{"id":10390,"date":"2025-03-01T14:07:52","date_gmt":"2025-03-01T19:07:52","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan417\/"},"modified":"2025-03-02T00:54:36","modified_gmt":"2025-03-02T05:54:36","slug":"dhan417","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan417\/","title":{"rendered":"php\/alerts\/dhan417 ~  Division of Public Health  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n\n\n  <br>\n\n\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n\n    <!-- BEGIN readspeaker div -->\n\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan417.html\" title=\"Listen to this page using ReadSpeaker\">\n\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n\n      <\/a>\n\n\n    <\/div>\n\n\n    <!-- END readspeaker div -->\n\n\n\n\n\n    \n\n\n    <header class=\"pull-left\">\n\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->417 <!--[END]--> <\/h1>\n\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->January 23, 2020 11:40 am <!--[END]--> <\/h2>\n\n\n    <\/header>\n\n\n  <\/div><br>\n\n\n \n\n\n  <div class=\"container\">\n\n\n    <div class=\"row\">\n\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n\n          <div class=\"panel sectionmenu_panel\">\n\n\n            <div class=\"panel-heading\">\n\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n\n            <\/div>\n\n\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; 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CDC has established an \n\n\n\n\n\nIncident Management System to coordinate a domestic and international public health response.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>The CDC confirmed the first case of 2019 Novel Coronavirus (2019\u2013nCoV) in the United States in the state of \n\n\n\n\n\nWashington on January 17, 2020. The patient recently returned from Wuhan, China, where an outbreak of pneumonia \n\n\n\n\n\ncaused by this novel coronavirus has been ongoing since December 2019. While originally thought to be spreading \n\n\n\n\n\nfrom animal\u2013to\u2013person, there are growing indications that limited person\u2013to\u2013person spread is happening. It&#8217;s unclear \n\n\n\n\n\nhow easily this virus is spreading between people.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>The patient from Washington with confirmed 2019\u2013nCoV infection returned to the United States from Wuhan on \n\n\n\n\n\nJanuary 15, 2020. The patient sought care at a medical facility in the state of Washington, where the patient was \n\n\n\n\n\ntreated for the illness. Based on the patient&#8217;s travel history and symptoms, healthcare professionals suspected \n\n\n\n\n\nthis new coronavirus. A clinical specimen was collected and sent to CDC overnight, where laboratory testing yesterday \n\n\n\n\n\nconfirmed the diagnosis via CDC&#8217;s Real time Reverse Transcription-Polymerase Chain Reaction (rRT\u2013PCR) test.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Coronaviruses are a large family of viruses. Some cause illness in people; numerous other coronaviruses circulate \n\n\n\n\n\namong animals, including camels, cats, and bats. Rarely, animal coronaviruses can evolve and infect people and then \n\n\n\n\n\nspread between people such as has been seen with Middle Eastern Respiratory Syndrome Coronavirus (MERS\u2013CoV) \n\n\n\n\n\n<a href=\"https:\/\/www.cdc.gov\/coronavirus\/mers\/index.html\">(https:\/\/www.cdc.gov\/coronavirus\/mers\/index.html)<\/a> and \n\n\n\n\n\nSevere Acute Respiratory Syndrome Coronavirus (SARS\u2013CoV) <a href=\"https:\/\/www.cdc.gov\/sars\/index.html\">(https:\/\/www.cdc.gov\/sars\/index.html)<\/a>.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Chinese authorities report most patients in the Wuhan City outbreak have been epidemiologically linked to a large \n\n\n\n\n\nseafood and animal market, suggesting a possible zoonotic origin to the outbreak. Chinese authorities additionally \n\n\n\n\n\nreport that they are monitoring several hundred healthcare workers who are caring for outbreak patients; no spread \n\n\n\n\n\nof this virus from patients to healthcare personnel has been reported to date. Chinese authorities are reporting no \n\n\n\n\n\nongoing spread of this virus in the community, but they cannot rule out that some limited person\u2013to\u2013person spread may \n\n\n\n\n\nbe occurring. China has reported that two of the patients have died, including one with pre\u2013existing medical conditions. \n\n\n\n\n\nChinese health officials publicly posted the genetic sequence of the 2019\u2013nCoV on January 12, 2020. This will facilitate \n\n\n\n\n\nidentification of infections with this virus and development of specific diagnostic tests.