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Volume 26, Number 8—August 2020
Synopsis

Investigation and Serologic Follow-Up of Contacts of an Early Confirmed Case-Patient with COVID-19, Washington, USA

Victoria T. Chu1Comments to Author , Brandi Freeman-Ponder1, Scott Lindquist, Christopher Spitters, Vance Kawakami, Jonathan W. Dyal, Shauna Clark, Hollianne Bruce, Jeffrey S. Duchin, Chas DeBolt, Sara Podczervinski, Marisa D’Angeli, Kristen Pettrone, Rachael Zacks, Grace Vahey, Michelle L. Holshue, Misty Lang, Rachel M. Burke, Melissa A. Rolfes, Mariel Marlow, Claire M. Midgley, Xiaoyan Lu, Stephen Lindstrom, Aron J. Hall, Alicia M. Fry, Natalie J. Thornburg, Susan I. Gerber, Satish K. Pillai, and Holly M. Biggs
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (V.T. Chu, B. Freeman-Ponder, J.W. Dyal, Kristen Pettrone, R. Zacks, G. Vahey, M.L. Holshue, R.M. Burke, M.A. Rolfes, M. Marlow, C.M. Midgley, X. Lu, S. Lindstrom, A.J. Hall, A.M. Fry, N.J. Thornburg, S.I. Gerber, S.K. Pillai, H.M. Biggs); Washington State Department of Public Health, Shoreline, Washington, USA (S. Lindquist, C. DeBolt, S. Podczervinski, M. D’Angeli, M.L. Holshue, M. Lang); Snohomish Health District, Everett, Washington, USA (C. Spitters, H. Bruce); Public Health—Seattle and King County, Seattle, Washington (V. Kawakami, S. Clark, J.S. Duchin); University of Washington, Seattle (J.S. Duchin)

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Figure 1

Case-patient investigation and contact identification during the investigation of an early confirmed US COVID-19 case, Washington, USA, 2020. The case-patient was asymptomatic when he arrived home from Wuhan, China. The next day, he developed a cough (day 1), followed by chills (day 2) and a subjective fever (day 3). When he arrived at the urgent care clinic (day 4), he was given a facemask and sat in the waiting room for ≈20 minutes. He was evaluated in a standard examination room, and received

Figure 1. Case-patient investigation and contact identification during the investigation of an early confirmed US COVID-19 case, Washington, USA, 2020. The case-patient was asymptomatic when he arrived home from Wuhan, China. The next day, he developed a cough (day 1), followed by chills (day 2) and a subjective fever (day 3). When he arrived at the urgent care clinic (day 4), he was given a facemask and sat in the waiting room for ≈20 minutes. He was evaluated in a standard examination room, and received a chest radiograph in a radiology room down the hallway from the exam room. The case-patient was identified as meeting the Centers for Disease Control and Prevention (CDC) criteria at the time for a person under investigation for COVID-19, and specimens (nasopharyngeal and oropharyngeal swabs and serum samples) were collected for testing (6). He was clinically stable and discharged home pending SARS-CoV-2 test results. When COVID-19 was confirmed (day 5), the case-patient was admitted to a hospital for observation and isolation. After 11 days, he was discharged to home isolation until 2 negative sets of nasopharyngeal and oropharyngeal specimens were obtained >24 hours apart, in accordance with CDC guidance at the time (7). Persons exposed during transient interactions, such as restaurant waitstaff and persons encountered at the grocery store, were not considered community contacts. COVID-19, coronavirus disease.

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1These authors contributed equally to this article.

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