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New report on first US case of novel coronavirus details mild symptoms followed by pneumonia

The World Health Organization has declared the novel coronavirus outbreak a public health emergency of international concern. Emory's Rollins School of Public Health professor Dr. Carlos del Rio says "the impact on the global economy could be significant."

Posted: Jan 31, 2020 3:00 PM
Updated: Jan 31, 2020 3:00 PM

Doctors have shared new details about the first case of Wuhan coronavirus in the United States in a paper published Friday in the New England Journal of Medicine.

In the new report, doctors describe how the man progressed from initially mild, nonspecific symptoms to pneumonia on the ninth day of his illness.

The patient -- a 35-year-old resident of Snohomish County, Washington, with no history of major health problems -- had returned from visiting family in Wuhan on January 15. He had not visited the seafood market where a number of early patients were initially linked, nor did he have any known contacts with sick people during his visit.

Still, the man had seen a health alert by the US Centers for Disease Control and Prevention and decided to visit an urgent care clinic on January 19, at which point he had been coughing for four days.

Doctors initially found nothing abnormal on chest X-rays, but sent swabs to the CDC because of his recent travel to Wuhan. By the following day, on January 20, they confirmed the man had the novel coronavirus.

At that point, the man was admitted to Providence Regional Medical Center in Everett, Washington, and placed in an airborne-isolation unit. Throughout his illness, he experienced a range of symptoms including fever, cough, fatigue, nausea, vomiting, diarrhea and runny nose.

But it wasn't until his fifth day in the hospital -- day nine of his illness -- that doctors saw signs of pneumonia on his chest X-ray, in the lower lobe of his left lung. On the following day, his chest X-ray showed "stable streaky opacities in the lung bases ... indicating likely atypical pneumonia."

On his eighth day in the hospital, his condition improved. As of January 30, he no longer had a fever, and his symptoms were gone except for his cough, which was "decreasing in severity," the doctors wrote. Officials are monitoring close contacts in the US but have not found evidence he transmitted the virus to anyone else.

The authors say the case underscores the importance of close collaboration between doctors, local and federal health authorities, and the quick dissemination of information throughout the medical community on how to care for patients like him. But it also illustrates what we don't know, the authors say, including how quickly and easily the virus spreads and the "full spectrum of clinical illness" it causes.

Since the Washington case, six other confirmed cases have emerged in the United States: one in Arizona, three in California and two in Illinois. The second case in Illinois is also the first confirmed case of person-to-person transmission of the virus in the United States.

California Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 793065

Reported Deaths: 15189
CountyConfirmedDeaths
Los Angeles2621336401
Riverside574821172
San Bernardino52873908
Orange523821150
San Diego45147765
Kern31572354
Fresno27843362
Sacramento21628383
Alameda20748390
Santa Clara20587299
San Joaquin20019421
Stanislaus16398339
Contra Costa16056201
Tulare15687256
Ventura12477146
Imperial11606314
San Francisco1086599
San Mateo9625144
Monterey956869
Santa Barbara8930110
Merced8820137
Kings753477
Sonoma7160120
Marin6613113
Solano619457
Madera442465
Placer350742
San Luis Obispo343827
Butte276940
Yolo276554
Santa Cruz22768
Sutter167910
Napa164113
San Benito131211
Yuba11307
El Dorado10744
Mendocino87518
Lassen7350
Shasta72414
Glenn5633
Nevada5246
Colusa5196
Tehama5134
Lake51211
Humboldt4896
Calaveras31114
Amador28616
Tuolumne2264
Inyo18714
Mono1652
Siskiyou1630
Del Norte1381
Mariposa752
Plumas500
Modoc250
Trinity150
Sierra60
Alpine20
Unassigned00
Chico
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Oroville
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Paradise
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Chester
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Red Bluff
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Willows
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Wednesday has been similar to Tuesday around northern California with comfortable temperatures, but unhealthy levels of smoke in the air. A cold front is approaching the West Coast, and that will move over the region on Thursday.
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