Novel Coronavirus in China

Warning - Level 3, Avoid Nonessential Travel
Alert - Level 2, Practice Enhanced Precautions
Watch - Level 1, Practice Usual Precautions

Key Points

  • CDC recommends that travelers avoid all nonessential travel to the People’s Republic of China (this does not include the Special Administrative Regions of Hong Kong and Macau, or the island of Taiwan).
  • There is an ongoing outbreak of respiratory illness caused by a novel (new) coronavirus that can be spread from person to person.
    • Chinese officials have closed transport within and out of Wuhan and other cities in Hubei province, including buses, subways, trains, and the international airport. Other locations may be affected.
    • Older adults and people with underlying health conditions may be at increased risk for severe disease.
    • The situation is evolving. This notice will be updated as more information becomes available.

What is the current situation?

  • CDC recommends that travelers avoid all nonessential travel to China. In response to an outbreak of respiratory illness, Chinese officials have closed transport within and out of Wuhan and other cities in Hubei province, including buses, subways, trains, and the international airport.  Additional restrictions and cancellations of events may occur.
  • The US Department of State has issued a Level 4 Travel Advisory asking people not to travel to China due to the coronavirus outbreak.
  • There is limited access to adequate medical care in affected areas.

A novel (new) coronavirus is causing an outbreak of respiratory illness that began in the city of Wuhan, Hubei Province, China. This outbreak began in early December 2019 and continues to grow. Initially, some patients were linked to the Wuhan South China Seafood City (also called the South China Seafood Wholesale Market and the Hua Nan Seafood Market) which has since closed.

Chinese health officials have reported thousands of cases in China and severe illness has been reported, including deaths. Cases have also been identified in travelers to other countries, including the United States. This virus can spread from person to person.

Coronaviruses are a large family of viruses. There are several known coronaviruses that infect people and usually only cause mild respiratory disease, such as the common cold. However, at least two previously identified coronaviruses have caused severe disease — severe acute respiratory syndrome (SARS) coronavirus and Middle East respiratory syndrome (MERS) coronavirus. 

Signs and symptoms of novel coronavirus infection include fever, cough, and difficulty breathing. Sore throat also has been reported in some patients. This novel coronavirus has the potential to cause severe disease and death. Risk factors for severe illness are not yet clear, although older patients and those with chronic medical conditions may be at higher risk for severe illness.

In response to this outbreak, Chinese officials are screening travelers leaving some cities in China. Several countries and territories throughout the world have implemented health screening of travelers arriving from China.

On arrival to the United States, travelers from China will undergo health screening. Travelers with signs and symptoms of illness (fever, cough, or difficulty breathing) will have an additional health assessment. Travelers who have been in China during the past 14 days, including US citizens or residents and others who are allowed to enter the US, will be required to enter the US through specific airports and participate in monitoring by health officials until 14 days after they left China. Some people may have their movement restricted or be asked to limit their contact with others until the 14-day period has ended.

What can travelers do to protect themselves and others?

CDC recommends avoiding nonessential travel to China. If you must travel:

  • Avoid contact with sick people.
  • Discuss travel to China with your healthcare provider. Older adults and travelers with underlying health issues may be at risk for more severe disease.
  • Avoid animals (alive or dead), animal markets, and products that come from animals (such as uncooked meat).
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after coughing, sneezing or blowing your nose. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

If you were in China in the last 14 days and feel sick with fever, cough, or difficulty breathing, do the following:

  • Seek medical advice - Call ahead before you go to a doctor’s office or emergency room. Tell them about your recent travel and your symptoms.
  • Avoid contact with others. 
  • Do not travel while sick.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
  • Wash your hands with soap and water immediately after coughing, sneezing or blowing your nose. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

Clinician Information

Healthcare providers should obtain a detailed travel history for patients with fever or acute respiratory symptoms.  For patients with these symptoms who were in China on or after December 1, 2019, and had onset of illness within 2 weeks of leaving, consider the novel coronavirus and notify infection control personnel and your local health department immediately.

Although routes of transmission have yet to be definitively determined, CDC recommends a cautious approach to interacting with patients under investigation. Ask such patients to wear a face mask as soon as they are identified. Conduct patient evaluation in a private room with the door closed, ideally an airborne infection isolation room, if available. Personnel entering the room should use standard precautions, contact precautions, and airborne precautions, and use eye protection (e.g., goggles or a face shield). For additional healthcare infection control recommendations, visit CDC's Infection Control webpage.

For additional information, please see:

 

This notice was originally posted January 6, 2020.