Update and interim guidance on outbreak of 2019 Novel Coronavirus (2019-nCoV)
January 31, 2020
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- The 2019 nCoV outbreak continues to evolve rapidly. Public health and clinical guidance will be revised as new information becomes available. Please check the CDC coronavirus web pages frequently for current information for healthcare providers on evaluation and management of persons for nCoV infection. CDC guidance is available at www.cdc.gov/coronavirus/2019-ncov
- See new criteria for evaluation of patients under investigation (PUI) for 2019-nCoV. Epidemiologic criteria now include (in addition to previous criteria for close contact with a confirmed case or PUI) travel to Hubeui Province, China (changed from Wuhan) and travel from other locations in mainland China within 14 days of symptom onset. For the mainland China travelers, PUI criteria require fever AND signs/symptoms of lower respiratory illness requiring hospitalization.
- New CDC guidance also includes Interim Clinical Guidance for Management of Patients with Confirmed 2019 Novel Coronavirus (2019-nCoV) Infection.
- Health care providers and facilities should obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness and plan for a potential increase in patients seeking information and/or evaluation for 2019-nCoV infection through use of triage systems.
- Ensure policies and practices are in place to minimize exposures in healthcare settings to respiratory pathogens including 2019-nCoV and be familiar with infection control and PPE guidance. Measures should be implemented before patient arrival, upon arrival, and throughout the duration of the affected patient’s presence in the healthcare setting. See: Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for 2019 Novel Coronavirus (2019-nCoV) in a Healthcare Setting).
- Persons being evaluated for 2019-nCoV 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, ideally an airborne infection isolation room (AIIR) if available.
- Healthcare personnel entering the room should use standard precautions, contact precautions, airborne precautions, and use eye protection (e.g., goggles or a face shield).
- Additional CDC guidance for clinics that do not have AIIR rooms is forthcoming.
- Commercial respiratory panel assays do NOT detect 2019-nCoV. Educate patients about the difference between endemic (circulating, seasonal, not serious) strains of human coronaviruses that cause common cold- like symptoms and the outbreak strain of nCoV if they are tested with a commercial respiratory panel and have a positive non-nCoV coronavirus result.
- Healthcare providers should immediately notify both infection control personnel at their healthcare facility (HCF) and Public Health (206-296-4774) in the event of a PUI for 2019-nCoV.
- At this time, diagnostic testing for 2019-nCoV can be conducted only at CDC. Public Health will work with HCF to facilitate collection, storage and shipment of specimens to CDC. Testing for other respiratory pathogens should not delay specimen shipping to CDC.