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Thailand and Japan have confirmed additional cases of 2019\u2013nCoV in travelers from Wuhan, China. It is possible that \n\n\n\n\n\nmore cases will be identified in the coming days. This is an ongoing investigation and given previous experience with \n\n\n\n\n\nMERS\u2013CoV and SARS\u2013CoV, it is possible that person\u2013person spread may occur. There is much more to learn about the \n\n\n\n\n\ntransmissibility, severity, and other features associated with 2019\u2013nCoV as the investigations in China, Thailand, \n\n\n\n\n\nand Japan continue. Additional information about this novel virus is needed to better inform population risk.<\/p> \n\n\n\n\n\n\n\n\n\n\n\n<p>This HAN Update provides a situational update and guidance to state and local health departments and healthcare providers \n\n\n\n\n\nthat supersedes guidance in CDC&#8217;s HAN Advisory 424 distributed on January 8, 2020. This HAN Update adds guidance for \n\n\n\n\n\nevaluation of patients under investigation (PUI) for 2019\u2013nCoV, prevention and infection control guidance, including \n\n\n\n\n\nthe addition of an eye protection recommendation, and additional information on specimen collection.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Background<\/h2>\n\n\n\n\n\n<p>An outbreak of pneumonia of unknown etiology in Wuhan City was initially reported to WHO on December 31, 2019. Chinese health \n\n\n\n\n\nauthorities have confirmed more than 40 infections with a novel coronavirus as the cause of the outbreak. Reportedly, most \n\n\n\n\n\npatients had epidemiological links to a large seafood and animal market. The market was closed on January 1, 2020. Currently, \n\n\n\n\n\nChinese health authorities report no community spread of this virus, and no transmission among healthcare personnel caring for \n\n\n\n\n\noutbreak patients. No additional cases of infection with 2019\u2013nCoV have been identified in China since January 3, 2020.<\/p> \n\n\n\n\n\n\n\n\n\n\n\n<p>On January 13, 2020 public health officials in Thailand confirmed detection of a human infection with 2019\u2013nCoV in a \n\n\n\n\n\ntraveler from Wuhan, China. This was the first confirmed case of 2019\u2013nCoV documented outside China. On January 17, 2020 \n\n\n\n\n\na second case was confirmed in Thailand, also in a returned traveler from Wuhan City. On January 15, 2020 health officials in Japan \n\n\n\n\n\nconfirmed 2019\u2013nCoV infection in a returned traveler from Wuhan City. These persons had onset dates after January 3, 2020. \n\n\n\n\n\nThese cases did not report visiting the large seafood and animal market to which many cases in China have been linked.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>On January 11, 2020, CDC updated the level 1 travel health notice (&#8220;practice usual precautions&#8221;) for Wuhan City, Hubei Province, \n\n\n\n\n\nChina with additional information (originally issued on January 6, 2020): <a href=\"https:\/\/wwwnc.cdc.gov\/travel\/notices\/watch\/novel-coronavirus-china\">https:\/\/wwwnc.cdc.gov\/travel\/notices\/watch\/novel-coronavirus-china<\/a>.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Recommendations for Healthcare Providers<\/h2>\n\n\n\n\n\n<p>Limited information is available to characterize the spectrum of clinical illness associated with 2019\u2013nCoV. No vaccine or \n\n\n\n\n\nspecific treatment for 2019\u2013nCoV infection is available; care is supportive.<\/p> \n\n\n\n\n\n\n\n\n\n\n\n<p>The CDC clinical criteria for a 2019\u2013nCoV patient under investigation (PUI) have been developed based on what is known \n\n\n\n\n\nabout MERS\u2013CoV and SARS\u2013CoV and are subject to change as additional information becomes available.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>Healthcare providers should obtain a detailed travel history for patients being evaluated with fever and acute respiratory illness. \n\n\n\n\n\nCDC guidance for evaluating and reporting a PUI for MERS-CoV remains unchanged.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>In an effort to reduce cases and transmission of respiratory illness in general, physicians are asked to increase their guidance to patients on:<\/p>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Vaccines for common illness, such as influenza and pneumococcal pneumonia<\/li>\n\n\n\n\n\n<li>Handwashing<\/li>\n\n\n\n\n\n<li>Covering coughs and sneezes<\/li>\n\n\n\n\n\n<li>Social distancing when sick<\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Criteria to Guide Evaluation of Patients Under Investigation (PUI) for 2019\u2013nCoV<\/h2>\n\n\n\n\n\n<p>Patients in the United States who meet the following criteria should be evaluated as a PUI in association with the outbreak of \n\n\n\n\n\n2019\u2013nCoV in Wuhan City, China.