Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020.

Publisher: U.S. Centers for Disease Control Country of Publication: United States NLM ID: 7802429 Publication Model: Electronic Cited Medium: Internet ISSN: 1545-861X (Electronic) Linking ISSN: 01492195 NLM ISO Abbreviation: MMWR Morb Mortal Wkly Rep Subsets: MEDLINE

Publication: Atlanta, GA : U.S. Centers for Disease Control
Original Publication: [Atlanta] U. S. Dept. of Health, Education, and Welfare, Public Health Service, Center for Disease Control.

Betacoronavirus/*isolation & purification ; Coronavirus Infections/*epidemiology ; Coronavirus Infections/*virology ; Disease Outbreaks/*prevention & control ; Pneumonia, Viral/*epidemiology ; Pneumonia, Viral/*virology; Adult ; Aged ; COVID-19 ; Centers for Disease Control and Prevention, U.S. ; Coronavirus Infections/prevention & control ; Female ; Humans ; Infection Control ; Laboratories ; Male ; Middle Aged ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Practice Guidelines as Topic ; Public Health Practice ; SARS-CoV-2 ; United States/epidemiology

On December 31, 2019, Chinese health officials reported a cluster of cases of acute respiratory illness in persons associated with the Hunan seafood and animal market in the city of Wuhan, Hubei Province, in central China. On January 7, 2020, Chinese health officials confirmed that a novel coronavirus (2019-nCoV) was associated with this initial cluster (1). As of February 4, 2020, a total of 20,471 confirmed cases, including 2,788 (13.6%) with severe illness,* and 425 deaths (2.1%) had been reported by the National Health Commission of China (2). Cases have also been reported in 26 locations outside of mainland China, including documentation of some person-to-person transmission and one death (2). As of February 4, 11 cases had been reported in the United States. On January 30, the World Health Organization (WHO) Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern. ^† On January 31, the U.S. Department of Health and Human Services (HHS) Secretary declared a U.S. public health emergency to respond to 2019-nCoV. ^§ Also on January 31, the president of the United States signed a "Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus," which limits entry into the United States of persons who traveled to mainland China to U.S. citizens and lawful permanent residents and their families (3). CDC, multiple other federal agencies, state and local health departments, and other partners are implementing aggressive measures to slow transmission of 2019-nCoV in the United States (4,5). These measures require the identification of cases and their contacts in the United States and the appropriate assessment and care of travelers arriving from mainland China to the United States. These measures are being implemented in anticipation of additional 2019-nCoV cases in the United States. Although these measures might not prevent the eventual establishment of ongoing, widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare health care systems and the general public to be ready if widespread transmission with substantial associated illness occurs; and 3) better characterize 2019-nCoV infection to guide public health recommendations and the development of medical countermeasures including diagnostics, therapeutics, and vaccines. Public health authorities are monitoring the situation closely. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC and state and local health departments.
Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Erratum in: MMWR Morb Mortal Wkly Rep. 2020 Feb 14;69(6):173. (PMID: 32053580)

Lancet. 2020 Feb 22;395(10224):565-574. (PMID: 32007145)
N Engl J Med. 2020 Mar 26;382(13):1199-1207. (PMID: 31995857)
Emerg Infect Dis. 2013 Jan;19(1):85-91. (PMID: 23260039)
MMWR Recomm Rep. 2019 Aug 23;68(3):1-21. (PMID: 31441906)
Lancet. 2020 Feb 15;395(10223):497-506. (PMID: 31986264)
MMWR Recomm Rep. 2014 Sep 26;63(RR-06):1-18. (PMID: 25254666)
Lancet. 2020 Feb 15;395(10223):507-513. (PMID: 32007143)

