In December 2019, a cluster of pneumonia cases emerged in the city of Wuhan, in the central Chinese province of Hubei. Genetic sequencing of isolates received from pneumonia patients with a known novel coronavirus (2019-nCoV) etiology. [1] As of February 4, 2020, there were approximately 20,000 known cases shown in China and an additional 159 cases shown in 23 other countries, adding 11 in the United States. [2,3] On January 17, the CDC and Department of US State The National Customs and Border Security Protection has begun physical fitness checks at US airports to identify unfit travelers returning from the city of Wuhan. [4] The CDC activated its Emergency Operations Center on January 21 and formalized a procedure to investigate additional people suspected of having the 2019-nCoV infection. [2] As of January 31, 2020, CDC responded to clinical inquiries from public fitness officials and fitness service providers to help match approximately 650 additional individuals who may be at risk for 2019- nCoV. Guided by the CDC Criteria for the Evaluation of Persons Under Investigation (PUI),[5] 210 symptomatic Americans were tested for 2019-nCoV; of those Americans, 148 (70%) had only one travel risk, 42 (20%) had close contact with a 2019-nCoV patient or PUI, and 18 (9%) had one travel and one contact. similar threats. Eleven of the other people had 2019-nCoV infection in the laboratory. Recognizing others at risk from 2019-nCoV is key to identifying cases and preventing further transmission. Healthcare providers deserve to remain vigilant and adhere to recommended infection prevention and control practices when comparing patients with imaginable 2019-nCoV infection. [6] Providers deserve to consult with their local and national fitness departments when testing not only ill travelers from countries affected by 2019-nCoV, but also other ill individuals who have been in close contact with infected patients. through the 2019-nCoV shown in the laboratory in the United States.
As part of CDC’s Emergency Operations Center activation, CDC staff are assisting state and local fitness decomposers in testing for 2019-nCoV PUIs. Public fitness laboratories were not yet testing for 2019-nCoV in the period covered by this report, pending emergency use authorization from the Food and Drug Administration for the test. (The authorization took position on February 4 *). Therefore, all testing was done at the CDC. A call center was staffed by a team of doctors and nurses 24 hours a day. From January 17 to January 31, the criteria used to determine whether a user was thought to have a PUI included the presence of fever and symptoms of lower respiratory tract disease (eg, cough or shortness of breath) in addition to the epidemiological threat. Points of epidemiological threat included travel history from the city of Wuhan, close contact with a patient infected with laboratory-confirmed 2019-nCoV, or close contact with a PUI in poor physical condition. Given the evolving understanding of the epidemiology of 2019-nCoV, some Americans who did not strictly meet the definition of PUI were advised to be tested, based on clinical discretion. For clinical investigations that resulted in testing for 2019-nCoV, real-time reverse transcription polymerase chain reaction tests were performed at CDC using component-developed strategies to detect 2019-nCoV. [7]
For this report, CDC reviewed requests for potential 2019-nCoV PUIs obtained through CDC through January 31, 2020, from state and local fitness departments, fitness care providers, and airport fitness assessment staff. Information compiled from PUI call records and bureaucracy to assess application source, PUI demographics (including age and gender), clinical information, epidemiological threat factors, and 2019-nCoV verification results. 2020 were collected until February 4, 2020.
Digit.
Number of Americans for 2019 novel coronavirus (2019-nCoV), as of date of initial investigation (N=256) — United States, January 2020*,† *Confirmed cases were reported through January 31, 2020. †Public announcements of a Reported cases of 2019-nCoV in the United States were on the following dates: 21 January, 24 January, 26 January, 27 January (two instances), 30 January and 31 January.
