美国首例新型冠状病毒病例

概述

一种新型冠状病毒（2019-nCoV）在中国武汉暴发并且迅速传播，目前已在多个国家出现确诊病例。我们在本文中报告了美国确诊的首例2019-nCoV感染病例，并描述了该病例的鉴别、诊断、临床病程和治疗，包括该患者最初就诊时的轻度症状及在发病第9日时进展为肺炎。该病例突出了临床医师与当地、州和国家公共卫生机构密切协调的重要性，以及快速发布突发感染患者相关临床信息的必要性。

2019年12月31日，中国报道了一起与湖北省武汉市华南海鲜批发市场相关的肺炎聚集性病例¹。2020年1月7日，中国卫生机构确认该聚集性病例与一种新型冠状病毒2019-nCoV相关²。最初的报道指出病例与武汉海鲜市场相关，但目前的流行病学数据表明2019-nCoV正在发生人际传播^3-6。截至2020年1月30日，至少21个国家已报道了9,976例确诊病例，其中包括美国在2020年1月20日报道的首例2019-nCoV感染确诊病例⁷。目前正在全球范围内展开调查，以便更好地了解其传播动力学和临床疾病谱。本文描述了美国首例2019-nCoV感染确诊病例的流行病学和临床特征。

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作者信息

Michelle L. Holshue, M.P.H., Chas DeBolt, M.P.H., Scott Lindquist, M.D., Kathy H. Lofy, M.D., John Wiesman, Dr.P.H., Hollianne Bruce, M.P.H., Christopher Spitters, M.D., Keith Ericson, P.A.-C., Sara Wilkerson, M.N., Ahmet Tural, M.D., George Diaz, M.D., Amanda Cohn, M.D., LeAnne Fox, M.D., Anita Patel, Pharm.D., Susan I. Gerber, M.D., Lindsay Kim, M.D., Suxiang Tong, Ph.D., Xiaoyan Lu, M.S., Steve Lindstrom, Ph.D., Mark A. Pallansch, Ph.D., William C. Weldon, Ph.D., Holly M. Biggs, M.D., Timothy M. Uyeki, M.D., and Satish K. Pillai, M.D. for the Washington State 2019-nCoV Case Investigation Team*
From the Epidemic Intelligence Service (M.L.H.), the National Center for Immunizations and Respiratory Diseases (A.C., L.F., A.P.), the Division of Viral Diseases (S.I.G., L.K., S.T., X.L., S. Lindstrom, M.A.P., W.C.W., H.M.B.), the Influenza Division (T.M.U.), and the Division of Preparedness and Emerging Infections (S.K.P.), Centers for Disease Control and Prevention, Atlanta; and the Washington State Department of Health, Shoreline (M.L.H., C.D., S. Lindquist, K.H.L., J.W.), Snohomish Health District (H.B., C.S.), Providence Medical Group (K.E.), and Providence Regional Medical Center (S.W., A.T., G.D.), Everett, and Department of Medicine, University of Washington School of Medicine, Seattle (C.S.) — all in Washington. Address reprint requests to Ms. Holshue at the Washington State Department of Health Public Health Laboratories, 1610 NE 150th St., Shoreline, WA 98155, or at michelle.holshue@doh.wa.gov. *A full list of the members of the Washington State 2019-nCoV Case Investigation Team is provided in the Supplementary Appendix, available at NEJM.org.

参考文献

1. World Health Organization. Pneumonia of unknown cause — China. 2020 (https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/. opens in new tab).

2. World Health Organization. Novel coronavirus — China. 2020 (https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/. opens in new tab).

3. Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020 January 24 (Epub ahead of print).

4. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 January 24 (Epub ahead of print).

5. Centers for Disease Control and Prevention. 2019 Novel coronavirus, Wuhan, China: 2019-nCoV situation summary. January 28, 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/summary.html. opens in new tab).

6. Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med 2020;382:872-874.

7. Johns Hopkins University CSSE. Wuhan coronavirus (2019-nCoV) global cases (https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6. opens in new tab).

8. Centers for Disease Control and Prevention. Interim guidance for healthcare professionals: criteria to guide evaluation of patients under investigation (PUI) for 2019-nCoV. 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html. opens in new tab).

9. Centers for Disease Control and Prevention. Infection control. 2019 Novel coronavirus, Wuhan, China. 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/infection-control.html. opens in new tab).

10. Mulangu S, Dodd LE, Davey RT Jr, et al. A randomized, controlled trial of ebola virus disease therapeutics. N Engl J Med 2019;381:2293-2303.

11. Sheahan TP, Sims AC, Leist SR, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun 2020;11:222-222.

12. Centers for Disease Control and Prevention. Interim guidelines for collecting, handling, and testing clinical specimens from patients under investigation (PUIs) for 2019 novel coronavirus (2019-nCoV). 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/guidelines-clinical-specimens.html. opens in new tab).

13. Centers for Disease Control and Prevention, Respiratory Viruses Branch, Division of Viral Diseases. Real-time RT-PCR panel for detection 2019-novel coronavirus. 2020 (https://www.cdc.gov/coronavirus/2019-ncov/downloads/rt-pcr-panel-for-detection-instructions.pdf. opens in new tab).

14. Centers for Disease Control and Prevention, Respiratory Viruses Branch, Division of Viral Diseases. 2019-novel coronavirus (2019-nCoV) real-time rRT-PCR panel primers and probes. 2020 (https://www.cdc.gov/coronavirus/2019-ncov/downloads/rt-pcr-panel-primer-probes.pdf. opens in new tab).

15. Centers for Disease Control and Prevention. Information for laboratories. 2019 novel coronavirus, Wuhan, China. 2020 (https://www.cdc.gov/coronavirus/2019-nCoV/guidance-laboratories.html. opens in new tab).

16. National Institutes of Health. GenBank overview (https://www.ncbi.nlm.nih.gov/genbank/. opens in new tab).

17. GISAID (Global Initiative on Sharing All Influenza Data) home page (https://www.gisaid.org/. opens in new tab).

18. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-733.

19. Washington State Department of Health. Novel coronavirus outbreak 2020 (https://www.doh.wa.gov/Emergencies/Coronavirus. opens in new tab).

20. Chen N, Zhou M, Dong X Jr, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020 January 30 (Epub ahead of print).