HEALTH ADVISORY
SUMMARY:
- The patient under investigation (PUI) criteria has been updated by the CDC to include recent travel to Hubei Province and mainland China. The updated PUI algorithm can be seen below.
- Additionally, today, January 31, 2020, the Virginia Department of Health (VDH) received laboratory confirmation from the CDC ruling out novel coronavirus for the first Northern Virginia PUI.
- As novel coronavirus case numbers continue to increase internationally, FCHD expects additional patients under investigation (PUI) among its residents. Healthcare providers need to stay appraised of updated guidance and vigilant in the identification of possible cases. Please review the information below.
SUGGESTED ACTIONS:
- Obtain a detailed travel history for all patients with fever and acute respiratory illness.
- If a patient meets the criteria of a PUI (see below)
- Ask the patient to wear a surgical mask as soon as the PUI is identified.
- Evaluate the patient in a private room with the door closed, ideally in an airborne infection isolation room if available.
- Use standard, contact and airborne precautions, and eye protection (e.g., goggles or face shield).
- Immediately notify infection control personnel and the Fairfax County Health Department (FCHD). We can be reached 24/7 at 703-409-8449.
- FCHD’s Acute Communicable and Emerging Disease Program will work with the Virginia Department of Health to coordinate laboratory testing at the CDC.
- Currently, 2019-nCoV testing is only available at CDC. Three specimen types (lower respiratory, upper respiratory and serum specimens) are recommended for this testing. If possible, more specimens (e.g., stool, urine) should be collected and stored until CDC determines if they should be tested.
- For biosafety reasons, virus isolation in cell culture or initial characterization of viral agents recovered in cultures of specimens from a PUI is not recommended.
- For more information on this rapidly evolving situation, please visit the CDC Novel Coronavirus 2019 website (https://www.cdc.gov/coronavirus/2019-nCoV/index.html) or call the Fairfax County Health Department at 703-409-8449.
Additional Information:
Contact the Fairfax County Health Department immediately for further guidance (staff available 24/7) if the following criteria are met at 703-409-8449.
| Clinical Features | & | Epidemiological Risk |
| Fever or signs/symptoms of a lower respiratory illness (e.g., cough or shortness of breath) | AND | Any person, including health care workers, who has had close contact* with a laboratory-confirmed 2019-nCoV patient within 14 days of symptom onset |
| Fever and signs/symptoms of a lower respiratory illness (e.g., cough or shortness of breath) | AND | A history of travel from Hubei Province, China within 14 days of symptom onset |
| Fever and signs/symptoms of alower respiratory illness (e.g., cough or shortness of breath) requiring hospitalization | AND | A history of travel from mainland China within 14 days of symptom onset |
If the criteria is not met, please proceed to evaluate, test, and/or treat for other causes of illness (e.g., influenza, pneumonia, or other infection cause) as clinically indicated.
*A close contact is defined as:
a) being within approximately 6 feet, or within the room or care area of a PUI or lab-confirmed novel coronavirus case for a prolonged period of time (while note wearing recommended personal protective equipment or PPE);
Note: close contact can include caring for, living with, visiting, or sharing a health care area or waiting area of room
-or-
b) having direct contact with infectious secretions of a novel coronavirus case (e.g., being coughed on) while note wearing recommended personal protective equipment or PPE