Update on Novel Coronavirus Infection updated recommendations

3 February 2020

South Australia now has two confirmed cases of 2019-novel coronavirus (2019-nCoV) in two adults who recently travelled to Wuhan (Hubei Province), China. There are 12 confirmed cases in Australia, 11 of which had travelled to Wuhan, with the remaining case having direct contact with a confirmed case from Wuhan. Currently, there is no evidence of local transmission in Australia.

While most cases continue to be reported from Hubei Province, China, over 17,000 confirmed cases have been reported with over 360 deaths in mainland China. The disease has now spread to all provinces of China, and there have been cases reported from more than a dozen other countries, including one death.

The Australian Government has now recommended that:

  • All travellers leaving from mainland China on or after 1 February 2020 must be isolated at home for 14 days after leaving mainland China, other than for seeking individual medical care.  This includes all health care workers.
  • All travellers who have been in Hubei Province must be isolated at home for 14 days after leaving mainland China, other than for seeking individual medical care.
  • People (including healthcare workers who have not used adequate PPE who have been in close contact with any confirmed 2019-nCoV cases must be isolated at home for 14 days after exposure.

The case definition for suspected cases has been updated.

Suspected cases require BOTH epidemiological AND clinical criteria

Epidemiological criteria: at least one of the following

  • Travel to (including transit through) mainland China in the 14 days before the onset of illness.
  • Close contact in the 14 days before illness onset with a case of 2019-nCoV.

Clinical criteria: at least one of the following

  • Acute respiratory infection (sudden onset of respiratory infection with at least one of: shortness of breath,

cough or sore throat) with or without fever or a history of fever.

The incubation period is thought to be 2-14 days. The infectious period is currently unknown, but there is early evidence of transmission in the pre-symptomatic phase.

Medical practitioners are advised to:

  • Assess patients with suspected 2019-nCoV infection using transmission based precautions in addition to standard precautions. This includes:
  • Put a surgical mask on patient and ask to observe respiratory (cough) etiquette.
  • Social distancing, i.e. move patient from general waiting area and use a single room, if available.
  • Staff examining patient to wear gloves, disposable long sleeved gown, mask (surgical for examination, P2/N95 respirator mask for specimen collection) and eye protection.
  • Hand hygiene with alcohol hand rub, or if hands visibly soiled, soap and water.
  • Avoid aerosol generating procedures, if possible. If they cannot be avoided, use full airborne precautions including P2/N95 respirator mask and negative pressure room (see below for testing). 
  • Consider laboratory testing if the suspected case definition is met
  • Discuss with CDCB medical officer alternatives for testing if unable to be performed at your practice as home testing is now available. Do not send patients to pathology collection centres.
  • Discuss testing with CDCB medical officer if you suspect 2019-nCov but case does not meet the suspected case definition.
  • Notify the CDCB medical officer on 1300 232 272 (24/7).
  • Isolate any patient with suspected 2019-nCoV (either in a healthcare facility or at home).

Dr Louise Flood – Director, Communicable Disease Control Branch

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