The Arkansas Department of Health (ADH) has issued an upate on the Cornovirus. To date, there have been no cases in Arkansas.
Jennifer A. Dillaha, M.D., medical director for immunizations and outbreak response, addressed the issue Jan. 28 in the following press release.
The Interim Guidance on the Outbreak of 2019 Novel Coronavirus (2019-nCoV) in Wuhan, China:
The U.S. Centers for Disease Control and Prevention (CDC) continues to closely monitor an outbreak of a 2019 novel coronavirus (2019-nCoV) in Wuhan City, Hubei Province, China, that began in December 2019. This is a new virus, and information is evolving on a daily basis.
An outbreak of pneumonia of unknown cause in Wuhan City was initially reported to WHO on December 31, 2019. Initially, most patients had epidemiological links to a large seafood and animal market. The market was closed on January 1, 2020. However, person-to-person spread is now confirmed. Currently, there are over 2,700 confirmed cases and over 80 deaths as of January 27. The number of cases is changing rapidly. There have now been 29 confirmed cases outside of China, including 5 cases in USA (WA, CA, AZ, IL). All US cases were in travelers who had been in Wuhan City in the previous 14 days.
Independent reporting for Pine Bluff & Jefferson County since 1879.
The CDC has been screening travelers who have traveled from or through Wuhan, China (including Wuhan Tianhe Int’l Airport) at 5 major airports: New York (JFK), San Francisco, Los Angeles, Chicago and Atlanta airports. All travelers from Wuhan had their itineraries re-routed through one of these 5 airports so that all travelers from Wuhan are screened. Attached, find a card given to screened travelers who are well. CDC is now recommending that all non-essential travel to China be avoided.
RECOMMENDATIONS FOR HEALTH CARE PROVIDERS:
We are still learning about the range of clinical illness associated with 2019-nCoV, but, in general, it causes a febrile, lower respiratory illness. It may be mild. However, persons over age 50 or with pre-existing conditions are noted to have more severe illness. No vaccine or specific treatment for 2019-nCoV infection is available. Care is supportive. Health care providers should obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness. ADH recommends asking about any travel to China in the last 14 days.
Patients in the United States who meet the following criteria should be evaluated as a Person Under Investigation (PUI) in association with the outbreak of 2019-nCoV in Wuhan City, China:
1) Fever AND symptoms of lower respiratory illness (e.g., cough, shortness of breath) –AND in the last 14 days before symptom onset, History of travel to/from Wuhan City, China -or- Close contact with a person who is under investigation for 2019-nCOV.
2) Fever OR symptoms of lower respiratory illness (e.g., cough, shortness of breath) –AND in the last 14 days before symptom onset, Close contact with an ill laboratory-confirmed 2019-nCoV patient.
The above criteria are also available at https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html. These criteria are intended to serve as guidance for evaluation. Patients should be evaluated and discussed with the Arkansas Department of Health (ADH) on a case-by-case basis. We also want to emphasize that clinicians should also, at the same time, proceed with normally indicated testing for pneumonia or similar respiratory infections (influenza, multiplex respiratory panel, CXR, etc.) We have also included a 1-page job aid for clinicians to help with first steps that can also be found at https://www.healthy.arkansas.gov/images/uploads/pdf/Job_Aid_for_Clinicians_1.pdf.
Interim Health Care Infection Prevention and Control Recommendations for Patients Under Investigation for 2019-nCoV:
Although the transmission dynamics have yet to be determined, CDC currently recommends a cautious approach to patients under investigation for 2019-nCoV (https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html).
Such patients should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed, ideally an airborne infection isolation room if available.
Health care personnel entering the room should use the following precautions: standard precautions (gloves), contact precautions (gown), airborne precautions (mask, N95 preferable), use eye protection (e.g., goggles or a face shield), Immediately notify your health care facility’s infection control personnel and ADH.
Additional Infection Control Practices Resources — Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings (https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html);
RECOMMENDATIONS FOR REPORTING, TESTING, AND SPECIMEN COLLECTION:
Health care providers should immediately notify both infection control personnel at their health care facility and ADH in the event of a Person Under Investigation for 2019-nCoV. ADH will help coordinate submission of samples.
CDC recommends collecting and testing multiple clinical specimens from different sites, including all three specimen types: Lower respiratory (sputum or BAL), Upper respiratory (nasopharyngeal swab AND oropharyngeal swab), Serum, Additional specimen types (e.g., stool, urine, whole blood) should be collected and stored, if possible.
Specimens should be collected as soon as possible once a PUI is identified regardless of time of symptom onset. Additional guidance for collection, handling, and testing of clinical specimens is available at https://www.cdc.gov/coronavirus/2019-nCoV/. At this time, diagnostic testing for 2019-nCoV can be conducted only at CDC. Testing for other respiratory pathogens should not delay specimen shipping to CDC. If a PUI tests positive for another respiratory pathogen, after clinical evaluation and consultation with ADH, they may no longer be considered a PUI. This may evolve as more information becomes available on possible 2019 nCoV co-infections.
For the latest information from the CDC on this outbreak: https://www.cdc.gov/coronavirus/2019-nCoV/. Information can also be found on the ADH website: https://www.healthy.arkansas.gov/programs-services/topics/novel-coronavirus.
For a sign to prompt patients to discuss travel with you: https://www.healthy.arkansas.gov/images/uploads/pdf/Travel_notice_generic_10112019.pdf .
We at ADH are here to help consult on the evaluation of such cases and keep you updated as this outbreak evolves. Please call the Outbreak Response Section at 501-537-8969 Monday-Friday 8am-4:30 p.m., or 1-800-554-5738 after hours or on weekends for any assistance.
The Health Alert Network (HAN) gives notification regarding outbreaks or other public health events. To learn more about HAN and sign up for alerts go to https://hanregistration.adh.arkansas.gov.