Novel Coronavirus (2019-nCoV) in China

Situational Update:

The Centers for Disease Control & Prevention (CDC) and Washington State Department of Health (DOH) continue to monitor the outbreak of Novel Coronavirus (2019-nCoV) that originated in Wuhan City, Hubei Province, China in late December. To date, over 8,000 cases have been identified in mainland China. Six cases have been identified in the United States, five of which had travel to Wuhan City, including one in Snohomish County. Cases with travel to China have also been identified in countries in Asia, Europe and Australia. 

On January 27, the CDC issued updated travel guidance for China, recommending that travelers avoid all nonessential travel to all of China.  

DOH and CDC have compiled additional guidance for healthcare providers, which is available on their website.
This is a rapidly evolving situation and you should continue to check the website for updates to these documents: https://www.doh.wa.gov/Emergen...

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

Actions requested:

  • Obtain a detailed travel history for patients being evaluated with fever and symptoms of acute lower respiratory illness.
  • Use the 2019-nCoV Evaluation Tool for Healthcare Providers to assist in screening for possible 2019-nCoV infection.
  • 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 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 509-869-3133 in the event of a suspected case of 2019-nCoV.
  • Collect an upper respiratory (an NP or OP swab) and store in viral transport medium. Sputum and serum should also be collected, if possible. If positive, public health may also request additional specimens to include stool and urine. Specimens should be refrigerated and shipped cold. Public health will provide guidance and facilitation regarding specimen collection, storage, and shipping.
    • Concurrent local commercial testing of a second upper respiratory specimen should occur with a respiratory pathogen panel to rule out other infectious causes, including but not limited to influenza.
  • Considerations specifically for outpatient settings:
    • Have patient enter through a separate entrance to the facility, if available, to avoid the reception and registration area
    • Instruct patient to wear a facemask when exiting the exam room, avoid coming into close contact with other patients, and practice respiratory hygiene and cough etiquette
    • Once the patient leaves, the exam room should remain vacant for generally at least one hour before anyone enters
    • Consider transfer of patient to an emergency department with proper infection control capacity to manage the patient, particularly if patient has other co-morbidities, fever with shortness of breath, etc.

Upcoming CDC Clinician Outreach and Communication Activity

  • Friday, January 31, 2020 11 am to 12 pm PST

Additional Resources