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Novel coronavirus and bleeding disorders update

The European Haemophilia Consortium (EHC) is closely following the recent developments on the emergence of the Coronavirus (2019-nCov) outbreak in Wuhan, Hubei Province, China.

They have produced this update for the European bleeding disorders community so we are reproducing it here for the benefit of our community in Scotland.  We have also included the current, general, advice for the UK in this blog. We are extremely grateful to the EHC for their work on this issue.

The EHC briefing relates to:

  1. Infection risks in Europe;
  2. Safety of plasma proteins used in the manufacturing of treatment products; and
  3. Potential risks with international travel.

Infection risks in Europe

The EHC refer readers to the European Centre for Disease Prevention and Control (ECDC), which has been closely following developments regarding 2019-nCoV. On 31 January 2020, the ECDC issued its third Rapid Risk Assessment update on this outbreak. On the basis of the latest information available the ECDC assesses that for the European region:

  • There is a moderate-to-high likelihood of additional imported cases in the EU/EEA;
  • The likelihood of observing further limited human-to-human transmission within the EU/EEA is estimated as very low-to-low, if cases are detected early and appropriate infection prevention and control (IPC) practices are implemented, particularly in healthcare settings in EU/EEA countries;
  • Assuming that cases in the EU/EEA are detected in a timely manner and that rigorous IPC measures are applied, the likelihood of sustained human-to-human transmission within the EU/EEA is currently very low-to-low;
  • The late detection of an imported case in an EU/EEA country without the application of appropriate infection prevention and control measures would result in the high likelihood of human-to-human transmission, therefore in such a scenario the risk of secondary transmission in the community setting is estimated to be high.

The full ECDC Risk Assessment is available here.

Safety of plasma proteins used in the manufacturing of treatment products

The 2019-nCoV virus is large in size (120 nM in diameter) and has a lipid envelope. This means that current viral inactivation and removal steps used in the manufacturing process of clotting factor concentrates (CFCs) and virally-inactivated fresh frozen plasma (FFP) should be effective in eliminating this virus.

The Plasma Protein Therapeutics Association (PPTA), an international trade association representing private plasma collectors and commercial manufacturers of plasma-derived treatments, including plasma-derived CFCs, issued a statement on 30 January 2020 which is available here.

Potential risks with international travel

The World Health Organisation (WHO) issued a global health emergency regarding 2019-nCoV on 30 January 2020. The EHC refers readers to the WHO ‘one-stop-shop’ information page for 2019-nCoV, available here in English, French, Spanish and Russian. Regarding potential risks with international travel, the EHC refers readers to the WHO advice for international travel in relation to this outbreak available here.

Regarding the upcoming WFH Congress to be held in Kuala Lumpur, Malaysia, from 14-17 June 2020, the World Federation of Hemophilia (WFH) issued a statement on 31 January 2020 available here, citing no current travel or health directives to note regarding the Congress, with updates to be posted on their website and by email.

The EHC will continue to monitor the situation. If you have questions about your treatment, please contact your healthcare provider.

 

Joint statement from the Chief Medical Officers of Scotland, England, Wales and Northern Ireland

Issued 30 Jan 2020

We have been working in close collaboration with international colleagues and the World Health Organisation to monitor the situation in China and around the world.

In light of the increasing number of cases in China and using existing and widely tested models, the four UK Chief Medical Officers consider it prudent for our governments to escalate planning and preparation in case of a more widespread outbreak.

For that reason, we are advising an increase of the UK risk level from low to moderate. This does not mean we think the risk to individuals in the UK has changed at this stage, but that government should plan for all eventualities.

As we have previously said, it is likely there will be individual cases and we are confident in the ability of the NHS in England, Scotland and Wales and HSC in Northern Ireland to manage these in a way that protects the public and provides high quality care.

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