Investigator: F Abdirizak, National Center for Immunization and Respiratory Diseases, CDC.; G Abedi, National Center for Immunization and Respiratory Diseases, CDC.; S Aggarwal, National Center for Immunization and Respiratory Diseases, CDC.; D Albina, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; E Allen, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; L Andersen, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; J Anderson, Center for Preparedness and Response, CDC.; M Anderson, Center for Preparedness and Response, CDC.; T Anderson, Center for State, Tribal, Local and Territorial Support, CDC.; K Anderson, National Center on Birth Defects and Developmental Disabilities, CDC.; AC Bardossy, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; V Barry, National Center for Injury Prevention and Control, CDC.; K Beer, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; M Bell, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; S Berger, Office of the Director, CDC.; J Bertulfo, Office of the Director, CDC.; H Biggs, National Center for Immunization and Respiratory Diseases, CDC.; J Bornemann, Office of the Director, CDC.; J Bornstein, Office of the Director, CDC.; W Bower, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; J Bresee, National Center for Immunization and Respiratory Diseases, CDC.; C Brown, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; A Budd, National Center for Immunization and Respiratory Diseases, CDC.; J Buigut, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; S Burke, National Center for Immunization and Respiratory Diseases, CDC.; R Burke, National Center for Immunization and Respiratory Diseases, CDC.; E Burns, National Center for Immunization and Respiratory Diseases, CDC.; J Butler, Office of the Deputy Director of Infectious Disease, CDC.; R Cantrell, Center for State, Tribal, Local and Territorial Support, CDC.; C Cardemil, National Center for Immunization and Respiratory Diseases, CDC.; J Cates, National Center for Immunization and Respiratory Diseases, CDC.; M Cetron, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; K Chatham-Stephens, National Center on Birth Defects and Developmental Disabilities, CDC.; K Chatham-Stevens, National Center on Birth Defects and Developmental Disabilities, CDC.; N Chea, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; B Christensen, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; V Chu, National Center for Immunization and Respiratory Diseases, CDC.; K Clarke, Center for Global Health, CDC.; A Cleveland, National Center for Immunization and Respiratory Diseases, CDC.; N Cohen, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; M Cohen, Center for State, Tribal, Local and Territorial Support, CDC.; A Cohn, National Center for Immunization and Respiratory Diseases, CDC.; J Collins, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Erin Conners, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Aaron Curns, National Center for Immunization and Respiratory Diseases, CDC.; R Dahl, National Center for Immunization and Respiratory Diseases, CDC.; W Daley, Center for Preparedness and Response, CDC.; V Dasari, Center for State, Tribal, Local and Territorial Support, CDC.; E Davlantes, Center for State, Tribal, Local and Territorial Support, CDC.; P Dawson, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; L Delaney, National Institute for Occupational Safety and Health, CDC.; M Donahue, Center for State, Tribal, Local and Territorial Support, CDC.; C Dowell, National Institute for Occupational Safety and Health, CDC.; J Dyal, National Center for Immunization and Respiratory Diseases, CDC.; W Edens, National Center for Immunization and Respiratory Diseases, CDC.; R Eidex, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; L Epstein, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; M Evans, National Center for Injury Prevention and Control, CDC.; R Fagan, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; K Farris, National Center for Immunization and Respiratory Diseases, CDC.; L Feldstein, National Center for Immunization and Respiratory Diseases, CDC.; L Fox, National Center for Immunization and Respiratory Diseases, CDC.; M Frank, Center for Preparedness and Response, CDC.; B Freeman, National Center for Immunization and Respiratory Diseases, CDC.; A Fry, National Center for Immunization and Respiratory Diseases, CDC.; J Fuller, Center for Global Health, CDC.; R Galang, National Center for Chronic Disease Prevention and Promotion, CDC.; S Gerber, National Center for Immunization and Respiratory Diseases, CDC.; R Gokhale, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; S Goldstein, National Center for Immunization and Respiratory Diseases, CDC.; S Gorman, Center for Preparedness and Response, CDC.; W Gregg, National Center for Immunization and Respiratory Diseases, CDC.; W Greim, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; S Grube, Office of the Director, CDC.; A Hall, National Center for Immunization and Respiratory Diseases, CDC.; A Haynes, National Center for Immunization and Respiratory Diseases, CDC.; S Hill, National Center for Immunization and Respiratory Diseases, CDC.; J Hornsby-Myers, National Institute for Occupational Safety and Health, CDC.; J Hunter, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; C Ionta, National Center for Immunization and Respiratory Diseases, CDC.; C Isenhour, National Center for Immunization and Respiratory Diseases, CDC.; M Jacobs, Center for State, Tribal, Local and Territorial Support, CDC.; KJ Slifka, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; D Jernigan, National Center for Immunization and Respiratory Diseases, CDC.; M Jhung, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; J Jones-Wormley, Center for Preparedness and Response, CDC.; A Kambhampati, National Center for Immunization and Respiratory Diseases, CDC.; S Kamili, National Center for Immunization and Respiratory Diseases, CDC.; P Kennedy, National Center for Immunization and Respiratory Diseases, CDC.; C Kent, Center for Surveillance, Epidemiology and Laboratory Services, CDC.; M Killerby, National Center for Immunization and Respiratory