery. Yet, the viability of 2019- nCoV detected on qRT-PCR in this patient remains to be proved by means of viral culture.
Despite these concerns, all four patients who were seen in Munich have had mild cases and were hospitalized primarily for public health purposes. Since hospital capacities are limited — in particular, given the concurrent peak of the influenza season in the northern hemisphere — research is needed to determine whether such patients can be treated with appropriate guidance and oversight outside the hospital.
左图中间两个大白泡泡是两个冠毒，看到的地方是它们的外膜，大白泡泡四周还有一些毛茸茸的样子的东西就是spike蛋白，中文可能叫刺突蛋白。这个蛋白的用处就是拿来
粘人细胞表面的ACE2蛋白（血管紧张素转化酶II）
右图是把一个被感染的细胞超薄切片的照片，其中燕尾箭头指的是已经跑到细胞外面的单个病毒颗粒，每个黑球应该是一个病毒。
带把箭头指的是已经包在在细胞里面的囊泡里准备外运的新病毒成体，
三角形指的是细胞表面的纤毛。（肺的上皮细胞会形成很多纤毛，见二楼。）
肺细支气管上皮的样子
密恐不？
长的是顶楼里提到的纤毛，下面很多小点点像拖把毛一样的是更小更短的微绒毛。呼
吸上皮上的 纤毛 是可以自己主动运动的，把粘液往一个方向推，形成痰鼻涕之类的东西。
这是从哪弄来的，这么像老照片的新发现
顶楼是1月24新英格兰医学上另一片paper的图 讲新病毒的鉴定过程的
https://www.nejm.org/doi/full/10.1056/NEJMoa2001017
BRIEF REPORT
A Novel Coronavirus from Patients with Pneumonia in China, 2019
【 在 dragonfly (小蜻蜓-原创成语：翻盖疾潜。) 的大作中提到: 】
: 这是从哪弄来的，这么像老照片的新发现
这俩冠毒太难看了，像土豆被地老虎啃了。
那还真新
【 在 Huangchong (净坛使者) 的大作中提到: 】
: 顶楼是1月29新英格兰医学上另一片paper的图 讲新病毒的鉴定过程的
: https://www.nejm.org/doi/full/10.1056/NEJMoa2001017
: BRIEF REPORT
: A Novel Coronavirus from Patients with Pneumonia in China, 2019
新英格兰医学正在狂发各国的报告
及时把新病的诊断治疗数据发医学期刊是正常的，不能说是发国难paper。
大德意志帝国也发paper了。说他们也发现没症状的患者也能传播病毒。
https://www.nejm.org/doi/full/10.1056/NEJMc2001468
Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany
TO THE EDITOR:
The novel coronavirus (2019-nCoV) from Wuhan is currently causing concern in the medical community as the virus is spreading around the world.1 Since
its identification in late December 2019, the number of cases from China
that have been imported into other countries is on the rise, and the
epidemiologic picture is changing on a daily basis. We are reporting a case of 2019-nCoV infection acquired outside of Asia in which transmission
appears to have occurred during the incubation period in the index patient.
A 33-year-old otherwise healthy German businessman (Patient 1) became ill
with a sore throat, chills, and myalgias on January 24, 2020. The following day, a fever of 39.1°C (102.4°F) developed, along with a productive cough. By the evening of the next day, he started feeling better and went back to work on January 27.
Figure 1.
Timeline of Exposure to Index Patient with Asymptomatic 2019-CoV Infection
in Germany.
Before the onset of symptoms, he had attended meetings with a Chinese
business partner at his company near Munich on January 20 and 21. The
business partner, a Shanghai resident, had visited Germany between Jan. 19
and 22. During her stay, she had been well with no signs or symptoms of
infection but had become ill on her flight back to China, where she tested
positive for 2019-nCoV on January 26 (index patient in Figure 1).
On January 27, she informed the company about her illness. Contact tracing
was started, and the above-mentioned colleague was sent to the Division of
Infectious Diseases and Tropical Medicine in Munich for further assessment. At presentation, he was afebrile and well. He reported no previous or
chronic illnesses and had no history of foreign travel within 14 days before the onset of symptoms. Two nasopharyngeal swabs and one sputum sample were obtained and were found to be positive for 2019-nCoV on quantitative reverse-transcriptase–polymerase-chain-reaction (qRT-PCR) assay.2 Follow-up qRT-
PCR assay revealed a high viral load of 108 copies per milliliter in his
sputum during the following days, with the last available result on January 29.
On January 28, three additional employees at the company tested positive for 2019-nCoV (Patients 2 through 4 in Figure 1). Of these patients, only
Patient 2 had contact with the index patient; the other two patients had
contact only with Patient 1. In accordance with the health authorities, all the patients with confirmed 2019-nCoV infection were admitted to a Munich
infectious diseases unit for clinical monitoring and isolation. So far, none of the four confirmed patients show signs of severe clinical illness.
This case of 2019-nCoV infection was diagnosed in Germany and transmitted
outside of Asia. However, it is notable that the infection appears to have
been transmitted during the incubation period of the index patient, in whom the illness was brief and nonspecific.3
The fact that asymptomatic persons are potential sources of 2019-nCoV
infection may warrant a reassessment of transmission dynamics of the current outbreak. In this context, the detection of 2019-nCoV and a high sputum
viral load in a convalescent patient (Patient 1) arouse concern about
prolonged shedding of 2019-nCoV after recovery. Yet, the viability of 2019-
nCoV detected on qRT-PCR in this patient remains to be proved by means of
viral culture.
Despite these concerns, all four patients who were seen in Munich have had
mild cases and were hospitalized primarily for public health purposes. Since hospital capacities are limited — in particular, given the concurrent peak of the influenza season in the northern hemisphere — research is needed to determine whether such patients can be treated with appropriate guidance
and oversight outside the hospital.
大越帝国： 可以人传人https://www.nejm.org/doi/full/10.1056/NEJMc2001272
Importation and Human-to-Human Transmission of a Novel Coronavirus in
Vietnam
看了这图我相信神创论了，靠进化怎么能进化出这么精细复杂的器官
【 在 Huangchong (净坛使者) 的大作中提到: 】
: 肺细支气管上皮的样子
: 密恐不？
: 长的是顶楼里提到的纤毛，下面很多小点点像拖把毛一样的是更小更短的微绒毛。呼: 吸上皮上的 纤毛 是可以自己主动运动的，把粘液往一个方向推，形成痰鼻涕之类的东
: 西。
漂亮的海洋生物
【 在 Huangchong (净坛使者) 的大作中提到: 】
: 肺细支气管上皮的样子
: 密恐不？
: 长的是顶楼里提到的纤毛，下面很多小点点像拖把毛一样的是更小更短的微绒毛。呼: 吸上皮上的 纤毛 是可以自己主动运动的，把粘液往一个方向推，形成痰鼻涕之类的东
: 西。
上帝真奇妙
宇宙真奇妙
【在 Huangchong(净坛使者)的大作中提到：】
：肺细支气管上皮的样子
：密恐不？
你要说奇妙，人体的免疫系统为了杀病毒能够自残。
【 在 verizonchen (verizonchen) 的大作中提到: 】
: 上帝真奇妙
: 宇宙真奇妙
: ：肺细支气管上皮的样子
: ：密恐不？