{"id":10391,"date":"2025-03-01T14:07:54","date_gmt":"2025-03-01T19:07:54","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan418\/"},"modified":"2025-03-02T00:54:36","modified_gmt":"2025-03-02T05:54:36","slug":"dhan418","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan418\/","title":{"rendered":"php\/alerts\/dhan418 ~  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\/dhan418.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\"]-->418 <!--[END]--> <\/h1>\n\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->February 3, 2020 10:20 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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It also adds<\/p>\n\n\n\n\n\n\n<ul>\n\n\n\n\n\n\n<li>guidance for clinicians caring for patients with 2019-nCoV (<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-guidance-management-patients.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-guidance-management-patients.html<\/a>),<\/li>\n\n\n\n\n\n\n<li>and for public health officials on the evaluation and testing of patients under investigation (PUIs) for 2019-nCoV (<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-guidance-management-patients.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/clinical-criteria.html<\/a>), and<\/li>\n\n\n\n\n\n\n<li>updated infection prevention and control guidance specific to 2019-nCoV (<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/infection-control.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/infection-control.html<\/a>).<\/li>\n\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n<p>Early in the outbreak, many of the patients with respiratory illness caused by 2019-nCoV in China had exposure to a large \n\n\n\n\n\n\nseafood and live animal market, suggesting animal-to-human transmission. More recently, cases have been confirmed with no \n\n\n\n\n\n\nexposure to animal markets, indicating that person-to-person spread of the virus has occurred. Chinese officials report that \n\n\n\n\n\n\nsustained person-to-person spread in the community is occurring in China.<\/p>\n\n\n\n\n\n\n<p>The first US case-patient was identified on January 21, 2020, and had recently traveled from Wuhan, China. Since that time, \n\n\n\n\n\n\nsix additional cases have been confirmed in the United States, four among persons who traveled from Wuhan, and one a close contact \n\n\n\n\n\n\nof a confirmed case. Globally, reported illnesses in people with 2019-nCoV have ranged from mild (no or few signs and symptoms), \n\n\n\n\n\n\nto severe, including death. These findings are consistent with other coronaviruses, including Severe Acute Respiratory Syndrome \n\n\n\n\n\n\n(SARS) (<a href=\"https:\/\/www.cdc.gov\/sars\/\">https:\/\/www.cdc.gov\/sars\/<\/a>) and Middle East Respiratory Syndrome (MERS) \n\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>). Additional \n\n\n\n\n\n\ninformation about 2019-nCoV is needed to better understand transmission, disease severity, and risk to the general population. \n\n\n\n\n\n\nThe goal of the ongoing US public health response is to identify and contain this outbreak and prevent sustained spread of 2019-nCoV in the United States.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>There was one Delawarean tested for 2019-nCoV. The test results were negative.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Recommendations for screening of patients for possible 2019-nCoV infection are based on (1) current knowledge of the characteristics \n\n\n\n\n\n\nof clinical illness observed in early cases, and (2) the geographic distribution of current cases. They reflect the current public health \n\n\n\n\n\n\ngoal of rapidly containing and preventing transmission of 2019-nCoV illness.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Patients presenting to healthcare facilities should be assessed for exposures associated with risk of 2019-nCoV infections \n\n\n\n\n\n\n(e.g., travel to China or close contact with a confirmed case) and for symptoms consistent with 2019-nCoV infection \n\n\n\n\n\n\n(<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/clinical-criteria.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/clinical-criteria.html<\/a>). \n\n\n\n\n\n\nThe assessment is intended to allow healthcare providers to make decisions about appropriate infection control and management of patients.  \n\n\n\n\n\n\nNote that the signs and symptoms of 2019-nCoV overlap with those associated with other viral respiratory tract infections. Given the time of year, \n\n\n\n\n\n\ncommon respiratory illnesses, including influenza, should also be considered in patients who are screened. (Figure 1)<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Clinicians should ask:<\/p>\n\n\n\n\n\n\n<ul>\n\n\n\n\n\n\n<li>Does the person have fever or symptoms of lower respiratory infection, such as cough or shortness of breath?<br>\n\n\n\n\n\n\nAND<\/li>\n\n\n\n\n\n\n<li>Has the patient traveled to mainland China within 14 days of symptom onset?