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Letters to the Editor

2019 novel coronavirus and awareness

Joob, Beuya,*; Wiwanitkit, Virojb,c

Author Information
Journal of the Chinese Medical Association: May 2020 - Volume 83 - Issue 5 - p 507
doi: 10.1097/JCMA.0000000000000306
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Dear Editor,

We would like to share ideas on publication entitled “The outbreak of COVID-19: An overview.” Wu et al noted that “To promptly identify patients and prevent further spreading, physicians should be aware of travel or contact history for patients with compatible symptoms.”1 In fact, the new disease started from Hubei in China mainland and spread to Thailand then to other countries.2 It is no doubt that the screening can help prevent spreading of the disease. If we focus on travel or contact history or classical clinical feature (fever and cough), we might misdiagnose some cases. Atypical clinical presentation and nonfebrile case is possible.3 In addition, the patient might get disease from nonsymptomatic patient. In our country, Thailand, some cases are not identified by any screening, but the patients visit the physician by themselves and get final diagnosis. Finally, the trail of disease transfer is complex. Multistep of disease transmission from China mainland to second and then to third country already occurs. Hence, we have to be aware of the possibility of disease in any patients with suspicious clinical feature regardless of the history of travel or contact to possible infected cases.


1. Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: an overview. J Chin Med Assoc. 2020; 83:217–20
2. Yasri S, Wiwanitkit V. Editorial: Wuhan coronavirus outbreak and imported case. Adv Trop Med Pub Health Int. 2020; 10:1–2
3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395:P497–506
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