Infectious Disease

CDC/WHO: Pneumonia of Unknown Origin Detected

In response to the detection of a cluster of pneumonia of unknown etiology (PUE) in Wuhan City, Hubei Province, China, the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) are recommending that clinicians ask patients with severe respiratory disease about travel history to the area.1,2

At this time, no cases have been reported outside of China.

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As of January 5, 2020, 59 patients with PUE have been reported to WHO. Symptoms of the illness include fever, dyspnea, and bilateral lung infiltrates on chest radiograph. Of the 59 cases, 7 are critically ill and no deaths have been reported. Human-to-human transmission has also not been reported.

Several of the patients have been reported to be vendors at the Wuhan South China Seafood Wholesale Market, where many species of wild animals are sold, suggesting a potential zoonotic origin.

CDC has issued a level 1 travel notice (Practice Usual Precautions) and recommends the following to health care providers:

  • PUE should be considered in patients with severe respiratory symptoms who traveled to Wuhan since December 1, 2019 and with onset of illness within 2 weeks of returning who also have no other known diagnosis that would explain their illness. If patients are identified who meet this criteria, infection control and state health departments should be notified immediately.
  • Among patients with infections suspected to be associated with the PUE cluster, multiple respiratory tract specimens should be collected, including nasopharyngeal, nasal, and throat swabs. Lower respiratory tract specimens should also be collected, if possible, and urine, stool, serum, and respiratory pathology specimens should be considered.
  • Despite no evidence of human-to-human transmission, patients with suspected PUE should be asked to wear surgical masks and should be evaluated in a private room with closed doors. N95 disposable facepiece respirators should be worn by personnel entering the room. Contact and airborne isolation precautions are recommended for those entering inpatient care.

At this time, WHO is recommending that travelers seek medical attention and share travel history with their health care provider if they experience symptoms of respiratory illness during or after travel and advise against the application of any travel or trade restrictions on China based on current information.

—Michael Potts

References:

  1. Outbreak of Pneumonia of Unknown Etiology (PUE) in Wuhan, China [press release]. Centers for Disease Control and Prevention; January 8, 2020. https://emergency.cdc.gov/han/han00424.asp. Accessed January 10, 2020.
  2. Pneumonia of unknown cause – China [press release]. World Health Organization; January 5, 2020. https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/. Accessed January 10, 2020.