The other 210 people tested were symptomatic: 143 (68%) had subjective fever or measured temperature ≥100. 4°F (≥38°C) and 189 (90%) had cough or shortness of breath. Upper respiratory tract symptoms (i. e. , sore throat, runny nose, or congestion) were not unusual and occurred in nine other people who did not have a cough or shortness of breath. Thirty other people reportedly tested positive for some other respiratory viral pathogen, such as influenza or respiratory syncytial virus. Forty-two (20%) patients were hospitalized and 4 (2%) were admitted to the intensive care unit. One patient had died at the time of notification; Tests for this user were negative and some other cause of death was established. The travel-related threat was known to 148 (70%) other persons, 42 (20%) had close contact with ill patients with laboratory-confirmed 2019-nCoV infection or PUI, 18 (9%) had travel and contact threats, and two (<1%) had imaginable contact with a laboratory-confirmed 2019-nCoV patient and were therefore Evaluated.
Of the other 210 people tested, 11 (5%) were found to be inflamed with 2019-nCoV. Nine of those others had travelled to the city of Wuhan; two other people had not yet traveled and had been in close contact with patients with laboratory-confirmed 2019-nCoV in the United States. All had symptoms with fever (subjective or measured) or cough.
Morbidity and Mortality Weekly Report. 2020;69(6):166-170. © 2020 Centers for Disease Control and Prevention (CDC)
*https://www. fda. gov/news-events/press-announcements/fda-takes-significant-step-coronavirus-response-efforts-issues-emergency-use-authorization-first.
Abbreviations: ICU = intensive care unit; IQR = interquartile range; PUI = user under investigation. * Numbers may not load in general due to lack of data. †This user tested negative for 2019-nCoV and some other cause of death was established. §Other people who were tracked through touch tracking but first sought remedy at a fitness center are not included in this category. ¶ Includes an additional 113 people who traveled from the city of Wuhan and 35 who traveled from parts of China outside of Wuhan within 14 days of symptom onset. ** Includes 33 other people who were in close contact with a patient with laboratory-confirmed 2019-nCoV and nine who were in close contact with PUI. All touches took place within 14 days of symptom onset. †† Includes 4 Americans who traveled from Wuhan City and were in close contact with a patient with laboratory-confirmed 2019-nCoV, 11 who traveled from Wuhan City and were in close contact with PUI, and 3 who traveled from China and they were in close contact with a PUÍS. §§ Had imaginable contact with a laboratory-confirmed 2019-nCoV patient and was therefore tested.
Kristina L. Bajema, MD1,2, Alexandra M. Oster, MD3, Olivia L. McGovern, PhD1,2, Stephen Lindstrom, PhD4, Mark R. Stenger, MA5, Tara C. Anderson, DVM, PhD6, Cheryl Isenhour, DVM2 , Kevin R. Clarke, MD7, Mary E. Evans, MD8, Victoria T. Chu, MD1,4, Holly M. Biggs, MD4, Hannah L. Kirking, MD4, Susan I. Gerber, MD4, Aron J. Hall, DVM4, Alicia M. Fry, MD9, and Sara E. Oliver, MD2, 2019-nCoV Investigation Team 1 Epidemic Intelligence Service, CDC; 2Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC; 3Division of HIV/AIDS Prevention, National Center for the Prevention of HIV/AIDS, Viral Hepatitis, STDs, and Tuberculosis, CDC; 4 Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC; 5Std Prevention Division, National Center for the Prevention of HIV/AIDS, Viral Hepatitis, STDs and Tuberculosis, CDC; 6Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology and Laboratory Services, CDC; 7 Division of Global Health Protection, Center for Global Health, CDC; 8 Division of Overdose Prevention, National Center for Injury Prevention and Control, CDC; 9 Division of Influenza, National Center for Immunization and Respiratory Diseases, CDC.
Correspondent Kristina L. Bajema, kbajema@cdc. gov, 404-639-1204.
All authors completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.
