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Id Subject Object Predicate Lexical cue
T1 0-74 Sentence denotes Persons Evaluated for 2019 Novel Coronavirus — United States, January 2020
T2 76-152 Sentence denotes On February 7, 2020, this report was posted online as an MMWR Early Release.
T3 153-259 Sentence denotes In December 2019, a cluster of cases of pneumonia emerged in Wuhan City in central China’s Hubei Province.
T4 260-392 Sentence denotes Genetic sequencing of isolates obtained from patients with pneumonia identified a novel coronavirus (2019-nCoV) as the etiology (1).
T5 393-584 Sentence denotes As of February 4, 2020, approximately 20,000 confirmed cases had been identified in China and an additional 159 confirmed cases in 23 other countries, including 11 in the United States (2,3).
T6 585-616 Sentence denotes On January 17, CDC and the U.S.
T7 617-778 Sentence denotes Department of Homeland Security’s Customs and Border Protection began health screenings at U.S. airports to identify ill travelers returning from Wuhan City (4).
T8 779-940 Sentence denotes CDC activated its Emergency Operations Center on January 21 and formalized a process for inquiries regarding persons suspected of having 2019-nCoV infection (2).
T9 941-1156 Sentence denotes As of January 31, 2020, CDC had responded to clinical inquiries from public health officials and health care providers to assist in evaluating approximately 650 persons thought to be at risk for 2019-nCoV infection.
T10 1157-1495 Sentence denotes Guided by CDC criteria for the evaluation of persons under investigation (PUIs) (5), 210 symptomatic persons were tested for 2019-nCoV; among these persons, 148 (70%) had travel-related risk only, 42 (20%) had close contact with an ill laboratory-confirmed 2019-nCoV patient or PUI, and 18 (9%) had both travel- and contact-related risks.
T11 1496-1565 Sentence denotes Eleven of these persons had laboratory-confirmed 2019-nCoV infection.
T12 1566-1677 Sentence denotes Recognizing persons at risk for 2019-nCoV is critical to identifying cases and preventing further transmission.
T13 1678-1854 Sentence denotes Health care providers should remain vigilant and adhere to recommended infection prevention and control practices when evaluating patients for possible 2019-nCoV infection (6).
T14 1855-2131 Sentence denotes Providers should consult with their local and state health departments when assessing not only ill travelers from 2019-nCoV-affected countries but also ill persons who have been in close contact with patients with laboratory-confirmed 2019-nCoV infection in the United States.
T15 2132-2283 Sentence denotes As part of CDC’s Emergency Operations Center activation, CDC personnel assist state and local health departments with the evaluation of 2019-nCoV PUIs.
T16 2284-2525 Sentence denotes Public health laboratories were not yet conducting 2019-nCoV testing during the period covered by this report, while awaiting Food and Drug Administration emergency use authorization for the test. (The authorization occurred on February 4*).
T17 2526-2570 Sentence denotes Therefore, all testing was conducted at CDC.
T18 2571-2649 Sentence denotes A call center was staffed by a team of physicians and nurses 24 hours per day.
T19 2650-2890 Sentence denotes During January 17–31, criteria used to determine whether a person was considered to be a PUI included presence of fever and symptoms of lower respiratory tract illness (e.g., cough or difficulty breathing) in addition to epidemiologic risk.
T20 2891-3071 Sentence denotes Epidemiologic risk factors included history of travel from Wuhan City, close contact with a patient with laboratory-confirmed 2019-nCoV infection, or close contact with an ill PUI.
T21 3072-3248 Sentence denotes Given the evolving understanding of 2019-nCoV epidemiology, testing was recommended for some persons who did not strictly meet the PUI definition, based on clinical discretion.
T22 3249-3456 Sentence denotes For clinical inquiries that resulted in 2019-nCoV testing, real-time reverse transcription polymerase chain reaction testing was conducted at CDC using methods developed specifically to detect 2019-nCoV (7).
T23 3457-3677 Sentence denotes For this report, CDC reviewed inquiries regarding potential 2019-nCoV PUIs received by CDC through January 31, 2020, from state and local health departments, health care providers, and airport health screening personnel.
T24 3678-3884 Sentence denotes Information was compiled from call logs and PUI forms to assess source of inquiry, PUI demographic data (including age and sex), clinical information, epidemiologic risk factors, and 2019-nCoV test results.
