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COVID-19 and Saliva: A Primer for Dental Health Care Professionals

This century has seen the emergence of three novel b coronavirus (CoV), namely the severe acute respiratory syndrome CoV (SARS-CoV-1), the Middle East respiratory syndrome CoV (MERS-CoV) and, most recently, the novel SARS-CoV-2 (COVID-19) that cause severe human diseases and death. Between November 2002 and August 2003, the global SARS-CoV-1 spread to 32 countries with a mortality rate of 10.87%. Between April and December 2012, the MERS-CoV spread to 27 countries affecting 2,496 individuals and causing 868 deaths. The COVID-19 virus spread even more rapidly constituting a global pandemic with over 6.5 million individuals infected and nearly 400,000 deaths worldwide as of June 2020. The spread of the 2003 SARS outbreak was primarily nosocomial largely affecting healthcare workers caring for sick individuals. However, SARs-CoV-2 spreads by contact with individuals in the early phase of illness accounting for the higher transmissibility. Critically, high percentages of COVID-19 patients with mild symptoms are often missed making the potential for unknown contact much higher. In addition, the short serial interval (4–9 days) and the varied reproduction number (R0) of the COVID-19 virus across the globe supports the potential for transmission by asymptomatic carriers.