CDC reminds clinicians to use standard precautions, recommends isolating patients with coronavirus symptoms

In light of the "emerging, rapidly evolving" outbreak of the novel coronavirus 2019-nCoV, the Centers for Disease Control and Prevention is reminding clinicians to use standard precautions consistently and advising they isolate patients who show signs and symptoms of the virus.

The new coronavirus has led to tens of thousands of cases of respiratory illness in China, and infections have been reported in other countries as well, most of them associated with travel from Wuhan, China, where the virus was first detected, according to the CDC. Coronaviruses are a large family of viruses that are common in animals and people, causing the common cold or more severe diseases, such as SARS and MERS.

As of Feb. 10, there were 12 confirmed U.S. cases of 2019-nCoV in Arizona, California, Illinois, Massachusetts, Washington and Wisconsin, as well as 68 other specimens awaiting testing or in route to the CDC. The first person-to-person transmission in the U.S. was reported Jan. 30 in the Chicago area.
Infographic map of U.S. cases of 2019-nCoV 20200210
Because of the growing number of cases and reach of the disease, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a "public health emergency of international concern" on Jan. 30. The next day, the U.S. Department of Health and Human Services secretary declared it a U.S. public health emergency.

Those caring for a patient with 2019-nCoV infection should follow infection control procedures, including administrative rules and engineering controls, environmental hygiene, correct work practices and appropriate use of personal protective equipment consisting of gloves, gowns, respiratory protection and eye protection, according to the CDC. The ADA's Oral Health Topics page on infection control and sterilization includes additional information on infection controls in dentistry.

"The use of standard precautions within the dental workplace and acquiring a thorough history of symptoms and potential exposure for patients is critical for dental health care professionals to maintain a healthy working environment, whether the concern is flu, 2019-nCoV or other transmissible illnesses," said Dr. Maria Geisinger, chair of the ADA Council on Scientific Affairs. "Furthermore, postponing nonemergent dental care in individuals who are ill and proper referral for diagnosis of suspected cases of transmissible illness is a critical role that the dentist can play in reducing the spread of these dangerous diseases."

The CDC's Guidelines for Infection Control in Dental Health-Care Settings—2003 notes dental health care personnel may consider postponing nonemergency or elective dental procedures until a patient is no longer contagious with diseases that can be transmitted through airborne, droplet or contact transmission.

If urgent dental treatment is needed and 2019-nCoV infection is confirmed or suspected, the care should be provided in a facility where there is a minimum of six air changes per hour, such as a hospital with dental care capabilities, according to the CDC. Information on respiratory protection programs is available on the Occupational Safety and Health Administration website.

The immediate health risk from 2019-nCoV to the general American public is considered low at this time, according to the CDC, emphasizing the flu is currently a greater threat. The CDC estimates there have been at least 22 million flu illnesses, 210,000 hospitalizations and 12,000 deaths from the flu so far this season.

During flu and respiratory disease season, the CDC recommends receiving the flu vaccine, using standard precautions, such as hand-washing and surface disinfection, and taking flu antivirals if prescribed. The CDC advises health care personnel experiencing a flu-like illness should not report to work. For 2019-nCoV, there is currently no vaccine or specific treatment besides supportive care, but the CDC shared its guidance for clinicians during a webinar Jan. 31.

Health care professionals should be on the lookout for patients who have traveled to China and show fever and lower respiratory symptoms, such as cough or shortness of breath, according to the CDC. However, some patients with 2019-nCoV infection may have no symptoms or unexpected symptoms, such as diarrhea.

The incubation period ranges from two to 14 days, according to the CDC. At this time, it is unclear how long infected patients shed the virus; it could be several weeks or longer.

The CDC advises health care workers should place face masks on infected patients, isolate them before and during care and report any cases to local and state public health authorities.

The Health Insurance Portability and Accountability Act Privacy Rule permits covered entities to disclose necessary protected health information without individual authorization to a public health authority, such as the CDC or a local or state health department.

For more information on how HIPAA relates to the release of protected health information for planning or response activities in emergency situations, visit the U.S. Department of Health and Human Services website.

To learn more about the coronavirus, visit the CDC website.