Provider Alert! Novel Coronavirus Infection – 5 Confirmed US Cases

By Texas Children's Health Plan OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists Corona Virus, coronavirus, COVID-19, Outbreak 0 Comments

Attention: All providers
Effective Date: January 27, 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.

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	In the last 14 days before symptom onset, a history of travel from Wuhan City, China. – or – In the last 14 days before symptom onset, close contact² with a person who is under investigation for 2019-nCoV while that person was ill.
Fever¹ or symptoms of lower respiratory illness (e.g., cough, difficulty breathing)	and	In the last 14 days, close contact² with an ill laboratory-confirmed 2019-nCoV patient.

Clinical Features

Epidemiologic Risk

Fever¹ and symptoms of lower respiratory illness (e.g., cough, difficulty breathing)

and

In the last 14 days before symptom onset, a history of travel from Wuhan City, China.

– or –

In the last 14 days before symptom onset, close contact² with a person who is under investigation for 2019-nCoV while that person was ill.

Fever¹ or symptoms of lower respiratory illness (e.g., cough, difficulty breathing)

and

In the last 14 days, close contact² with an ill laboratory-confirmed 2019-nCoV patient.

¹Fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain fever-lowering medications. Clinical judgment should be used to guide testing of patients in such situations.

²Close contact is defined as:

being within approximately 6 feet (2 meters), or within the room or care area, of a novel coronavirus 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 include caring for, living with, visiting, or sharing a health care waiting area or room with a novel coronavirus case.

– or –

having direct contact with infectious secretions of a novel coronavirus case (e.g., being coughed on) while not wearing recommended personal protective equipment.

See CDC’s 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 novel coronavirus (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.

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.

Download fillable PDF form

Download Microsoft Word form

CDC’s EOC will assist local/state health departments to collect, store, and ship specimens appropriately to CDC, including during after-hours or on weekends/holidays. At this time, diagnostic testing for 2019-nCoV can be conducted only at CDC.

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.

Provider Alert! Novel Coronavirus Infection – 5 Confirmed US Cases