新型冠状病毒肺炎在一个长期护理机构-国王县，华盛顿，2 月 27 日-3 月 9 日，2020 年。
- 作者列表："McMichael TM","Clark S","Pogosjans S","Kay M","Lewis J","Baer A","Kawakami V","Lukoff MD","Ferro J","Brostrom-Smith C","Riedo FX","Russell D","Hiatt B","Montgomery P","Rao AK","Currie DW","Chow EJ","Tobolowsky F","Bardossy AC","Oakley LP","Jacobs JR","Schwartz NG","Stone N","Reddy SC","Jernigan JA","Honein MA","Clark TA","Duchin JS","Public Health – Seattle & King County, EvergreenHealth, and CDC COVID-19 Investigation Team.
:On February 28, 2020, a case of coronavirus disease (COVID-19) was identified in a woman resident of a long-term care skilled nursing facility (facility A) in King County, Washington.* Epidemiologic investigation of facility A identified 129 cases of COVID-19 associated with facility A, including 81 of the residents, 34 staff members, and 14 visitors; 23 persons died. Limitations in effective infection control and prevention and staff members working in multiple facilities contributed to intra- and interfacility spread. COVID-19 can spread rapidly in long-term residential care facilities, and persons with chronic underlying medical conditions are at greater risk for COVID-19-associated severe disease and death. Long-term care facilities should take proactive steps to protect the health of residents and preserve the health care workforce by identifying and excluding potentially infected staff members and visitors, ensuring early recognition of potentially infected patients, and implementing appropriate infection control measures.
: 2020 年 2 月 28 日，华盛顿国王县一家长期护理技术护理机构 (设施a) 的一名女性居民发现了一例冠状病毒疾病 (新型冠状病毒肺炎)。* 对A机构的流行病学调查发现了 129 例与A机构有关的新型冠状病毒肺炎，包括 81 名居民，34 名工作人员和 14 名访客; 23 人死亡。有效感染控制和预防的局限性以及在多个设施工作的工作人员导致了设施内和设施间的传播。新型冠状病毒肺炎可以在长期的住院护理设施中迅速传播，患有慢性基础疾病的人患新型冠状病毒肺炎相关严重疾病和死亡的风险更大。长期护理机构应采取积极措施，通过识别和排除潜在感染的工作人员和访客，确保早期识别潜在感染的患者，保护居民的健康和维护卫生保健人员队伍，并实施适当的感染控制措施。
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.