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Case Reports
. 2020 Mar 5;382(10):929-936.
doi: 10.1056/NEJMoa2001191. Epub 2020 Jan 31.

First Case of 2019 Novel Coronavirus in the United States

Michelle L Holshue  1 , Chas DeBolt  1 , Scott Lindquist  1 , Kathy H Lofy  1 , John Wiesman  1 , Hollianne Bruce  1 , Christopher Spitters  1 , Keith Ericson  1 , Sara Wilkerson  1 , Ahmet Tural  1 , George Diaz  1 , Amanda Cohn  1 , LeAnne Fox  1 , Anita Patel  1 , Susan I Gerber  1 , Lindsay Kim  1 , Suxiang Tong  1 , Xiaoyan Lu  1 , Steve Lindstrom  1 , Mark A Pallansch  1 , William C Weldon  1 , Holly M Biggs  1 , Timothy M Uyeki  1 , Satish K Pillai  1 ; Washington State 2019-nCoV Case Investigation Team
Collaborators, Affiliations
Case Reports

First Case of 2019 Novel Coronavirus in the United States

Michelle L Holshue et al. N Engl J Med. .

Abstract

An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.

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Figures

Figure 1
Figure 1. Posteroanterior and Lateral Chest Radiographs, January 19, 2020 (Illness Day 4).
No thoracic abnormalities were noted.
Figure 2
Figure 2. Symptoms and Maximum Body Temperatures According to Day of Illness and Day of Hospitalization, January 16 to January 30, 2020.
Figure 3
Figure 3. Posteroanterior and Lateral Chest Radiographs, January 22, 2020 (Illness Day 7, Hospital Day 3).
No acute intrathoracic plain-film abnormality was noted.
Figure 4
Figure 4. Posteroanterior Chest Radiograph, January 24, 2020 (Illness Day 9, Hospital Day 5).
Increasing left basilar opacity was visible, arousing concern about pneumonia.
Figure 5
Figure 5. Anteroposterior and Lateral Chest Radiographs, January 26, 2020 (Illness Day 10, Hospital Day 6).
Stable streaky opacities in the lung bases were visible, indicating likely atypical pneumonia; the opacities have steadily increased in density over time.
See this image and copyright information in PMC

Comment in

References

    1. World Health Organization. Pneumonia of unknown cause — China. 2020. (https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-ch...).
    1. World Health Organization. Novel coronavirus — China. 2020. (https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/).
    1. 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). - PMC - PubMed
    1. 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). - PMC - PubMed
    1. 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).

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