CDC Morbidity and Mortality Weekly Report (MMWR)
On January 17, CDC and the U.S. Department of Homeland Security’s Customs and Border Protection began health screenings at U.S. airports to identify ill travelers returning from Wuhan City. CDC activated its Emergency Operations Center on January 21 and formalized a process for inquiries regarding persons suspected of having 2019-nCoV infection. As of January 31, 2020, CDC had responded to clinical inquiries from public health officials and health care providers to assist in evaluating approximately 650 persons thought to be at risk for 2019-nCoV infection.
Guided by CDC criteria for the evaluation of persons under investigation (PUIs), 210 symptomatic persons were tested for 2019-nCoV; among these persons, 148 (70%) had travel-related risk only, 42 (20%) had close contact with an ill laboratory-confirmed 2019-nCoV patient or PUI, and 18 (9%) had both travel- and contact-related risks. Eleven of these persons had laboratory-confirmed 2019-nCoV infection. Recognizing persons at risk for 2019-nCoV is critical to identifying cases and preventing further transmission.
Health care providers should remain vigilant and adhere to recommended infection prevention and control practices when evaluating patients for possible 2019-nCoV infection. Providers should consult with their local and state health departments when assessing not only ill travelers from 2019-nCoV-affected countries but also ill persons who have been in close contact with patients with laboratory-confirmed 2019-nCoV infection in the United States.
A call center was staffed by a team of physicians and nurses 24 hours per day. During January 17–31, criteria used to determine whether a person was considered to be a PUI included presence of fever and symptoms of lower respiratory tract illness (e.g., cough or difficulty breathing) in addition to epidemiologic risk. Epidemiologic risk factors included history of travel from Wuhan City, close contact with a patient with laboratory-confirmed 2019-nCoV infection, or close contact with an ill PUI. Given the evolving understanding of 2019-nCoV epidemiology, testing was recommended for some persons who did not strictly meet the PUI definition, based on clinical discretion. For clinical inquiries that resulted in 2019-nCoV testing, real-time reverse transcription polymerase chain reaction testing was conducted at CDC using methods developed specifically to detect 2019-nCoV.
For this report, CDC reviewed inquiries regarding potential 2019-nCoV PUIs received by CDC through January 31, 2020, from state and local health departments, health care providers, and airport health screening personnel. Information was compiled from call logs and PUI forms to assess source of inquiry, PUI demographic data (including age and sex), clinical information, epidemiologic risk factors, and 2019-nCoV test results. To allow for delays in specimen shipping and testing, data for PUIs for whom an initial inquiry was received during January 2020 were collected through February 4, 2020.
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Bajema KL, Oster AM, McGovern OL, et al. Persons Evaluated for 2019 Novel Coronavirus — United States, January 2020. MMWR Morb Mortal Wkly Rep 2020;69:166–170. DOI: http://dx.doi.org/10.15585/mmwr.mm6906e1