T25 3885-4054 Sentence denotes To allow for delays in specimen shipping and testing, data for PUIs for whom an initial inquiry was received during January 2020 were collected through February 4, 2020.
T26 4055-4178 Sentence denotes During January 2020, approximately 30 CDC physicians and nurses responded to inquiries regarding approximately 650 persons.
T27 4179-4339 Sentence denotes Testing was recommended for 256 persons (Figure) across 34 jurisdictions (the jurisdictions included states, the District of Columbia, Puerto Rico, and the U.S.
T28 4340-4390 Sentence denotes Virgin Islands) and was completed for 210 persons.
T29 4391-4494 Sentence denotes Testing of PUIs was not always performed because alternative diagnoses were made, or symptoms resolved.
T30 4495-4674 Sentence denotes Among inquiries resulting in testing, six (3%) persons were identified through airport screening, 178 (85%) in a health care setting, and 26 (12%) through contact tracing (Table).
T31 4675-4933 Sentence denotes Among 178 persons identified in a health care setting, the type of setting was reported for 125 (70%), including 79 (63%) who were evaluated at an emergency department or hospital, 22 (18%) at a student clinic, and 24 (19%) in other outpatient care settings.
T32 4934-5045 Sentence denotes A total of 115 (55%) persons tested were male, and median age was 29 years (interquartile range = 21–49 years).
T33 5046-5173 Sentence denotes Seventeen (8%) were health care workers, and 48 of 129 persons with available information were reported to be college students.
T34 5174-5362 Sentence denotes FIGURE Number of persons for whom 2019 novel coronavirus (2019-nCoV) testing was recommended, by date of initial inquiry (N = 256) — United States, January 2020*,† <Fig_Large></Fig_Large>
T35 5363-5418 Sentence denotes * Confirmed cases were reported as of January 31, 2020.
T36 5419-5526 Sentence denotes † Public announcements of a confirmed 2019-nCoV case in the United States were made on the following dates:
T37 5527-5590 Sentence denotes Jan 21, Jan 24, Jan 26, Jan 27 (two cases), Jan 30, and Jan 31.
T38 5591-5798 Sentence denotes The figure is a bar chart indicating the number of persons (N = 256) in the United States for whom 2019 novel coronavirus (2019-nCoV) testing was recommended, by date of initial inquiry, during January 2020.
T39 5799-5971 Sentence denotes TABLE Clinical characteristics and epidemiologic risk factors among persons tested for 2019 novel coronavirus (2019-nCoV) infection (N = 210) — United States, January 2020
T40 5972-6024 Sentence denotes Characteristic Completed 2019-nCoV testing
No.* (%)
T41 6025-6037 Sentence denotes Demographics
T42 6038-6079 Sentence denotes Age group (yrs), median (IQR) 29 (21–49)
T43 6080-6090 Sentence denotes <5 10 (5)
T44 6091-6102 Sentence denotes 5–17 8 (4)
T45 6103-6118 Sentence denotes 18–49 138 (66)
T46 6119-6133 Sentence denotes 50–64 46 (22)
T47 6134-6144 Sentence denotes ≥65 4 (2)
T48 6145-6163 Sentence denotes Male sex 115 (55)
T49 6164-6181 Sentence denotes Clinical features
T50 6182-6199 Sentence denotes Signs or symptoms
T51 6200-6269 Sentence denotes Subjective fever or measured temperature ≥100.4°F (≥38.0°C) 143 (68)
T52 6270-6308 Sentence denotes Cough or shortness of breath 189 (90)
T53 6309-6324 Sentence denotes Clinical Course
T54 6325-6346 Sentence denotes Hospitalized 42 (20)
T55 6347-6369 Sentence denotes Admitted to ICU 4 (2)
T56 6370-6383 Sentence denotes Died† 1 (<1)
T57 6384-6416 Sentence denotes Setting where patient identified
T58 6417-6441 Sentence denotes Airport screening 6 (3)
T59 6442-6471 Sentence denotes Health care setting 178 (85)
T60 6472-6497 Sentence denotes Contact tracing§ 26 (12)
T61 6498-6525 Sentence denotes Epidemiologic risk category
T62 6526-6554 Sentence denotes Travel from China¶ 148 (70)
T63 6555-6660 Sentence denotes Close contact with an ill laboratory-confirmed 2019-nCoV patient or a PUI in the United States** 42 (20)
T64 6661-6717 Sentence denotes Travel from China and close contact identified†† 18 (9)
T65 6718-6738 Sentence denotes Other risk§§ 2 (<1)
T66 6739-6841 Sentence denotes Abbreviations: ICU = intensive care unit; IQR = interquartile range; PUI = person under investigation.