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>1) Fever<sup>1<\/sup> AND symptoms of lower respiratory illness (e.g., cough, shortness of breath)<br>\n\n\n\n\n\n\u2013and in the last 14 days before symptom onset, <br>\n\n\n\n\n\n\u2022\u00a0History of travel from Wuhan City, China<br>\n\n\n\n\n\n\u2013or\u2013<br>\n\n\n\n\n\n\u2022\u00a0Close contact<sup>2<\/sup> with a person who is under investigation for 2019\u2013nCOV while that person was ill.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>2) Fever<sup>1<\/sup> OR symptoms of lower respiratory illness (e.g., cough, shortness of breath)<br>\n\n\n\n\n\n\u2013and in the last 14 days before symptom onset,<br>\n\n\n\n\n\n\u2022\u00a0Close contact<sup>2<\/sup> with an ill laboratory-confirmed 2019\u2013nCoV patient.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>The above criteria are also available at <a href=\"https:\/\/www.cdc.gov\/coronavirus\/novel-coronavirus-2019\/clinical-criteria.html\">https:\/\/www.cdc.gov\/coronavirus\/novel-coronavirus-2019\/clinical-criteria.html<\/a>. The criteria are intended to serve as guidance for evaluation. Patients should be evaluated \n\n\n\n\n\nand discussed with public health departments on a case-by-case basis if their clinical presentation or exposure \n\n\n\n\n\nhistory is equivocal (e.g., uncertain travel or exposure).<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Recommendations for Reporting, Testing, and Specimen Collection<\/h2>\n\n\n\n\n\n<p>Healthcare providers should immediately notify both infection control personnel at their healthcare facility and their \n\n\n\n\n\nlocal or state health department in the event of a PUI for 2019\u2013nCoV. State health departments that have identified \n\n\n\n\n\na PUI should immediately contact CDC&#8217;s Emergency Operations Center (EOC) at 770-488-7100 and complete a 2019\u2013nCoV \n\n\n\n\n\nPUI case investigation form available at <a href=\"https:\/\/www.cdc.gov\/coronavirus\/novel-coronavirus-2019\/downloads\/pui-form.pdf\">https:\/\/www.cdc.gov\/coronavirus\/novel-coronavirus-2019\/downloads\/pui-form.pdf<\/a>. CDC&#8217;s EOC will assist local\/state health departments to collect, store, and ship specimens appropriately \n\n\n\n\n\nto CDC, including during afterhours or on weekends\/holidays. At this time, diagnostic testing for 2019\u2013nCoV can be \n\n\n\n\n\nconducted only at CDC. Testing for other respiratory pathogens should not delay specimen shipping to CDC. If a PUI tests \n\n\n\n\n\npositive for another respiratory pathogen, after clinical evaluation and consultation with public health authorities, they \n\n\n\n\n\nmay no longer be considered a PUI. This may evolve as more information becomes available on possible 2019\u2013nCoV co\u2013infections.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p><strong>For biosafety reasons, it is not recommended to perform virus isolation in cell culture or initial characterization \n\n\n\n\n\nof viral agents recovered in cultures of specimens from a PUI for 2019\u2013nCoV.<\/strong> To increase the likelihood of \n\n\n\n\n\ndetecting 2019\u2013nCoV infection, CDC recommends collecting and testing multiple clinical specimens from different sites, \n\n\n\n\n\nincluding all three specimen types\u2013lower respiratory, upper respiratory, and serum specimens. Additional specimen types \n\n\n\n\n\n(e.g., stool, urine) may be collected and stored. Specimens should be collected as soon as possible once a PUI is identified \n\n\n\n\n\nregardless of time of symptom onset. Additional guidance for collection, handling, and testing of clinical specimens is available \n\n\n\n\n\nat <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/\">https:\/\/www.cdc.gov\/coronavirus\/2019\u2013nCoV\/<\/a>.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p><strong>Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019\u2013nCoV<\/strong>\n\n\n\n\n\nAlthough the transmission dynamics have yet to be determined, CDC currently recommends a cautious approach to patients under investigation \n\n\n\n\n\nfor 2019\u2013nCoV <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/clinical-criteria.html\">(https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/clinical-criteria.html)<\/a>. \n\n\n\n\n\nSuch patients should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed, \n\n\n\n\n\nideally an airborne infection isolation room if available. Healthcare personnel entering the room should use standard precautions, contact \n\n\n\n\n\nprecautions, airborne precautions, and use eye protection (e.g., goggles or a face shield). Immediately notify your healthcare facility&#8217;s \n\n\n\n\n\ninfection control personnel and local health department.