LAPD-EM NEWS

Los Alamos Police Department Emergency Management Cmdr. Bev Simpson has released the Jan. 31 New Mexico Department of Health advisory on coronavirus

Key Points 

• This is a rapidly evolving outbreak and we are learning more about the virus every day. Our recommendations and our response will continue to evolve. 
• NMDOH is actively monitoring the situation and coordinating preparedness and response activities, including participating in national and international teleconferences, distributing Health Alert Notices (HANs) to healthcare providers, hosting teleconference calls with New Mexico hospitals, Emergency Medical Services and universities, and publishing a 2019-nCoV webpage on the NMDOH website. 
• There have been no cases detected in New Mexico, and the NMDOH believes the risk of importation to NM is low. 

Suspected cases NMDOH staff will determine if the suspect patient meets the criteria for a patient under investigation (PUI) for 2019-nCoV. Healthcare professionals who suspect 2019-nCoV in a patient who has traveled from Wuhan City and/or Hubei Province, China or had exposure to a confirmed case within 14 days of illness onset, or a case requiring hospitalization with any travel to China within 14 days of illness onset should immediately notify infection control personnel at their facility and contact the New Mexico Department of Health at the 24/7/365 epidemiology hotline: 505-827-0006. 

Background As of January 30, 2020, there have been 7818 confirmed cases of 2019-nCoV reported globally, 7736 of which were in China. There have been 170 deaths reported for a case fatality rate (CFR) of 2.2%. All deaths have occurred in China. There have been 82 confirmed cases reported from 18 countries, including the United States, and there have been 8 cases of human-to-human transmission in four countries outside of China: Germany, Vietnam, Japan and the United States. Asymptomatic transmission has been documented in Germany. 

EPIDEMIOLOGY AND RESPONSE 1190 St. Francis Drive, N1320 • Santa Fe, New Mexico • 87502-6110 (505) 827-0006 • FAX: (505) 827-2110 • http://www.nmhealth.org 

Novel Coronavirus and the United States As of January 31, 2020, there have been 6 confirmed cases reported from the United States in Washington state, Illinois, Arizona and California. There has been one incidence of secondary transmission to the spouse of the initial Illinois case. There have been no confirmed cases in New Mexico. 

The Centers for Disease Control and Prevention (CDC) has updated the following guidance: 

Patients in the United States who meet the following criteria should be evaluated for 2019- nCoV. 

Clinical Features & Epidemiologic Risk 

Fever1 or signs/symptoms of lower respiratory illness (e.g. cough or shortness of breath) 

Any person, including health care workers, who has had close contact with a laboratory- confirmed 2019-nCoV patient within 14 days of symptom onset Fever1 and signs/symptoms of a lower respiratory illness (e.g., cough or shortness of breath) 

AND 

AND A within history 14 of days travel of symptom from Hubei onset 

Province, China 

Fever1 and signs/symptoms of a lower respiratory illness (e.g., cough or shortness of breath) requiring hospitalization 

AND A 14 history days of of symptom travel from onset 

mainland China within 

1Fever may be subjective or confirmed 

For more information on close contact definitions, laboratory-confirmation and hospitalization requirement, see: 

• Interim Guidance for Healthcare Professionals 

Infection Prevention and Control (IPC) 

Transmission dynamics of this virus are still being investigated, but CDC is recommending that healthcare personnel implement standard precautions, contact precautions and airborne precautions including eye protection when seeing a PUI. The PUI should be asked to wear a mask and should be evaluated in a private room, ideally in an airborne infection isolation room. 

Routine procedures can be used for cleaning and disinfection using products that are EPA- approved for emerging viral pathogens or human coronaviruses. Management of laundry, food service utensils and medical waste can also be handled in accordance with routine procedures. 

For more information, see CDC’s updated IPC guidance: 

• Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus 

Laboratory Testing 

In addition to considering the novel coronavirus, clinicians should immediately perform diagnostic testing for respiratory pathogens, including influenza, respiratory syncytial virus and other common pathogens via commercially available tests. There is no commercially available test to diagnose 2019-nCoV. Some commercially available respiratory panels test for common coronaviruses. However, 2019-nCoV is distinct from these common viruses and commercial respiratory panels should not be used to test for 2019-nCoV. 

CDC has developed and is performing a real time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) test on respiratory specimens shipped through state public health laboratories. CDC is working with the U.S. Food and Drug Administration to gain approval to manufacture and distribute these tests to state public health laboratories in the coming weeks. 

Specimens to Collect 

If you suspect a patient may have 2019-nCoV, please collect the following specimens as soon as possible: 

• Bronchoalveolar lavage or tracheal aspirate 
• Sputum 
• Nasopharyngeal swab AND Oropharyngeal swab 
• Serum 
• Urine 
• Stool 

NMDOH will work with you to coordinate shipment to CDC for testing. For more information on specimen collection and shipping please see: 

• Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Patients Under Investigation (PUIs) for 2019 Novel Coronavirus (2019-nCoV) 

Travel recommendations 

• Guidance for travelers : CDC has issued a Level 3 Travel Advisory advising travelers to avoid all nonessential travel to China. 
• Travel Advisory : The US State Department has issued a Level 4 Travel Advisory advising US citizens: do not travel to China. 

CDC has implemented screening of travelers arriving directly from Wuhan at twenty major airports. Travelers arriving in the US from China are being screened with a short questionnaire 

about their travel, symptoms and exposures. They are also being screened for fever, cough and difficulty breathing. Sick travelers are being further evaluated by CDC to determine if they need medical attention. Asymptomatic travelers are provided with health information cards telling them which symptoms to watch for and what to do if they develop symptoms. 

Please consult the CDC website on 2019-nCoV for the most up to date information. Please call NMDOH at 505-827-0006 if you have any questions.