Diseases, CDC.; L Kim, National Center for Immunization and Respiratory Diseases, CDC.; H Kirking, National Center for Immunization and Respiratory Diseases, CDC.; L Koonin, National Center for Immunization and Respiratory Diseases, CDC.; R Koppaka, National Center for Immunization and Respiratory Diseases, CDC.; C Kosmos, Center for Preparedness and Response, CDC.; D Kuhar, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; W Kuhnert-Tallman, Deputy Director for Infectious Diseases, CDC.; S Kujawski, National Center for Immunization and Respiratory Diseases, CDC.; A Kumar, National Center for Immunization and Respiratory Diseases, CDC.; A Landon, Office of the Director, CDC.; L Lee, National Center for Immunization and Respiratory Diseases, CDC.; J Leung, National Center for Immunization and Respiratory Diseases, CDC.; S Lindstrom, National Center for Immunization and Respiratory Diseases, CDC.; R Link-Gelles, National Center for Immunization and Respiratory Diseases, CDC.; J Lively, National Center for Immunization and Respiratory Diseases, CDC.; X Lu, National Center for Immunization and Respiratory Diseases, CDC.; B Lynch, National Center for Immunization and Respiratory Diseases, CDC.; L Malapati, National Center for Immunization and Respiratory Diseases, CDC.; S Mandel, National Center for Immunization and Respiratory Diseases, CDC.; B Manns, National Center for Immunization and Respiratory Diseases, CDC.; N Marano, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; M Marlow, National Center for Immunization and Respiratory Diseases, CDC.; B Marston, Center for Global Health, CDC.; N McClung, National Center for Immunization and Respiratory Diseases, CDC.; L McClure, Center for Global Health, CDC.; E McDonald, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; O McGovern, National Center for Immunization and Respiratory Diseases, CDC.; N Messonnier, National Center for Immunization and Respiratory Diseases, CDC.; C Midgley, National Center for Immunization and Respiratory Diseases, CDC.; D Moulia, National Center for Immunization and Respiratory Diseases, CDC.; J Murray, National Center for Immunization and Respiratory Diseases, CDC.; K Noelte, Center for Preparedness and Response, CDC.; M Noonan-Smith, Office of the Director, CDC.; K Nordlund, National Center for Immunization and Respiratory Diseases, CDC.; E Norton, National Institute for Occupational Safety and Health, CDC.; S Oliver, National Center for Immunization and Respiratory Diseases, CDC.; M Pallansch, National Center for Immunization and Respiratory Diseases, CDC.; U Parashar, National Center for Immunization and Respiratory Diseases, CDC.; A Patel, National Center for Immunization and Respiratory Diseases, CDC.; M Patel, National Center for Immunization and Respiratory Diseases, CDC.; K Pettrone, National Center for Health Statistics, CDC.; T Pierce, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; H Pietz, Center for Preparedness and Response, CDC.; S Pillai, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; L Radonovich, National Institute for Occupational Safety and Health, CDC.; S Reagan-Steiner, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; A Reel, National Center for Immunization and Respiratory Diseases, CDC.; H Reese, National Center for Immunization and Respiratory Diseases, CDC.; B Rha, National Center for Immunization and Respiratory Diseases, CDC.; P Ricks, Center for Global Health, CDC.; M Rolfes, National Center for Immunization and Respiratory Diseases, CDC.; S Roohi, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; L Roper, National Center for Immunization and Respiratory Diseases, CDC.; L Rotz, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; J Routh, National Center for Immunization and Respiratory Diseases, CDC.; SK Sakthivel, National Center for Immunization and Respiratory Diseases, CDC.; L Sarmiento, National Institute for Occupational Safety and Health, CDC.; J Schindelar, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; E Schneider, National Center for Immunization and Respiratory Diseases, CDC.; A Schuchat, Office of the Director, CDC.; S Scott, Center for State, Tribal, Local and Territorial Support, CDC.; V Shetty, Center for State, Tribal, Local and Territorial Support, CDC.; C Shockey, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; J Shugart, National Institute for Occupational Safety and Health, CDC.; M Stenger, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.; M Stuckey, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; B Sunshine, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; T Sykes, Office of the Director, CDC.; J Trapp, Office of the Director, CDC.; T Uyeki, National Center for Immunization and Respiratory Diseases, CDC.; G Vahey, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; A Valderrama, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; J Villanueva, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; T Walker, Center for Preparedness and Response, CDC.; M Wallace, National Center for Immunization and Respiratory Diseases, CDC.; L Wang, National Center for Immunization and Respiratory Diseases, CDC.; J Watson, National Center for Immunization and Respiratory Diseases, CDC.; A Weber, National Institute for Occupational Safety and Health, CDC.; C Weinbaum, National Center for Immunization and Respiratory Diseases, CDC.; W Weldon, National Center for Immunization and Respiratory Diseases, CDC.; C Westnedge, National Center for Immunization and Respiratory Diseases, CDC.; B Whitaker, National Center for Immunization and Respiratory Diseases, CDC.; M Whitaker, National Center for Immunization and Respiratory Diseases, CDC.; A Williams, Office of the Director, CDC.; H Williams, Office of the Director, CDC.; I Willams, National Center for Emerging and Zoonotic Infectious Diseases, CDC.; K Wong, Center for Surveillance, Epidemiology and Laboratory Services, CDC.; A Xie, Center for State, Tribal, Local and Territorial Support, CDC.; A Yousef, National Center for Immunization and Respiratory Diseases, CDC.

Date Created: 20200207 Date Completed: 20200207 Latest Revision: 20240404

20240404

PMC7004396

10.15585/mmwr.mm6905e1

32027631