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Health Alerts

Posted on: January 21, 2020

Novel Coronavirus (2019-nCoV) Respiratory Infection Wuhan City, China & Snohomish County

Action requested:

  • Be aware that 2019-nCoV has been confirmed in a traveler who recently returned to Snohomish County from Wuhan, China.
  • Obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness.
  • 2019-nCoV should be suspected in patients who present with:
    • fever AND symptoms of lower respiratory illness (e.g., cough, difficulty breathing) AND in the 14 days before symptom onset:
      •  have a history of travel from Wuhan City, China --or--
      •  had close contact with a person who is under investigation for 2019-nCoV while that person was ill.
    •  fever OR symptoms of lower respiratory illness (e.g., cough, difficulty breathing) AND in the 14 days before symptom onset had close contact with an ill lab-confirmed 2019-nCoV patient.
  • Ask patients with suspected 2019-nCoV infection to wear a surgical mask as soon as they are identified and evaluate them in a private room with the door closed, ideally an airborne infection isolation room if available.
  • All healthcare personnel entering the room should use standard precautions, contact precautions, airborne precautions, and use eye protection (e.g., gown, gloves, N95 mask or PAPR, and face shield or goggles).
  • Immediately notify both infection control personnel at your healthcare facility and the Snohomish Health District at 425.339.5278 in the event of a suspected case of 2019-nCoV.
  • Prepare to collect lower respiratory, upper respiratory and serum specimens. Stool and urine may also be collected. Specimens should be refrigerated. Public health will provide guidance and facilitation regarding specimen collection, storage, and shipping.


The Centers for Disease Control and Prevention (CDC) is closely monitoring an outbreak caused by a novel (new) coronavirus in Wuhan City, Hubei Province, China. Chinese authorities first identified the new coronavirus, which has resulted in more than 200 confirmed human infections in China with three deaths reported. A number of countries, including the United States, are actively screening incoming travelers from Wuhan. Exported cases have been confirmed in neighboring countries and in a traveler who returned to Snohomish County from Wuhan last week.

Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with MERS and SARS. Past MERS and SARS outbreaks have been complex, requiring comprehensive public health responses.

Health Advisory

Many of the patients in the outbreak in Wuhan, China have reported some link to a large seafood and animal market, suggesting animal-to-person spread. However, a growing number of patients reportedly have not had exposure to animal markets, suggesting person-to-person spread is occurring.

Based on current information, the immediate health risk from 2019-nCoV to the general American public is deemed to be low at this time.


Information for Healthcare Professionals

Interim Guidance for Preventing Transmission in Homes and Communities

Guidance for Travelers

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