<br>\n\n\n\n\n\n\nOR<\/li>\n\n\n\n\n\n\n<li>Has the patient had close contact1 with a person confirmed with 2019-nCoV infection?<\/li>\n\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>If a patient meets these criteria:<\/p>\n\n\n\n\n\n\n<ul>\n\n\n\n\n\n\n<li>To minimize the risk that other people will be exposed to individuals who may have 2019-nCoV,  patients who report having \n\n\n\n\n\n\nthese symptoms should be asked to wear a surgical mask as soon as they are identified and directed to a separate area, if possible, \n\n\n\n\n\n\nwith at least 6 feet (2 meters) separation from other persons. Patients should be evaluated in a private room with the door closed, \n\n\n\n\n\n\nideally an airborne infection isolation room (AIIR), if available. Healthcare personnel entering the room should use standard \n\n\n\n\n\n\nprecautions, contact precautions, airborne precautions, and use eye protection (e.g., goggles or a face shield). For more information \n\n\n\n\n\n\nabout this, see CDC&#8217;s <em>Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation \n\n\n\n\n\n\nfor 2019 Novel Coronavirus (2019-nCoV) in a Healthcare Setting<\/em> (<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/infection-control.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/infection-control.html<\/a>).<\/li>\n\n\n\n\n\n\n<\/ul>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Clinicians should immediately notify the healthcare facility&#8217;s infection control personnel and local health department. \n\n\n\n\n\n\nThe health department will determine if this patient needs to be considered a PUI for 2019-nCoV and be tested for infection.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h2>Criteria to Guide Evaluation and Testing of Patients Under Investigation (PUI) for 2019-nCoV<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Local health departments, in consultation with clinicians, should determine whether a patient is a PUI for 2019-nCoV. \n\n\n\n\n\n\nThe CDC clinical criteria for 2019-nCoV PUIs have been developed based on available information about this novel virus, \n\n\n\n\n\n\nas well as what is known about SARS and MERS. These criteria are subject to change as additional information becomes \n\n\n\n\n\n\navailable: <a href=\"https:\/\/emergency.cdc.gov\/han\/han00427.asp\">https:\/\/emergency.cdc.gov\/han\/han00427.asp<\/a>.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>These criteria are intended to serve as guidance for evaluation and testing. Patients should be evaluated and discussed \n\n\n\n\n\n\nwith public health departments on a case\u2013by\u2013case basis for possible 2019-nCoV infection. Testing decisions \n\n\n\n\n\n\nmight be further informed by the clinical presentation or exposure history (e.g., uncertain travel or exposure), and the \n\n\n\n\n\n\npresence of an alternative diagnosis that explains their clinical presentation.<\/p>\n\n\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\n<p>Healthcare providers should <strong>immediately<\/strong> notify infection control personnel at their healthcare \n\n\n\n\n\n\nfacility if a patient is classified a PUI for 2019-nCoV. State health departments that have identified a PUI should \n\n\n\n\n\n\nimmediately contact CDC&#8217;s Emergency Operations Center (EOC) at 770-488-7100 and complete a 2019-nCoV PUI case \n\n\n\n\n\n\ninvestigation form (<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-criteria.html#reporting-testing-specimen-collection\">https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/clinical-criteria.html#reporting-testing-specimen-collection<\/a>). CDC&#8217;s EOC will assist local and state health departments \n\n\n\n\n\n\nwith obtaining, storing, and shipping appropriate specimens to CDC, including afterhours or on weekends or holidays. \n\n\n\n\n\n\nCurrently, diagnostic testing for 2019-nCoV can be done only at CDC. Testing for other respiratory pathogens should \n\n\n\n\n\n\nnot delay specimen shipping to CDC.<\/p>\n\n\n\n\n\n\n<p>For initial diagnostic testing for 2019-nCoV, CDC recommends collecting and testing upper respiratory (nasopharyngeal \n\n\n\n\n\n\nAND oropharyngeal swabs), and lower respiratory (sputum, if possible)) for those patients with productive coughs. \n\n\n\n\n\n\nInduction of sputum is not indicated. Specimens should be collected as soon as possible once a PUI is identified, \n\n\n\n\n\n\nregardless of the time of symptom onset. See <em>Interim Guidelines for Collecting, Handling, and Testing Clinical \n\n\n\n\n\n\nSpecimens from Patients Under Investigation (PUIs) for 2019 Novel Coronavirus (2019-nCoV)<\/em> (<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/lab\/guidelines-clinical-specimens.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/lab\/guidelines-clinical-specimens.html<\/a>).<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h2>Recommendations for Healthcare Providers<\/h2>\n\n\n\n\n\n\n<p>No vaccine or specific treatment for 2019-nCoV infection is available. At present, medical care for patients with 2019-nCoV is supportive.