ID Consult

2019-nCoV outbreak: A few lessons learned for pediatric practices


 

In late January, signs were posted in all of the offices in our faculty medical practice building.

Combined with current worldwide health concerns and flu season, we are now asking all patients two questions:

1. Do you have a fever, cough or shortness of breath?

2. Have you traveled to China in the last 2 weeks, or have you had contact with someone who has and who now is sick?

CDC/ Dr. Fred Murphy; Sylvia Whitfield

Similar signs appeared in medical offices and EDs across the city. Truth be told, when the signs first went up, some thought it was an overreaction. I practice in a city in the Southeast that is not a port of entry and has no scheduled international passenger flights. Wuhan City, China and the threat of 2019 novel coronavirus (2019-nCoV) seemed very far away.

As the international tally of cases has grown, so have local concerns.

Hopefully, proactive public health measures to care for the few individuals currently infected in the United States and appropriately assessing individuals arriving from mainland China will prevent widespread circulation of 2019-nCoV here. If this is the case, most of us likely will never see a case of the virus. Still, there are important lessons to be learned from current preparedness efforts.

A travel history is important. Public health authorities long have emphasized the importance of a travel history. Several years ago, during the height of concern over the spread of Ebola, the health care systems in which I practice asked everyone about travel to West Africa as soon as they approached the registration desk. In the intervening years, asking about a travel history largely was delegated to providers, and I suspect it largely was driven by patient presentation. Child presenting with 10 days of fever? The clinician likely took a travel history. Child presenting for runny nose, ear ache, or rash? Maybe not. With more consistent screening, we are learning how frequently our patients and their families do travel, and that is helping us expand our differential diagnosis.

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