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Persons evaluated for 2019 novel coronaVirus — United States, January 2020
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February 7, 2020
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Corporate Authors:2019-nCoV Persons Under Investigation. ; Centers for Disease Control and Prevention (U.S.)Epidemic Intelligence Service. ; National Center for Immunization and Respiratory Diseases (U.S.)Division of Bacterial Diseases. ; National Center for Immunization and Respiratory Diseases (U.S.)Division of Viral Diseases. ; National Center for Immunization and Respiratory Diseases (U.S.)Influenza Division. ; ... More +
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Description:What is already known about this topic? - During a 2020 outbreak of novel coronaVirus (2019-nCoV) infection, CDC provided consultation to public health officials and health care providers evaluating persons at risk for 2019-nCoV infection.
What is added by this report? - During January 2020, CDC responded to clinical inquiries regarding approximately 650 persons in the United States and tested 210 for 2019-nCoV, one fifth of whom reported no recent travel-related risk but had close contact with a 2019-nCoV patient or a person under investigation for 2019-nCoV in the United States
What are the implications for public health practice? - Health care providers should remain vigilant regarding possible 2019-nCoV exposure not only among returning travelers, but also among persons in close contact with 2019-nCoV patients in the United States
In December 2019, a cluster of cases of pneumonia emerged in Wuhan City in central China’s Hubei Province. Genetic sequencing of isolates obtained from patients with pneumonia identified a novel coronaVirus (2019-nCoV) as the etiology (1). As of February 4, 2020, approximately 20,000 confirmed cases had been identified in China and an additional 159 confirmed cases in 23 other countries, including 11 in the United States (2,3). On January 17, CDC and the U.S. Department of Homeland Security’s Customs and Border Protection began health screenings at U.S. airports to identify ill travelers returning from Wuhan City (4). CDC activated its Emergency Operations Center on January 21 and formalized a process for inquiries regarding persons suspected of having 2019-nCoV infection (2). As of January 31, 2020, CDC had responded to clinical inquiries from public health officials and health care providers to assist in evaluating approximately 650 persons thought to be at risk for 2019-nCoV infection. Guided by CDC criteria for the evaluation of persons under investigation (PUIs) (5), 210 symptomatic persons were tested for 2019-nCoV; among these persons, 148 (70%) had travel-related risk only, 42 (20%) had close contact with an ill laboratory-confirmed 2019-nCoV patient or PUI, and 18 (9%) had both travel- and contact-related risks. Eleven of these persons had laboratory-confirmed 2019-nCoV infection. Recognizing persons at risk for 2019-nCoV is critical to identifying cases and preventing further Transmission. Health care providers should remain vigilant and adhere to recommended infection Prevention and control practices when evaluating patients for possible 2019-nCoV infection (6). Providers should consult with their local and state health departments when assessing not only ill travelers from 2019-nCoV-affected countries but also ill persons who have been in close contact with patients with laboratory-confirmed 2019-nCoV infection in the United States
As part of CDC’s Emergency Operations Center activation, CDC personnel assist state and local health departments with the evaluation of 2019-nCoV PUIs. Public health laboratories were not yet conducting 2019-nCoV tTesting during the period covered by this report, while awaiting Food and Drug Administration emergency use authorization for the test. (The authorization occurred on February 4*). Therefore, all tTesting was conducted at CDC. A call center was staffed by a team of physicians and nurses 24 hours per day. During January 17–31, criteria used to determine whether a person was considered to be a PUI included presence of fever and symptoms of lower respiratory tract illness (e.g., cough or difficulty breathing) in addition to epidemiologic risk. Epidemiologic risk factors included History of travel from Wuhan City, close contact with a patient with laboratory-confirmed 2019-nCoV infection, or close contact with an ill PUI. Given the evolving understanding of 2019-nCoV Epidemiology, tTesting was recommended for some persons who did not strictly meet the PUI definition, based on clinical discretion. For clinical inquiries that resulted in 2019-nCoV tTesting, real-time reverse transcription polymerase chain reaction tTesting was conducted at CDC using Methods developed specifically to detect 2019-nCoV (7).
For this report, CDC reviewed inquiries regarding potential 2019-nCoV PUIs received by CDC through January 31, 2020, from state and local health departments, health care providers, and airport health screening personnel. Information was compiled from call logs and PUI forms to assess source of inquiry, PUI demographic data (including age and sex), clinical information, epidemiologic risk factors, and 2019-nCoV test results. To allow for delays in specimen shipping and tTesting, data for PUIs for whom an initial inquiry was received during January 2020 were collected through February 4, 2020.
Suggested citation for this article: Bajema KL, Oster AM, McGovern OL, et al. Persons Evaluated for 2019 Novel CoronaVirus — United States, January 2020. MMWR Morb Mortal Wkly Rep. ePub: 7 February 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6906e1
mm6906e1-H.pdf
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Content Notes:Summary -- Discussion -- Acknowledgments -- Figure -- Table -- References.
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