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The Snohomish Health District (SHD) is actively involved with the Washington State Department of Health (DOH), neighboring local public health agencies, and the Centers for Disease Control and Prevention (CDC) in addressing the recently diagnosed case of novel coronavirus infection (2019-nCoV) connected to the outbreak that has emerged in Wuhan City, Hubei Province, China. Current local public health activity is focused on monitoring of contacts for development of symptoms and, if indicated, isolating and collecting specimens for testing. No additional cases have been diagnosed at this time among the case’s contacts.
Our initial communication earlier this week stated that that no health care providers to date had been infected in China, where the outbreak appears to have originated from a market where live animals were sold. More recent reports indicate that a small number of health care providers have indeed been infected in China and there is evidence of several generations of person-to-person spread in some non-health care settings. Although occupational or nosocomial transmission appears less than for MERS or SARS, these findings make infection control measures a priority in the evaluation of suspected cases.
SHD seeks to raise awareness among clinicians to maintain vigilance, promptly institute appropriate infection control precautions, and notify public health when patients with a compatible clinical and epidemiologic history present for care. Please use the attached tool (document linked here) to guide your evaluation and infection control measures.
Coronaviruses (CoVs) are a large family of viruses, most causing mild respiratory illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people—often with a more virulent strain-- such as has been seen with MERS and SARS. Past MERS and SARS outbreaks have been complex, requiring comprehensive public health responses to control transmission. With this novel virus, we have limited information about severity and natural history of illness, mode of transmission, and duration of contagiousness. The case fatality rate reported from China (currently 17 [3%] of 571) appears lower than for MERS and SARS; 95 (17%) are reported as “severely ill” (not further specified). Typically, transmission of CoVs is via respiratory droplet (directly via cough-or-sneeze or indirectly via hands or fomites) with incubation periods of up to 14 days. Nevertheless, out of an abundance of caution, currently recommended infection control measures for 2019-nCoV include the potential for airborne transmission.
SHD is working closely with DOH and CDC to prevent the spread of this condition from the original case and contacts and to learn more as we go about the best methods for doing so. This is a rapidly evolving situation. SHD will continue to keep you posted as meaningful updates occur. Meanwhile, we urge you to follow these guidelines and assist us in reassuring people in our community that they are not at risk for 2019-nCoV infection if they have not recently traveled from the affected area or had recent close contact with a patient suspected or known to have the infection. SHD appreciates the ongoing efforts of health care providers, Providence Regional Medical Center Everett, DOH and CDC in this challenging and high-profile situation.
Snohomish Health Districthttps://www.snohd.org/CivicAlerts.aspx?AID=246
Washington State Department of Healthhttps://www.doh.wa.gov/Emergencies/Coronavirus
Centers for Disease Control and Preventionhttps://www.cdc.gov/coronavirus/2019-ncov/index.html
World Health Organizationhttps://www.who.int/emergencies/diseases/novel-coronavirus-2019
Information for Healthcare Professionalshttps://www.cdc.gov/coronavirus/2019-nCoV/guidance-hcp.htmlhttps://www.doh.wa.gov/Emergencies/Coronavirus/Resources
Interim Guidance for Preventing Transmission in Homes and Communitieshttps://www.cdc.gov/coronavirus/2019-ncov/guidance-prevent-spread.html
Guidance for Travelershttps://wwwnc.cdc.gov/travel/notices/watch/novel-coronavirus-china
Phone line for questions/information from the public1-800-525-0217, then press #
Public Health Insider (Public Health Seattle & King County)https://publichealthinsider.com/2020/01/21/questions-and-answers-about-a-novel-coronavirusin-washington/