COVID-19 testing criteria expanded
Editor's Note: The AAP has been working to stay abreast of all confirmed developments related to the global spread of COVID. AAP subject matter experts and staff will continue to be vigilant in efforts to share information and guidance with members. For the latest news, visithttps://www.aappublications.org/news/2020/01/28/coronavirus.
Federal health officials are loosening criteria on testing for coronavirus disease 2019 (COVID-19).
The Centers for Disease Control and Prevention (CDC) is telling clinicians to use their judgment in determining whether testing is necessary. They should consider the presence of symptoms (fever, cough, shortness of breath), travel history, contact with a confirmed COVID-19 patient and local epidemiology, and should rule out other potential causes of illness.
Those with a suspected case should immediately notify their state or local health department and implement infection control practices.
Sean T. O'Leary, M.D., M.P.H., FAAP, a member of the AAP Committee on Infectious Diseases, said availability of testing will be another factor to consider.
"In some places it's going to be easier to get the testing done than others, so listening to your state and local health departments' guidance is probably the best way to go in terms of the decisions around who and when to test," he said.
The Food and Drug Administration recently said it would allow facilities such as state laboratories to immediately use tests they developed under emergency use authorization. In addition, kits are being distributed to hospitals this week, and officials are working with commercial laboratories.
There have been at least 99 domestic cases of COVID-19 in 13 states, according to the CDC. There also have been 49 cases among people who were repatriated from Wuhan, China or the Diamond Princess cruise ship. Twelve people in the U.S. have died.
After monitoring 445 people who had come into contact with someone who had travel-related COVID-19, the CDC found a symptomatic secondary attack rate of 10.5% among household members and 0.45% among all close contacts.
Dr. O'Leary, associate professor of pediatrics at the University of Colorado Anschutz Medical Campus, recommends that as the situation rapidly evolves, pediatricians keep up with the latest guidance from the AAP and CDC and also make sure their patients are vaccinated against flu, which has been especially severe for children this season.
In addition, families should be counseled on infection control measures. The CDC recommends people wash their hands regularly for at least 20 seconds; avoid touching their eyes, nose and mouth; cover their coughs and sneezes; disinfect surfaces regularly; stay home when they are sick and avoid others who are sick. The general public does not need to wear face masks.
The CDC recommends schools and child care settings prepare by reviewing, updating and implementing their existing emergency operations plans and has provided detailed guidance at https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/guidance-for-schools.html. It also has created web pages answering frequently asked questions regarding the virus and children, pregnant women and breastfeeding.
