A patient who was evaluated at Hackensack University Medical Center on Thursday night turned out not to have the virus from China that is causing international concern about a possible pandemic.
But across the country, 63 patients in 22 states have been tested for the virus, with two patients — in Chicago and Washington State — confirmed Friday to have the disease. New Jersey has no confirmed cases or cases under investigation, the state Health Department said.
The virus, a new form of coronavirus that is believed to have been transmitted from animals to humans in a wholesale market where fish and live animals were sold, emerged in December in the central Chinese city of Wuhan.
More than 1,400 people in China have been diagnosed, and 41 deaths have been reported. The virus has spread to other cities in China, as well as to Thailand, South Korea, Taiwan and Japan.
"While this situation poses a very serious public health threat, the immediate risk to the public is low at this time," Dr. Nancy Messonnier, director of the center for immunization and respiratory disease at the Centers for Disease Controls, said in a teleconference Friday. "The situation continues to evolve rapidly."
The Hackensack patient was discharged Thursday night after being evaluated, said Nancy Radwin, a spokeswoman for Hackensack Meridian Health, the parent health system of the hospital.
The patient, identified by Edgewater police dispatchers as a 25-year-old woman, was transported to Hackensack by Edgewater's emergency medical service Thursday evening.
The Health Department on Thursday night "consulted with CDC and it was determined the patient did not meet CDC criteria for testing," the spokeswoman, Donna Leusner, said in an email at 11:30 p.m. Thursday.
The state, with guidance from the CDC, had distributed criteria Wednesday for clinicians to use when evaluating potential cases of the virus, known as "2019 novel coronavirus” or “2019-nCoV."
Currently, the only definitive tests for the virus are performed at the CDC's laboratory in Atlanta.
Those criteria include a fever of 100.4 degrees or more, lower respiratory illness such as a cough and shortness of breath, and either travel from Wuhan, China within the previous two weeks or close contact with a person under investigation for the virus while the person was sick.
Further details about the North Jersey patient, including her recent travel or the nature of her symptoms, was not provided by the hospital, citing patient privacy concerns.
The flu season is at its height around the country and emergency rooms already are busy; influenza has killed an estimated 8,200 people since the fall, including 52 children. It's important to use resources wisely as concerns about the new coronavirus escalate, health officials said.
“While [the novel coronavirus] nCoV is very concerning, hospital emergency departments and urgent care centers need to consider other more common diagnoses,” such as MERS (Middle Eastern Respiratory Syndrome), seasonal respiratory viruses and measles, said Judith Persichilli, New Jersey's health commissioner.
The key question asked of patients with respiratory complaints who arrive at the emergency department is whether they have traveled to Wuhan, the epidemic's epicenter, within the past two weeks, said Dr. Debra Chew, medical director for infection prevention and control at University Hospital in Newark.
Her hospital has posted signs in Chinese and English at entry points and within the emergency department asking patients to identify themselves if they've been in Wuhan recently, and so far none have, she said.
Meanwhile, the CDC confirmed Friday that a Chicago resident in her 60s who returned from Wuhan on Jan. 13 was the second person in the United States to be diagnosed with the virus. Her condition is stable, Chicago public health officials said, and she remains hospitalized in isolation primarily to prevent the spread of infection.
She had limited contact with others, and was not symptomatic when she flew back to the United States on Jan. 13, the CDC said.
A Washington State resident who was diagnosed earlier this week is also in stable condition, and none of his close contacts has shown signs of disease, Messonnier said.
The extent of human-to-human transmission of the coronavirus is not known at this time, she said. "This virus was only identified within the past month," she said, "and there is much we don't know yet."
The virus reportedly causes mild to severe respiratory illness with symptoms of fever, cough and shortness of breath, with symptoms appearing as few as two days or as long as two weeks after exposure, the CDC said.
Of the 63 lab specimens sent to the CDC so far for testing, two have been positive and 11 have been negative, she said. The rest are either in transit or pending results, which take four to six hours once the test is started, she said. As health care providers and local and state health officials evaluate patients and send specimens for testing, Messonier said, "this is a sign the public health system is working."
She predicted that the United States would see additional patients with the virus, either among travelers from China or close contacts of those travelers.
Screening of passengers arriving at five U.S. airports for signs of fever will continue, but may be reevaluated in light of China's ban on outgoing travel from Wuhan, said Dr. Martin Cetron, director of the CDC's division of global migration and quarantine.
The CDC has deployed staff to help with the screenings at New York's JFK International Airport, Chicago O'Hare, San Francisco, Los Angeles and Atlanta airports.
Moe than 2,000 passengers had been screened as of Thursday, Cetron said, and only one had been referred for additional medical evaluation — which was negative for the virus. Both U.S. patients arrived before screening was started, and did not have a fever or other symptoms upon arrival.
The primary effort now, Cetron said, must be made at the state and local level to identify new cases and their close contacts.
However, U.S. Sen. Bob Menendez, a New Jersey Democrat, on Friday renewed his call for the CDC to extend screening to patients arriving at Newark Liberty International Airport. Menendezco-hosted a briefing by federal health officials for senators about the emerging outbreak Friday.
"The Chinese government has taken steps to share information with international health experts, and we encourage their cooperation and transparency as this situation unfolds," said the senator, ranking member of the Senate Foreign Relations Committee.
In China, most of the fatalities have been among older adults with underlying health conditions, according to Chinese health authorities