CDC: Anticipate Change to Coronavirus Travel Guidance

While there were no new confirmed cases of novel coronavirus in the U.S. overnight, CDC officials said Monday they will probably revise their travel guidance in the coming days.
Details were sparse, but Nancy Messonnier, MD, director of the CDC National Center for Immunization and Respiratory Diseases in Atlanta, previewed that the agency was “imminently thinking” about this decision, but would not elaborate what it would entail.

“I expect in the coming days, travel recommendations will change,” she said on a conference call with reporters, adding that “there may be some disruptions.”
However, the U.S. State Department may have offered a preview of the CDC’s plan, when it issued a Level 3 China travel advisory on Monday, saying travelers should “reconsider travel” to China due to novel coronavirus.
“Although the [CDC] has not yet issued a level 3 warning for all of China, the Chinese authorities are imposing quarantines and restricting travel throughout the country,” the new advisory said.
So far, somewhere around 2,400 people have been screened at U.S. airports, Messonnier said on the press call, and enhanced screening measures continue at the five previously reported U.S. airports. However, she added that the agency is “considering broadening screening.”
Otherwise, Messonnier was tight-lipped about the changes, but perhaps dropped a few bread crumbs. She reiterated the CDC’s current travel guidance: that the agency recommends avoiding all non-essential travel to Hubei province (where Wuhan is located), or a Level 3 travel alert.

But she added that, as of January 26, the CDC has a Level 2 alert on travel to China, asking that travelers returning from China mention it to their healthcare providers, avoid contact with sick people, and wash hands with soap and water for at least 20 seconds.
Currently, 110 persons are under investigation in 26 states. Messonnier said reporters should contact state health departments if they want to know if any of these people are in a particular state. Of these, so far 32 have tested negative, with five confirmed positive.
Data as of Monday morning indicated 2,886 global cases and 81 deaths related to the novel coronavirus. There are now 16 international locations with confirmed cases of the virus, Messonnier said.
Johns Hopkins University’s Center for Systems Science and Engineering has posted a map illustrating the virus’s global spread “in near-real time,” according to a press release.
“As you know, there’s lot of new information coming out of China and we’re trying to take that into account as we move as quickly as we can towards any decision,” Messonnier noted. “We want to make sure we’re being expedient and sensible.”

Messonnier also addressed the issue of transmissibility raised by a reporter, who discussed the ongoing dispute about the coronavirus’s “reproduction number,” the average number of people likely to be develop infection from contact with an infected person.
“I wouldn’t say it’s a dispute,” she said, adding that the reproductive number is “somewhere between 1.5 and 3, which is not really a dramatic difference.” In contrast, the reproduction number for measles virus — one of the most contagious pathogens known — is roughly 12-18.
While Messonnier noted just a “handful of patients with the virus” in the U.S., she reiterated that it doesn’t appear to be spreading in the community. On the other hand, Reuters reported on Monday that Canada’s second case of travel-associated coronavirus was confirmed in the first patient’s wife.
On the press call, CDC officials also said that they have developed a real-time reverse transcription-polymerase chain reaction (rRT-PCR) test for novel coronavirus to diagnose the virus from respiratory specimens. CDC posted the blueprint for this test on Friday, and officials said they anticipate getting it out to clinicians and public health departments in the next 1-2 weeks.
Messonnier also said that the CDC has posted the entire genome of the virus from the first and second patients. She said it is “similar to the one China initially posted a couple weeks ago,” meaning that “it doesn’t look like the virus has mutated.”
https://www.medpagetoday.com/infectiousdisease/publichealth/84563