Novel Coronavirus Alert for Healthcare Providers

Novel Coronavirus (2019-nCoV) Respiratory Infection in Wuhan City, China and Snohomish County

Posted Jan. 22, 2020. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.


Washington State Department of Health (DOH) yesterday reported a confirmed infection of Novel Coronavirus (2019-nCoV) in a Snohomish County resident returning from Wuhan City, Hubei Province, China where an ongoing outbreak of 2019-nCoV is occurring. The man in his 30s is hospitalized in good condition as a precaution. His infection is not considered a threat to medical staff or the public.

The Centers for Disease Control & Prevention (CDC) continues to closely monitor the outbreak of 2019-nCoV that began in December 2019. Since that time over 400 cases have been reported with at least 17 deaths. Today’s announcement of the Snohomish County case is the first in the United States. Other cases have been reported in Japan, South Korea, Thailand, Taiwan, and other cities in China; all associated with Wuhan City.

Coronaviruses are a large family of viruses; some affect people, some affect animals, and some animal coronaviruses can evolve and infect people and then spread between people, such as has been seen with Middle Eastern Respiratory Syndrome. Chinese authorities report most patients in the Wuhan City outbreak have been epidemiologically linked to a large seafood and animal market, suggesting a possible zoonotic origin to the outbreak. However, a growing number of patients reportedly have not had exposure to animal markets, suggesting person-to-person spread is occurring.

Action requested:

  • Be aware that 2019-nCoV has been confirmed in a traveler who recently returned to Snohomish County from Wuhan, China.
  • Obtain a detailed travel history for patients being evaluated with fever and symptoms of acute lower respiratory illness.
  • 2019-nCoV should be suspected in patients who present with:
    • fever AND symptoms of lower respiratory illness (e.g., cough, difficulty breathing) AND in the 14 days before symptom onset:
      • have a history of travel from Wuhan City, China --or--
      • had close contact with a person who is under investigation for 2019-nCoV while that person was ill.
    • fever OR symptoms of lower respiratory illness (e.g., cough, difficulty breathing) AND in the 14 days before symptom onset had close contact with an ill lab-confirmed 2019-nCoV patient.
  • Ask patients with suspected 2019-nCoV infection to wear a surgical mask as soon as they are identified and evaluate them in a private room with the door closed, ideally an airborne infection isolation room if available.
  • All healthcare personnel entering the room should use standard precautions, contact precautions, airborne precautions, and use eye protection (e.g., gown, gloves, N95 mask or PAPR, and face shield or goggles).
  • Immediately notify both infection control personnel at your healthcare facility and Spokane Regional Health District at 509.324.1442 in the event of a suspected case of 2019-nCoV.
  • Prepare to collect lower respiratory, upper respiratory and serum specimens. Stool and urine may also be collected. Specimens should be refrigerated. Public health will provide guidance and facilitation regarding specimen collection, storage, and shipping.

A number of countries, including the United States, are actively screening incoming travelers from Wuhan. Based on current information, the immediate health risk from 2019-nCoV to the general American public is deemed to be low at this time.

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