T67 6842-6899 Sentence denotes * Numbers might not sum to total because of missing data.
T68 6900-7005 Sentence denotes † For this person, testing was negative for 2019-nCoV, and an alternative cause of death was established.
T69 7006-7165 Sentence denotes § Additional persons who were being followed through contact tracing but initially sought treatment at a health care setting are not included in this category.
T70 7166-7304 Sentence denotes ¶ Includes 113 persons who traveled from Wuhan City and 35 who traveled from areas of China outside Wuhan within 14 days of symptom onset.
T71 7305-7442 Sentence denotes ** Includes 33 persons who were close contacts of an ill laboratory-confirmed 2019-nCoV patient and nine who were close contacts of PUIs.
T72 7443-7497 Sentence denotes All contacts occurred within 14 days of symptom onset.
T73 7498-7758 Sentence denotes †† Includes four persons who traveled from Wuhan City and were close contacts of an ill laboratory-confirmed 2019-nCoV patient, 11 who traveled from Wuhan City and were close contacts of PUIs, and three who traveled from China and were close contacts of a PUI.
T74 7759-7855 Sentence denotes §§ Had possible contact with a laboratory-confirmed 2019-nCoV patient and were therefore tested.
T75 7856-7905 Sentence denotes All 210 persons who were tested were symptomatic:
T76 7906-8028 Sentence denotes 143 (68%) had subjective fever or a measured temperature ≥100.4°F (≥38°C), and 189 (90%) had cough or shortness of breath.
T77 8029-8200 Sentence denotes Upper respiratory tract symptoms (i.e., sore throat, rhinorrhea, or congestion) were common and were present in nine persons who did not have cough or shortness of breath.
T78 8201-8338 Sentence denotes Thirty persons were reported to test positive for another respiratory viral pathogen, including influenza or respiratory syncytial virus.
T79 8339-8437 Sentence denotes Forty-two (20%) patients were hospitalized, and four (2%) were admitted to an intensive care unit.
T80 8438-8580 Sentence denotes One patient was deceased at the time of notification; testing for this person was negative, and an alternative cause of death was established.
T81 8581-8898 Sentence denotes Travel-related risk was identified for 148 (70%) persons, 42 (20%) had close contact with ill patients with laboratory-confirmed 2019-nCoV infection or PUIs, 18 (9%) had both travel- and contact-related risks, and two (<1%) had possible contact with a laboratory-confirmed 2019-nCoV patient and were therefore tested.
T82 8899-8976 Sentence denotes Among the 210 persons tested, 11 (5%) were found to have 2019-nCoV infection.
T83 8977-9157 Sentence denotes Nine of these persons had traveled to Wuhan City; two persons had not traveled but had been in close contact with patients with laboratory-confirmed 2019-nCoV in the United States.
T84 9158-9224 Sentence denotes All were symptomatic with fever (subjective or measured) or cough.
T85 9226-9236 Sentence denotes Discussion
T86 9237-9365 Sentence denotes Quickly identifying persons at risk for 2019-nCoV is critical to slowing the potential spread of 2019-nCoV in the United States.
T87 9366-9504 Sentence denotes This report describes CDC’s current approach to facilitating recommended diagnostic testing of persons who might have 2019-nCoV infection.
T88 9505-9845 Sentence denotes In response to the emergence of 2019-nCoV in China during a time of rapidly evolving understanding of the epidemiology and clinical presentation of 2019-nCoV infection, CDC has provided consultation regarding persons suspected of being at risk for 2019-nCoV to public health officials and health care providers throughout the United States.
T89 9846-9943 Sentence denotes Epidemiologic risk factors among the 210 persons tested for 2019-nCoV were not limited to travel:
T90 9944-10079 Sentence denotes 20% of PUIs tested had not recently traveled to China but reported close contact with a person being evaluated for 2019-nCoV infection.
