CDC Confirms a Second Travel-Related Case of Coronavirus in the US

Nancy Messonnier, MD, director of the National Center for Immunization and Respiratory Diseases: "The situation is evolving rapidly."

A Chicago woman in her 60s who recently returned from Wuhan, China, is the second confirmed case of the novel coronavirus in the United States, the US Centers for Disease Control and Prevention (CDC) confirmed this morning. 

The first case was confirmed earlier this week, garnering headlines and keeping healthcare officials scurrying. That was a man in his 30s from Washington state who recently returned from a trip to Wuhan, China, where the infection is believed to have originated. The second patient returned to the US from Wuhan on January 13. Both patients are doing well. Another 63 patients in 22 states are being monitored for signs of the virus, the CDC told reporters in a conference call.

This, just a day after the World Health Organization said that the problem had not yet reached the point of being labeled a global public health emergency. 

However, Tedros Adhanom Ghebreyesus, PhD, the WHO’s director-general, added this caveat: “It may yet become one.” 

“Make no mistake: This is an emergency in China,” he said.  

China’s health authorities today confirmed that the death toll has risen to 25 with about 830 confirmed cases. 

Judith Guzman-Cottrill, DO, a professor of pediatrics and a member of the board of the Society for Healthcare Epidemiology of America, has advice for healthcare workers on the frontlines of infection control. She tells Infection Control Today®  that there must be one guiding principle in such situations: “Healthcare facilities must create strong systems to quickly identify and isolate patients who might be infected with the novel virus,” said Guzman-Cottrill. “In this specific situation, the critical question that allows for rapid identification and isolation is recent travel to Wuhan, China.” 

Guzman-Cottrill said that outpatient clinics, urgent care centers, and emergency departments should develop ways to screen all patients with fever or respiratory symptoms about recent travel to Wuhan, or close contact with a person who has been diagnosed with coronavirus. 

Nancy Messonnier, MD, the director of the National Center for Immunization and Respiratory Diseases, said on the conference call that “the immediate risk to the US public is low at this time, but the situation is evolving rapidly. We have our best people working on this problem.”

The CDC has raised its travel advisory to alert level 3, indicating a recommendation to avoid nonessential travel to Wuhan, China. The decision came after Chinese officials announced they would shut down all transportation in and out of Wuhan. 

The WHO case definitions include standards for patients with severe acute respiratory infection as well as acute respiratory illness. A suspect case applies to patients with severe acute respiratory infection when there is no other etiology that fully explains clinical presentation and travel to or residence in Wuhan, or no other etiology and status as health care worker in an environment where severe acute respiratory infections of unknown etiology are being cared for.

A suspect case also applies to patients with any acute respiratory illness and close contact with a confirmed or probable case of novel coronavirus, working in an animal market, or working in a health care facility with reports of novel coronavirus in the 14 days prior to onset of symptoms.

Probable cases are defined as suspect cases where novel coronavirus testing is inconclusive or testing was positive on a pan-coronavirus assay. Confirmed cases are defined by laboratory confirmation of novel coronavirus infection.