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January 8, 2020

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  • Clinicians should consider pneumonia related to an outbreak of pneumonia of unknown etiology (PUE) in Wuhan City, China, for patients with severe respiratory symptoms who traveled to Wuhan since December 1, 2019 AND had onset of illness within two weeks of returning, AND who do not have another known diagnosis that would explain their illness.

  • Notify infection control personnel and contact Public Health immediately (206-296-4774) if any patients meet these criteria.

  • Multiple respiratory tract specimens should be collected from persons with infections suspected to be associated with this cluster, including nasopharyngeal, nasal, and throat swabs. Patients with severe respiratory disease also should have lower respiratory tract specimens collected, if possible. Consider saving urine, stool, serum, and respiratory pathology specimens if available.

  • Although the etiology and transmissibility have yet to be determined, and to date, no human-to-human transmission has been reported and no health care providers have been reported ill, CDC currently recommends a cautious approach to symptomatic patients with a history of travel to Wuhan City.
    • Such patients should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed.
    • Personnel entering the room to evaluate the patient should use contact precautions and wear an N95 disposable facepiece respirator.

For patients admitted for inpatient care, contact and airborne isolation precautions, in addition to standard precautions, are recommended until further information becomes available.

CDC is monitoring a reported cluster of pneumonia of unknown etiology (PUE) with possible epidemiologic links to a large wholesale fish and live animal market in Wuhan City, Hubei Province, China. An outbreak investigation by local officials is ongoing in China. Currently, there are no known U.S. cases nor have cases been reported in countries other than China.

According to a report from the Wuhan Municipal Health Commission, as of January 5, 2020, the national authorities in China have reported 59 patients with PUE to WHO. The patients had symptom onset dates from December 12 through December 29, 2019. Patients involved in the cluster reportedly have had fever, dyspnea, and bilateral lung infiltrates on chest radiograph. Of the 59 cases, seven are critically ill, and the remaining patients are in stable condition. No deaths have been reported and no health care providers have been reported to be ill. The Wuhan Municipal Health Commission has not reported human-to-human transmission.

Reports indicate that some of the patients were vendors at the Wuhan South China Seafood City (South China Seafood Wholesale Market) where, in addition to seafood, chickens, bats, marmots, and other wild animals are sold, suggesting a possible zoonotic origin to the outbreak. The market has been closed for cleaning and disinfection. On January 8th, WHO reported that Chinese authorities believe a novel (non-SARS, non-MERS) coronavirus may be causing the infections, but this has not been confirmed.