Impact of Travel History in COVID-19 Infectivity in Nowshera KP, Pakistan

Dear Editor

COVID-19 (Corona virus disease) was first reported from metropolitan city, Wuhan, Hubei province of China in Dec 2019 that causes severe respiratory disease/pneumonia. The etiology of COVID-19 is yet to be confirmed, but majority of the scientists agree that it most likely originated from the zoonotic corona virus, SARS-CoV that emerged in 2002 [1]. Corona Virus disease termed as COVID-19, is an emerging highly contagious respiratory disease that is caused by novel corona virus. Its main clinical symptoms are fever, dry cough, fatigue, myalgia and dyspnea. Case fatality rate of 2.3% has been reported from china that is lower than SARS (9.5%), MERS (34.4%) and H7N9 (39%) [2].

People adherence to preventive and precautionary measures is essential, which largely depends on the knowledge attitude and practice of people toward COVID-19. Italy, the second mostly affected country, with 888 cases of SARS-CoV infection with history of travel to the epidemic area was initially reported in Lombardia and Veneto regions. They attributed these infections with poor compliance of the people towards precautionary measures during the early stages of current epidemic in the country [3]. To facilitate the healthcare workers working in COVID-19 clinics, management and administration of district Nowshera, of KP state of Pakistan to handle suspects, We feel a dire need to give facts and figures on the impact of travel and positive contact history and its correlation with 2019-nCoV infectivity, hence we followed some interventions.

In one of our intervention with 75 suspects who were selected under strict criteria for PCR testing and we found that out of total, 11(14.6%) positive cases had a history of travel to an epidemic area. Our findings are still comparably lower than Qiu H, et al. [4] who reported (33%) positive Letter to Editor cases from the suspects with history of exposure to epidemic areas in China.

Similarly we used Spearman correlation test to see the correlation of the travel history and viral infectivity and observed a statistically significant moderate uphill positive correlation of COVID-19 with history of travel to epidemic area (p=0.001, rho=0.34).

In China where unprecedented measures were taken well in time to control the rapid spread of COVID-19 epidemics in china. They succeeded to adhere people to homes that were properly achieved by their improved Knowledge, attitude and practices towards COVID-19 [5].

Travel history has its importance in the transmission of COVID-19. Countries have imposed strict restrictions on travel including the borders restrictions especially for the people of China, or those who travelled China in last 14 days, to contain the virus [6]. Therefore the message is to “STAY IN HOME” travel history especially to an infected area with positive cases can increase the chances of getting infection with 2019-nCoV. Travel to an epidemic area is a strong risk factor for COVID-19.