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<h2>Additional Infection Control Practices Resources<\/h2>\n\n\n\n\n\n<ul>\n\n\n\n\n\n<li>Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings <a href=\"https:\/\/www.cdc.gov\/infectioncontrol\/guidelines\/isolation\/index.html\">(https:\/\/www.cdc.gov\/infectioncontrol\/guidelines\/isolation\/index.html)<\/a><\/li>\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n<p><strong>Notes<\/strong><\/p>\n\n\n\n\n\n<p><sup>1<\/sup>Fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain fever\u2013lowering medications. Clinical judgment should be used to guide testing of patients in such situations.<\/p>\n\n\n\n\n\n<p><sup>2<\/sup>Close contact with a person who is under investigation for 2019\u2013nCOV.<br>\n\n\n\n\n\nClose contact is defined as \u2013<br> \n\n\n\n\n\na) being within approximately 6 feet (2 meters), or within the room or care area, of a novel coronavirus case for a prolonged period \n\n\n\n\n\nof time while not wearing recommended personal protective equipment or PPE (e.g., gowns, gloves, NIOSH\u2013certified disposable N95 \n\n\n\n\n\nrespirator, eye protection); close contact can include caring for, living with, visiting, or sharing a healthcare waiting area or room with a novel coronavirus case.<br>\n\n\n\n\n\n\u2013 or \u2013<br>\n\n\n\n\n\nb) having direct contact with infectious secretions of a novel coronavirus case (e.g., being coughed on) while not wearing recommended personal protective equipment.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>See CDC&#8217;s Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus\n\n\n\n\n\n<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/infection-control.html\">(https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/infection-control.html)<\/a>.<\/p> \n\n\n\n\n\n\n\n\n\n\n\n<p>Data to inform the definition of close contact are limited. Considerations when assessing close contact include \n\n\n\n\n\nthe duration of exposure (e.g., longer exposure time likely increases exposure risk) and the clinical symptoms of \n\n\n\n\n\nthe person with novel coronavirus (e.g., coughing likely increases exposure risk as does exposure to a severely \n\n\n\n\n\nill patient). Special consideration should be given to those exposed in healthcare settings.<\/p> \n\n\n\n\n\n\n\n\n\n\n\n<h2>For More Information<\/h2>\n\n\n\n\n\n<p>More information is available at <a href=\"https:\/\/.cdc.gov\/coronavirus\/2019-ncov\/index.html\">https:\/\/.cdc.gov\/coronavirus\/2019-ncov\/index.html<\/a> \n\n\n\n\n\nor by calling 800-CDC-INFO | (800-232-4636) | TTY: (888) 232-6348.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>************************************<\/p>\n\n\n\n\n\n\n\n\n\n\n\n<p>You are receiving this email because you are a registered member of the Delaware Health Alert Network.\n\n\n\n\n\nIf you are not a member and would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a><\/p>\n\n\n\n\n\n\n\n\n\n\n\n<br>\n\n\n\n\n\n<br>\n\n\n\n\n\n<p class=\"smalltext\"><a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\"><img loading=\"lazy\" decoding=\"async\" alt=\"Download Adobe Acrobat Reader\" height=\"21\" src=\"\/wp-content\/uploads\/dhss\/img\/getacro60.gif\" width=\"60\"><\/a> Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader.  A free copy of Adobe Acrobat Reader can be downloaded directly from <a href=\"http:\/\/www.adobe.com\/products\/acrobat\/readstep2.html\">Adobe <\/a>. If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe&#8217;s <a href=\"http:\/\/access.adobe.com\">Accessibility Tools page<\/a>.<\/p>\n<!--[END]-->\n\n\n  \n\n\n        <div class=\"panel panel-danger\">\n\n\n          <div class=\"panel-heading\">    \n\n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n\n       <\/div>\n\n\n       <div class=\"panel-body\">\n\n\n      <ul>\n\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n\n            <\/ul>\n\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n\n          <\/div> \n\n\n        <\/div><br>  \n\n\n\n\n\n      <\/div>\n\n\n    <\/div>\n\n\n  <\/div><!-- \/container -->\n\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #417 January 23, 2020 11:40 am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10390","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10390","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10390"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10390\/revisions"}],"predecessor-version":[{"id":11566,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10390\/revisions\/11566"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10390"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}