Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020.
2019 新型冠状病毒暴发的初始公共卫生应对和中期临床指导-美国，2019 年 12 月 31 日至 20 20 年 2 月 4 日。
- 作者列表："Patel A","Jernigan DB","2019-nCoV CDC Response Team.
:On December 31, 2019, Chinese health officials reported a cluster of cases of acute respiratory illness in persons associated with the Hunan seafood and animal market in the city of Wuhan, Hubei Province, in central China. On January 7, 2020, Chinese health officials confirmed that a novel coronavirus (2019-nCoV) was associated with this initial cluster (1). As of February 4, 2020, a total of 20,471 confirmed cases, including 2,788 (13.6%) with severe illness,* and 425 deaths (2.1%) had been reported by the National Health Commission of China (2). Cases have also been reported in 26 locations outside of mainland China, including documentation of some person-to-person transmission and one death (2). As of February 4, 11 cases had been reported in the United States. On January 30, the World Health Organization (WHO) Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern.† On January 31, the U.S. Department of Health and Human Services (HHS) Secretary declared a U.S. public health emergency to respond to 2019-nCoV.§ Also on January 31, the president of the United States signed a "Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus," which limits entry into the United States of persons who traveled to mainland China to U.S. citizens and lawful permanent residents and their families (3). CDC, multiple other federal agencies, state and local health departments, and other partners are implementing aggressive measures to slow transmission of 2019-nCoV in the United States (4,5). These measures require the identification of cases and their contacts in the United States and the appropriate assessment and care of travelers arriving from mainland China to the United States. These measures are being implemented in anticipation of additional 2019-nCoV cases in the United States. Although these measures might not prevent the eventual establishment of ongoing, widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare health care systems and the general public to be ready if widespread transmission with substantial associated illness occurs; and 3) better characterize 2019-nCoV infection to guide public health recommendations and the development of medical countermeasures including diagnostics, therapeutics, and vaccines. Public health authorities are monitoring the situation closely. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC and state and local health departments.
: 2019 年 12 月 31 日，中国卫生官员报告了与湖北省武汉市湖南海鲜和动物市场相关的一组急性呼吸道疾病病例，在中国中部。2020 年 1 月 7 日，中国卫生官员证实，一个新型冠状病毒 (20 19-ncov) 与这个初始集群相关 (1)。截至 2 月 4 日，2 0，共 2 0，4 71 确诊病例，其中 2，788 (13.6%) 患有严重疾病，* 和 4 2 5 死亡 (2。1%) 由中国国家卫生委员会报告 (2)。中国大陆以外的 2 6 个地点也报告了病例，包括一些人与人之间传播和 1 例死亡的文件 (2)。截至 2 月 4 日，美国报告了 11 例病例。1 月 30 日，世卫组织总干事宣布 2019-nCoV疫情构成国际关注的突发公共卫生事件。† 1 月 31 日，美国卫生与公众服务部 (HHS) 部长宣布美国突发公共卫生事件，以应对 2019-nCoV。§ 同样在 1 月 31 日，美国总统签署了一项 “关于暂停有可能传播 2019 新型冠状病毒的人作为移民和非移民入境的公告”，“这限制了美国公民和合法永久居民及其家人进入中国大陆的人进入美国 (3)。CDC、多个其他联邦机构、州和地方卫生部门以及其他合作伙伴正在实施积极措施，以减缓美国 2019-nCoV的传播 (4,5)。这些措施需要识别病例及其在美国的接触者，并对从中国大陆抵达美国的旅行者进行适当的评估和护理。这些措施正在实施，预计美国将有额外的 2019 例nCoV病例。虽然这些措施可能无法阻止病毒在美国持续、广泛传播的最终建立，但它们正在实施以 1) 减缓疾病的传播; 2)提供时间，让卫生保健系统和公众更好地做好准备，以便在发生与大量相关疾病的广泛传播时做好准备; 和 3) 更好地描述 2019-nCoV感染，以指导公共卫生建议和医疗对策的发展，包括诊断、治疗和疫苗。公共卫生当局正在密切监测局势。随着对这种新型病毒和这次疫情的了解越来越多，CDC将迅速将新知识纳入CDC以及州和地方卫生部门的行动指导。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.