UPDATED MARCH 12, 2020
Patients in West Virginia who meet the following criteria should be evaluated as a patient under investigation in association with Coronavirus Disease 2019 (COVID-19) outbreak:
1. Fever AND/OR signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath) AND is any person, including health care workers, who has had close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset.
2. Fever AND/OR signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath) requiring hospitalization AND has a history of travel from affected geographic areas† within 14 days of symptom onset.
3. Fever with severe acute lower respiratory illness (e.g. pneumonia, ARDS) requiring hospitalization and without alternative explanatory diagnosis (e.g. influenza) AND no source of exposure has been identified.
4. Fever AND/OR signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath) AND lives or has a history of travel from affected geographic areas† within 14 days of symptom onset AND negative influenza test/multiplex PCR respiratory panel.
†Affected geographic areas include any U.S. state/locality with sustained (ongoing) transmission or countries with a level 2 or 3 travel health notice. Those countries with a level 2 or 3 travel health notice include: China, Iran, South Korea, Most of Europe, and Japan. Those states with sustained community transmission include California, Washington state, and New York. Air crew (pilots, attendants) and travelers on cruise ships are also included in this consideration. Please note this is an emerging, rapidly evolving situation, updates will be provided as it becomes available.
Exercise clinical judgement in evaluating patients with respiratory illness. If testing is indicated, influenza testing (rapid or molecular testing, including panels) and a respiratory panel should be conducted. If the patient is negative for influenza and the submitting provider or facility does not have the capability of conducting a respiratory panel, Division of Infectious Disease Epidemiology (DIDE) staff can approve respiratory panel testing at Office of Laboratory Services (OLS), with reflex to COVID-19 testing.
If a patient is positive for another respiratory pathogen, we are currently considering COVID-19 as a remote possibility and not recommending further diagnostics specific for the COVID-19 virus. Exceptions for severely ill patients with atypical clinical presentation may be warranted.