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Update on Novel Coronavirus Infection updated recommendations

6 February 2020

Updated case definition: 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 OR
      • Close contact in the 14 days before illness onset with a confirmed case of 2019-nCoV
  • Clinical criteria: at least one of the following
      • Fever OR acute respiratory infection (e.g. shortness of breath or cough) with or without fever
  • For “case” or “close contact” definition see CDNA National Guidelines for Public Health Units

It is 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 medical care).
  • All travellers who have been in Hubei Province must be isolated at home for 14 days after leaving mainland China (other than for seeking medical care).
  • Close contacts of a confirmed case (i.e. persons exposed while unprotected e.g. no PPE, including healthcare workers) are not to work in a healthcare setting and must be isolated at home for 14 days following the last possible contact with the confirmed case (other than for seeking medical care).
  • Those seeking medical care must notify the medical provider of their impending arrival and wear a surgical mask if leaving home isolation.

Medical practitioners are advised to:

  • Assess patients with suspected 2019-nCoV infection using standard and transmission based precautions (contact and droplet). This includes:
      • The patient is to wear a surgical mask. Ask them to observe respiratory (cough) etiquette.
      • Isolation: move patient from the waiting area to a single room or at least 1 metre away from others.
      • Staff examining the patient to wear PPE i.e. disposable gloves, long sleeved gown, surgical mask and eye protection.
      • Perform hand hygiene using alcohol hand rub, or if hands visibly soiled using soap and water.

If the patient meets the suspected case definition (see above)

  • Consider coronavirus specimen collection.
  • Use airborne precautions for the collection of specimens including:
      • PPE i.e. gloves, long sleeve gown, fit tested P2/N95 mask and protective eye wear. 
      • Use a single room with the door closed or a negative pressure room where available. 
  • Swab both throat and nose using the same swab. Request respiratory viruses including coronavirus. See specimen collection guide at https://www.sapathology.sa.gov.au/genericfiles/PUB-0712.pdf
  • Send specimens to SA Pathology.
  • Where appropriate PPE and/or facilities are not available for specimen collection, SA Pathology can provide a domiciliary service for in home testing OR a dedicated coronavirus specimen collection centre located in metropolitan Adelaide. Both are by appointment only, doctors must ring 82223000 to arrange for this service. These need to be pre-approved by CDCB (phone 1300 232 272).
  • Do not send patients to general pathology specimen collection centres.
  • Discuss testing with CDCB medical officer if you suspect 2019-nCov but case does not meet the suspected case definition. Testing of asymptomatic persons is generally not recommended.
  • Isolate any patient with suspected 2019-nCoV (either in a healthcare facility or at home). Patient with severe symptoms should be referred to hospital.
  • Avoid aerosol generating procedures, if possible. If they cannot be avoided, use airborne precautions including P2/N95 mask and negative pressure room where available.   
  • After patient consultation staff should remove PPE with care and perform hand hygiene. 
  • Clean and disinfect potentially contacted/contaminated environmental surfaces and general equipment  with detergent followed by disinfectant (either use bleach or alcohol)
  • Notify cases by phone to CDCB on 1300 232 272.

For further information see SA Health www.sahealth.sa.gov.au/novelcoronavirus.

Dr Louise Flood – Director, Communicable Disease Control Branch

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