Provider Alert! Novel Coronavirus Infection – Continued Updates
Date: 2/3/2020
TCHP wants to help keep you up-to-date on developing issues. Because updates are coming so frequently about the new coronavirus, please look for our posts on TheCheckup.org where you’ll find the latest information. Also check with your institutional leaders to see if they have developed specific protocols for infection control.
A new coronavirus (2019-nCoV) was recently detected in Wuhan City, China and is causing an outbreak of respiratory illness. The 2019-nCoV outbreak began in December 2019, and Chinese health officials have reported hundreds of 2019‑nCoV infections in China, including several that resulted in death. Several additional countries have identified cases of 2019-nCoV infection including the United States.
The Texas Department of State Health Services (DSHS) is working closely with the Centers for Disease Control and Prevention (CDC) in monitoring the developing outbreak. There are now 8 confirmed cases in the United States.
Guidelines for Healthcare professionals can be found on the CDC website. They are briefly summarized here for your convenience. Notify your local health department immediately if you identify a patient meeting the criteria below by selecting the appropriate local health entity from this list: Texas Disease Reporting Contacts.
SCREENING
Patients in the United States who meet the following criteria should be evaluated as a Patient under Investigation (PUI) in association with the outbreak of 2019-nCoV in Wuhan City, China.
| Clinical Features | & | Epidemiologic Risk |
| Fever1 and symptoms of lower respiratory illness (e.g., cough, difficulty breathing) | and | Any person, including health care workers, who has had close contact2 with a laboratory confirmed 2019-nCoV patient3-4 within 14 days of onset |
| Fever1 or symptoms of lower respiratory illness (e.g., cough, difficulty breathing) | and | A history of travel from Hubei Province, China within 14 days of symptom onset |
| Fever1 or symptoms of lower respiratory illness (e.g., cough, difficulty breathing) requiring hospitalization4 | A history of travel from mainland China5 within 14 days of symptom onset
|
1-5Footnotes are at the end of the document
TESTING
Healthcare providers should immediately notify both infection control personnel at their healthcare facility and their local or state health department in the event of a PUI for 2019-nCoV. You can find the Texas Disease Reporting Contacts here.
State health departments that have identified a PUI should immediately contact CDC’s Emergency Operations Center (EOC) at 770-488-7100 and complete a 2019-nCoV PUI case investigation form available below.
CDC’s EOC will assist local/state health departments to collect, store, and ship specimens appropriately to CDC, including during afterhours or on weekends/holidays. At this time, diagnostic testing for 2019-nCoV can be conducted only at CDC.
FOOTNOTES
1Fever may be subjective or confirmed
2Close contact is defined as—
- a) being within approximately 6 feet (2 meters) of a 2019-nCoV case for a prolonged period of time while not wearing recommended personal protective equipment or PPE (e.g., gowns, gloves, NIOSH-certified disposable N95 respirator, eye protection); close contact can occur while caring for, living with, visiting, or sharing a health care waiting area or room with a 2019-nCoV case – or –
- b) having direct contact with infectious secretions of a 2019-nCoV case (e.g., being coughed on) while not wearing recommended personal protective equipment.
See CDC’s updated Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus.
Data to inform the definition of close contact are limited. Considerations when assessing close contact include the duration of exposure (e.g., longer exposure time likely increases exposure risk) and the clinical symptoms of the person with 2019-nCoV (e.g., coughing likely increases exposure risk as does exposure to a severely ill patient). Special consideration should be given to those exposed in health care settings.
3Documentation of laboratory-confirmation of 2019-nCoV may not be possible for travelers or persons caring for patients in other countries.
4Category also includes any member of a cluster of patients with severe acute lower respiratory illness (e.g., pneumonia, ARDS) of unknown etiology in which 2019-nCoV is being considered that requires hospitalization. Such persons should be evaluated in consultation with state and local health departments regardless of travel history.
5For persons with travel to China within 14 days that are being regularly monitored by local health departments or referred for evaluation from border screening, testing for nCoV can be considered at the discretion of the health officials for all persons with illnesses with fever and lower respiratory symptoms (those hospitalized and those not hospitalized).
If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.
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