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Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith Tuesday evening, January 21, 2020 Should You Be Concerned? You live or work in Alpine County, and today you have heard that the Centers for Disease Control and Prevention (CDC) has confirmed the first case of 2019 Novel Coronavirus (2019-nCoV) in the United States in Washington State. What happened today? A Washington State resident in his 30’s recently returned from Wuhan City, Hubei Province, China, on January 15, 2020, where an outbreak of pneumonia caused by a novel coronavirus has been ongoing since December. He was returning from visiting relatives and traveled through Seattle- Tacoma International Airport. After he developed he saw information about the spread of the virus on the Internet and took the initiative to reach out to his health care provider. Based on his travel history and healthcare professionals suspected the new coronavirus. A clinical specimen was collected and sent to CDC overnight, where laboratory testing yesterday confirmed this diagnosis via a CDC-developed Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test. Precautions have been taken to prevent further exposures and an investigation is underway to trace close contacts of the patient to determine if others might have become infected. What has been happening over the last few weeks? China has confirmed that a novel coronavirus (2019-nCoV) is responsible for a cluster of unidentified atypical viral pneumonia cases recently reported in Wuhan, Hubei Province, in Central China. The cluster was first identified on December 31st, 2019, when the Hong Kong Centre of Health Protection Public Health Brief Richard O. Johnson, M.D., MPH Nichole Williamson Public Health Officer HHS Director Office: [PHONE REDACTED], Ext 249 Office: [PHONE REDACTED] e-mail: [EMAIL REDACTED] 24/7/365 Emergency Contact Numbers Dr. Johnson’s cell: (760) 914-0496 Dispatch: [PHONE REDACTED], Ext 330 ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith (CHP) reported 27 cases of unidentified atypical viral pneumonia from the South China Seafood City Market area in Wuhan. On January 9th, Chinese authorities made a preliminary determination that the illness was associated with 2019-nCoV and then released the genetic sequencing of the virus on January 12th. As of January 21st, the Wuhan Municipal Health Commission reports 258 confirmed cases, including 6 deaths and 249 close contacts under medical supervision. Dozens of patients are hospitalized and are reported to be in serious or critical condition. Confirmed cases of 2019-nCoV have been identified in multiple cities in China and exported cases have been reported in the United States; Bangkok, Thailand; Kanagawa Prefecture, Japan; Taiwan; and South Korea. Why the concern? While originally thought to be spreading from animal-to-person at the market, there have been growing indications that limited person-to-person spread is happening. Wuhan now reports that 15 health care workers caring for patients have come down with the disease. In addition, new cases continue to be identified that have not had any contact with the suspected market. In our world today, we are less than 24 hours from anywhere, and relatively isolated areas like Alpine County have a robust tourist economy with visitors from around the world. In addition, some of our residents have the privilege of traveling globally. The timing of this outbreak is also of concern as the Chunyun holiday (China’s annual Lunar New Year) is rapidly approaching. The celebration lasts about 40 days and represents the largest annual human migration event in the world. What is being done? Follow-up investigations, contact tracing, and decontamination of the market area are ongoing. In addition, increased health surveillance is being conducted at ports of entry within Wuhan and internationally. On January 21st, 2020, CDC updated its interim travel health notice for this destination to provide information to people who may be traveling to Wuhan City and who may get sick. The travel notice was raised from Level 1; “Practice Usual Precautions”, to a Level 2: “Practice Enhanced Precautions” advising travelers that preliminary information suggests that older adults with underlying health conditions may be at increased risk for severe disease. On January 17, 2020 CDC began implementing public health entry screening at San Francisco (SFO), New York (JFK), and Los Angeles (LAX) airports, the three of which receive the most travelers from Wuhan, China as well as issuing an updated health alert to clinicians. ---PAGE BREAK--- Alpine County Health Department, 75-B Diamond Valley Rd., Markleeville, CA 96120 Alpine County Board of Supervisors, Phone: (530) 694-2281 District 1: Donald M. Jardine, District 2: Ron Hames, District 3: Katherine Rakow, District 4: Terry Woodrow, District 5: David Griffith Tomorrow, CDC will add entry health screening at two more airports – Atlanta (ATL) and Chicago (ORD). CDC, working with the Department of Homeland Security, will funnel all travelers from Wuhan, China to the five airports conducting entry health screening. Together, the five airports will cover all travelers arriving in the United States whose travel originated from Wuhan, China. Public health entry screening is part of a layered approach that, when used with other public health measures already in place to detect ill arriving travelers, can slow and reduce the spread of disease into the United States. Public health entry screening alone is not a guarantee against the possible importation of this new virus but is an important public health tool during this period of uncertainty and part of a multilayered response strategy. CDC is working with state and local public health authorities in the event a traveler is identified after arrival in the US. Healthcare workers have been reminded by the CDC on January 8th and 17th to pay close attention to clinical information including presence of fever and acute respiratory illness, or pneumonia, and travel history to Wuhan within 14 days before onset of CDC also has developed guidance for clinicians for testing and treatment of 2019-nCoV, as well as developed guidance for home care of patients with 2019-nCoV. How does all of this information apply to you? Based on what is known at this time, the current situation poses a potentially serious public health threat. We are working with the California Department of Public Health and the CDC as every possible precaution is taken to contain this emerging public health threat. While this is a worrisome public health situation, we believe that the immediate health risk from 2019- nCoV to the general American public continues to be low at this time. The bottom line is this. If you develop a “flu-like” illness, and you have not been to Asia or around someone who has in the previous 2 weeks, you most likely have the flu. Don’t forget that even though it is winter, we live in an area where hantavirus infections also occasionally occur and mimic the flu. And – don’t forget to wash your hands, cover your cough, and stay home when you are sick!! If you are concerned or have any questions about an illness when you are sick, please contact your health care provider. Reference and Link: CDC – Novel Coronavirus 2019 (nCoV-2019)