2019-CoV Persons Under Investigation Glen Abedi Team, National Center for Immunization and Respiratory Diseases, CDC; William Bower, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Kevin Chatham-Stephens, National Center on Birth Defects and Developmental Disabilities, CDC; Laura Conklin, Center for Global Health, CDC; Laura Cooley, National Center for the Prevention of HIV/AIDS, Viral Hepatitis, STDs and Tuberculosis, CDC; Margaret Cortese, National Center for Immunization and Respiratory Diseases, CDC; Aaron Curns, National Center for Immunization and Respiratory Diseases, CDC; Kathleen Dooling, National Center for Immunization and Respiratory Diseases, CDC; Runa Gokhale, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Jeremy Gold, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Gavin Grant, Center for Global Health, CDC; Julie Gutman, Center for Global Health, CDC; Elisabeth Hesse, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Shifaq Kamili, National Center for Immunization and Respiratory Diseases, CDC; Lindsay Kim, National Center for Immunization and Respiratory Diseases, CDC; Robert Kirkcaldy, National Center for the Prevention of HIV/AIDS, Viral Hepatitis, STDs and Tuberculosis, CDC; Emily Koumans, National Center for Chronic Disease Prevention and Health Promotion, CDC; Stephanie Kujawski, National Center for Immunization and Respiratory Diseases, CDC; Gayle Langley, National Center for Immunization and Respiratory Diseases, CDC; Joana Lively, National Center for Immunization and Respiratory Diseases, CDC; Xiaoyan Lu, National Center for Immunization and Respiratory Diseases, CDC; Brian Lynch, National Center for Immunization and Respiratory Diseases, CDC; Sheryl Lyss, National Center for the Prevention of HIV/AIDS, Viral Hepatitis, STDs and Tuberculosis, CDC; Lakshmi Malapati, National Center for Immunization and Respiratory Diseases, CDC; Michael Martin, National Center for the Prevention of HIV/AIDS, Viral Hepatitis, STDs and Tuberculosis, CDC; Sarah Mbaeyi, National Center for Immunization and Respiratory Diseases, CDC; Paul McClung, National Center for the Prevention of HIV/AIDS, Viral Hepatitis, STDs and Tuberculosis, CDC; Claire Midgley, National Center for Immunization and Respiratory Diseases, CDC; Maureen Miller, National Center for Chronic Disease Prevention and Health Promotion, CDC; Michelle Morales, Center for Global Health, CDC; Janna’ Murray, National Center for Immunization and Respiratory Diseases, CDC; Amy Parker Fiebelkorn, National Center for Immunization and Respiratory Diseases, CDC; Manisha Patel, National Center for Immunization and Respiratory Diseases, CDC; Georgina Peacock, National Center on Birth Defects and Developmental Disabilities, CDC; Taran Pierce, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Brian Rha, National Center for Immunization and Respiratory Diseases, CDC; Senthilkumar Sakthivel, National Center for Immunization and Respiratory Diseases, CDC; Eileen Schneider, National Center for Immunization and Respiratory Diseases, CDC; David A. Siegel, National Center for Chronic Disease Prevention and Health Promotion, CDC; Brittany Sunshine, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Megan Wallace, National Center for Immunization and Respiratory Diseases, CDC; Lijuan Wang, National Center for Immunization and Respiratory Diseases, CDC; John Watson, National Center for Immunization and Respiratory Diseases, CDC; Brett Whitaker, National Center for Immunization and Respiratory Diseases, CDC; Anna Yousaf, National Center for Immunization and Respiratory Diseases, CDC.
What do we already know about this topic?
During an outbreak of infection with the novel coronavirus (2019-nCoV) in 2020, CDC consulted public fitness officials and health care providers who screened Americans for the threat of 2019-nCoV infection.
What does this bring?
As of January 2020, CDC responded to clinical inquiries involving approximately 650 other people in the U. S. They tested 210 for 2019-nCoV, one-fifth of whom reported no recent travel-related hazards but had close contact with a 2019-nCoV patient or user under investigation for 2019-nCoV in the United States.
What are the implications for public practice?
Health care providers deserve to remain vigilant for imaginable exposure to 2019-nCoV not only among returning travelers, but also among others in close contact with 2019-nCoV patients in the United States.
Digit.
Digit.
Number of Americans for 2019 novel coronavirus (2019-nCoV), as of date of initial investigation (N=256) — United States, January 2020*,† *Confirmed cases were reported through January 31, 2020. †Public announcements of a Reported cases of 2019-nCoV in the United States were on the following dates: 21 January, 24 January, 26 January, 27 January (two instances), 30 January and 31 January.
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