<\/p>\n\n\n\n\n\n\n<p>Persons with confirmed or suspected 2019-nCoV infection who are hospitalized should be evaluated and cared for in a private \n\n\n\n\n\n\nroom with the door closed, ideally an airborne infection isolation room, if available. For more information, see \n\n\n\n\n\n\n<em>Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation \n\n\n\n\n\n\nfor 2019 Novel Coronavirus (2019-nCoV) in a Healthcare Setting<\/em> (<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/infection-control.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-nCoV\/hcp\/infection-control.html<\/a>).<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Home care and isolation may be an option, based on clinical and public health assessment, for some persons. Please see \n\n\n\n\n\n\n<em>Interim Guidance for Preventing the Spread of 2019 Novel Coronavirus (2019-nCoV) in Homes and Communities<\/em> \n\n\n\n\n\n\n(<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/guidance-prevent-spread.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/guidance-prevent-spread.html<\/a>).<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>Those isolated at home should be monitored by public health officials to the extent possible. Refer to <em>Interim Guidance \n\n\n\n\n\n\nfor Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus (2019-nCoV)<\/em> \n\n\n\n\n\n\n(<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/guidance-home-care.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/guidance-home-care.html<\/a>) for more information.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h3>Notes<\/h3>\n\n\n\n\n\n\n<p><sup>1<\/sup>\u00a0Close contact is defined as:<\/p>\n\n\n\n\n\n\n<p>a) being within approximately 6 feet (2 meters), or within the room or care area, of a 2019-nCoV case for a prolonged period of time while not wearing recommended personal protective equipment or PPE (e.g., gowns, gloves, NIOSH-certified disposable N95 respirator, eye protection); close contact can include caring for, living with, visiting, or sharing a health care waiting area or room with a 2019-nCoV case<br>     \n\n\n\n\n\n\n\u2013 or \u2013<br>\n\n\n\n\n\n\nb) having direct contact with infectious secretions of a 2019-nCoV 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\n\n<p><sup>2<\/sup>\u00a0Fever may be subjective or confirmed<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p>See CDC&#8217;s updated <em>Interim Infection Prevention and Control Recommendations for Patients with Known or Patients Under Investigation for 2019 Novel Coronavirus (2019-nCoV) in a Healthcare Setting<\/em> (<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\n\n<p>Data to inform the definition of close contact are limited. Considerations when assessing close contact include the duration of exposure (e.g., longer exposure time likely increases exposure risk) and the clinical symptoms of the person with 2019-nCoV (e.g., coughing likely increases exposure risk as does exposure to a severely ill patient). Special consideration should be given to those exposed in health care settings.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p><sup>3<\/sup>\u00a0Documentation of laboratory-confirmation of 2019-nCoV may not be possible for travelers or persons caring for patients in other countries.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p><sup>4<\/sup>\u00a0Category also includes any member of a cluster of patients with severe acute lower respiratory illness (e.g., pneumonia, ARDS) of unknown etiology in which 2019-nCoV is being considered that requires hospitalization. Such persons should be evaluated in consultation with state and local health departments regardless of travel history.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<h3>For More Information<\/h3>\n\n\n\n\n\n\n<p>More information is available at the 2019 Novel Coronavirus website (<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/index.html\">https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/index.html<\/a>) or by\n\n\n\n\n\n\ncalling 800-CDC-INFO | (800-232-4636) | TTY: (888) 232-6348<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<p><em>The Centers for Disease Control and Prevention (CDC) protects people&#8217;s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.<\/em><\/p>\n\n\n\n\n\n\n<p>************************************<\/p>\n\n\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\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><!--[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 #418 February 3, 2020 10:20 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-10391","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10391","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=10391"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10391\/revisions"}],"predecessor-version":[{"id":11567,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10391\/revisions\/11567"}],"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=10391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}