T91 10080-10336 Sentence denotes Because person-to-person transmission is expected to continue, and as further travel restrictions are implemented, it is likely that the proportion of PUIs with such contact risk in the United States will increase among all persons evaluated for 2019-nCoV.
T92 10337-10494 Sentence denotes CDC mobilized early in the response and state and local health departments similarly increased capacity to provide clinical consultation regarding 2019-nCoV.
T93 10495-10664 Sentence denotes The collection of clinical and epidemiologic data that described characteristics of persons tested for 2019-nCoV helped to inform changes to criteria for PUI evaluation.
T94 10665-10883 Sentence denotes On January 31, 2020, CDC published updated PUI guidance (8) in response to the evolving global epidemiology of 2019-nCoV, including the rapid geographic expansion and documentation of person-to-person transmission (9).
T95 10884-11208 Sentence denotes Updated guidance emphasizes 2019-nCoV testing for symptomatic persons in close contact with patients with laboratory-confirmed 2019-nCoV infection, persons returning from Hubei province in addition to Wuhan City, and persons from mainland China requiring hospitalization because of fever and lower respiratory tract illness.
T96 11209-11349 Sentence denotes Additional refinements to this approach likely will be needed in the future as understanding of 2019-nCoV epidemiology continues to improve.
T97 11350-11420 Sentence denotes The findings in this report are subject to at least three limitations.
T98 11421-11541 Sentence denotes First, the number of clinical inquiries received by CDC does not represent all inquiries received by health departments.
T99 11542-11710 Sentence denotes Second, because the primary objective of this effort was to guide a timely public health response, some clinical and epidemiologic risk factor data might be incomplete.
T100 11711-11938 Sentence denotes Finally, given the limited available epidemiologic information early in the outbreak, to provide some latitude for clinical decision-making regarding diagnostic testing, the PUI definition was not strictly applied in all cases.
T101 11939-12126 Sentence denotes A coordinated national effort to diagnose 2019-nCoV among persons at high risk for infection is important to facilitate appropriate management and limit transmission in the United States.
T102 12127-12230 Sentence denotes CDC’s website provides guidance for health care professionals on evaluating persons for 2019-nCoV (10).
T103 12231-12550 Sentence denotes Clinicians should maintain a high index of suspicion for possible 2019-nCoV illness not only among persons with fever and lower respiratory tract illness who report travel from China in the past 14 days but also symptomatic persons who have had close contact with patients with laboratory-confirmed 2019-nCoV infection.
T104 12551-12714 Sentence denotes Clinicians should consult their local and state health departments when they suspect possible 2019-nCoV illness to facilitate diagnosis and aid prevention efforts.
T105 12715-12722 Sentence denotes Summary
T106 12724-12763 Sentence denotes What is already known about this topic?
T107 12764-12961 Sentence denotes During a 2020 outbreak of novel coronavirus (2019-nCoV) infection, CDC provided consultation to public health officials and health care providers evaluating persons at risk for 2019-nCoV infection.
T108 12963-12992 Sentence denotes What is added by this report?
T109 12993-13308 Sentence denotes During January 2020, CDC responded to clinical inquiries regarding approximately 650 persons in the United States and tested 210 for 2019-nCoV, one fifth of whom reported no recent travel-related risk but had close contact with a 2019-nCoV patient or a person under investigation for 2019-nCoV in the United States.
T110 13310-13363 Sentence denotes What are the implications for public health practice?
T111 13364-13568 Sentence denotes Health care providers should remain vigilant regarding possible 2019-nCoV exposure not only among returning travelers, but also among persons in close contact with 2019-nCoV patients in the United States.
T112 13570-13585 Sentence denotes Acknowledgments
T113 13586-14109 Sentence denotes Laboratory and Epidemiology Task Forces; state and local health department partners; Chris Edens, Jessica Leung, Michael Wellman, CDC; David Hyung Won Oh, Tufts University School of Medicine, Boston, Massachusetts; Sean Stapleton, Cornell University College of Veterinary Medicine, Ithaca, New York; Emily Trautner, Emory University School of Medicine, Atlanta, Georgia. * https://www.fda.gov/news-events/press-announcements/fda-takes-significant-step-coronavirus-response-efforts-issues-emergency-use-authorization-first.
T114 14111-14262 Sentence denotes All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest.
T115 14263-14313 Sentence denotes No potential conflicts of interest were disclosed.