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CDC issues guidance for novel coronavirus

Friday March 8, 2013
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The Centers for Disease Control and Prevention has issued an update about the novel coronavirus that first was reported in September.

“Genetic sequence analyses have shown that this new virus is different from any other known human coronaviruses, including the one that caused severe acute respiratory syndrome,” corresponding author Brian Rha, MD, wrote in the March 8 issue of the Morbidity and Mortality Weekly Report.

As of March 7, a total of 14 confirmed cases of novel coronavirus infection have been reported to the World Health Organization, with eight deaths. Illness onsets occurred from April 2012 through February 2013, with no cases reported in the United States.

Three confirmed cases were identified in the United Kingdom as part of a cluster within one family, according to the report. The index patient in the cluster was a 60-year-old man who recently had traveled to Pakistan and Saudi Arabia. He was hospitalized Jan. 31 with severe lower respiratory tract disease and has been receiving intensive care. “Respiratory specimens from this patient taken on Feb. 1 tested positive for influenza A (H1N1) virus and for novel coronavirus infection,” the authors wrote.

“The second patient was an adult male household member with an underlying medical condition who became ill on Feb. 6, after contact with the index patient, and received intensive treatment but died with severe respiratory disease. This patient’s underlying illness might have made him more susceptible to severe respiratory infection. The third patient is an adult female who developed a respiratory illness on Feb. 5, following contact with the index patient after he was hospitalized. She did not require hospitalization and had recovered by Feb. 19.”

Since only the index patient had traveled recently outside the United Kingdom, the UK Health Protection Agency concluded that person-to-person transmission likely occurred among family members.

“This recent cluster provides the first clear evidence of human-to-human transmission of this novel coronavirus, coinfection of this novel coronavirus with another pathogen (influenza A), and a case of mild illness associated with this novel coronavirus infection,” according to the CDC report.

People “who develop severe acute lower respiratory illness within 10 days after traveling from the Arabian Peninsula or neighboring countries should continue to be evaluated according to current guidelines,” according to the CDC. Those “whose respiratory illness remains unexplained and who meet criteria for ‘patient under investigation’ should be reported immediately to the CDC through state and local health departments.

People “who develop severe acute lower respiratory illness of known etiology within 10 days after traveling from the Arabian Peninsula or neighboring countries but who do not respond to appropriate therapy may be considered for evaluation for novel coronavirus infection.”

Likewise, those "who develop severe acute lower respiratory illness who are close contacts of a symptomatic traveler who developed fever and acute respiratory illness within 10 days of traveling from the Arabian Peninsula or neighboring countries may be considered for evaluation for novel coronavirus infection.” The CDC will conduct testing of specimens.

Recommendations and guidance on case definitions, infection control (including use of personal protective equipment), case investigation and specimen collection and shipment for testing, are available at the CDC coronavirus website: http://www.cdc.gov/coronavirus/ncv/index.html. State and local health departments with questions should contact the CDC Emergency Operations Center (770-488-7100).

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