2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus
Identifieur interne : 001225 ( Pmc/Curation ); précédent : 001224; suivant : 0012262019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus
Auteurs : Kristi L. Koenig [États-Unis] ; Christian K. Be [États-Unis] ; Eric C. Mcdonald [États-Unis]Source :
- Western Journal of Emergency Medicine [ 1936-900X ] ; 2020.
Abstract
2019 Novel Coronavirus (2019-nCoV) is an emerging infectious disease closely related to MERS-CoV and SARS-CoV that was first reported in Wuhan City, Hubei Province, China in December 2019. As of January 2020, cases of 2019-nCoV are continuing to be reported in other Eastern Asian countries as well as in the United States, Europe, Australia, and numerous other countries. An unusually high volume of domestic and international travel corresponding to the beginning of the 2020 Chinese New Year complicated initial identification and containment of infected persons. Due to the rapidly rising number of cases and reported deaths, all countries should be considered at risk of imported 2019-nCoV. Therefore, it is essential for prehospital, clinic, and emergency department personnel to be able to rapidly assess 2019-nCoV risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) Tool, originally conceived for the initial detection and management of Ebola virus and later adjusted for other infectious agents, can be adapted for any emerging infectious disease. This paper reports a modification of the 3I Tool for use in the initial detection and management of patients under investigation for 2019-nCoV. After initial assessment for symptoms and epidemiological risk factors, including travel to affected areas and exposure to confirmed 2019-nCoV patients within 14 days, patients are classified in a risk-stratified system. Upon confirmation of a suspected 2019-nCoV case, affected persons must immediately be placed in airborne infection isolation and the appropriate public health agencies notified. This modified 3I Tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing persons with suspected or confirmed 2019-nCoV.
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DOI: 10.5811/westjem.2020.1.46760
PubMed: 32191174
PubMed Central: 7081861
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Koenig</name><affiliation wicri:level="2"><nlm:aff id="af1-wjem-21-184">County of San Diego, Health & Human Services Agency, Emergency Medical Services, San Diego, California</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>County of San Diego, Health & Human Services Agency, Emergency Medical Services, San Diego</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="af2-wjem-21-184">University of California Irvine, Department of Emergency Medicine, Orange, California</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>University of California Irvine, Department of Emergency Medicine, Orange</wicri:cityArea></affiliation></author><author><name sortKey="Be, Christian K" sort="Be, Christian K" uniqKey="Be C" first="Christian K." last="Be">Christian K. Be</name><affiliation wicri:level="2"><nlm:aff id="af3-wjem-21-184">University of California San Diego, La Jolla, California</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>University of California San Diego, La Jolla</wicri:cityArea></affiliation></author><author><name sortKey="Mcdonald, Eric C" sort="Mcdonald, Eric C" uniqKey="Mcdonald E" first="Eric C." last="Mcdonald">Eric C. Mcdonald</name><affiliation wicri:level="2"><nlm:aff id="af4-wjem-21-184">County of San Diego, Health & Human Services Agency, Public Health Services, San Diego, California</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>County of San Diego, Health & Human Services Agency, Public Health Services, San Diego</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32191174</idno><idno type="pmc">7081861</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081861</idno><idno type="RBID">PMC:7081861</idno><idno type="doi">10.5811/westjem.2020.1.46760</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">001225</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001225</idno><idno type="wicri:Area/Pmc/Curation">001225</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001225</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus</title><author><name sortKey="Koenig, Kristi L" sort="Koenig, Kristi L" uniqKey="Koenig K" first="Kristi L." last="Koenig">Kristi L. Koenig</name><affiliation wicri:level="2"><nlm:aff id="af1-wjem-21-184">County of San Diego, Health & Human Services Agency, Emergency Medical Services, San Diego, California</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>County of San Diego, Health & Human Services Agency, Emergency Medical Services, San Diego</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="af2-wjem-21-184">University of California Irvine, Department of Emergency Medicine, Orange, California</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>University of California Irvine, Department of Emergency Medicine, Orange</wicri:cityArea></affiliation></author><author><name sortKey="Be, Christian K" sort="Be, Christian K" uniqKey="Be C" first="Christian K." last="Be">Christian K. Be</name><affiliation wicri:level="2"><nlm:aff id="af3-wjem-21-184">University of California San Diego, La Jolla, California</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>University of California San Diego, La Jolla</wicri:cityArea></affiliation></author><author><name sortKey="Mcdonald, Eric C" sort="Mcdonald, Eric C" uniqKey="Mcdonald E" first="Eric C." last="Mcdonald">Eric C. Mcdonald</name><affiliation wicri:level="2"><nlm:aff id="af4-wjem-21-184">County of San Diego, Health & Human Services Agency, Public Health Services, San Diego, California</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>County of San Diego, Health & Human Services Agency, Public Health Services, San Diego</wicri:cityArea></affiliation></author></analytic><series><title level="j">Western Journal of Emergency Medicine</title><idno type="ISSN">1936-900X</idno><idno type="eISSN">1936-9018</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>2019 Novel Coronavirus (2019-nCoV) is an emerging infectious disease closely related to MERS-CoV and SARS-CoV that was first reported in Wuhan City, Hubei Province, China in December 2019. As of January 2020, cases of 2019-nCoV are continuing to be reported in other Eastern Asian countries as well as in the United States, Europe, Australia, and numerous other countries. An unusually high volume of domestic and international travel corresponding to the beginning of the 2020 Chinese New Year complicated initial identification and containment of infected persons. Due to the rapidly rising number of cases and reported deaths, all countries should be considered at risk of imported 2019-nCoV. Therefore, it is essential for prehospital, clinic, and emergency department personnel to be able to rapidly assess 2019-nCoV risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) Tool, originally conceived for the initial detection and management of Ebola virus and later adjusted for other infectious agents, can be adapted for any emerging infectious disease. This paper reports a modification of the 3I Tool for use in the initial detection and management of patients under investigation for 2019-nCoV. After initial assessment for symptoms and epidemiological risk factors, including travel to affected areas and exposure to confirmed 2019-nCoV patients within 14 days, patients are classified in a risk-stratified system. Upon confirmation of a suspected 2019-nCoV case, affected persons must immediately be placed in airborne infection isolation and the appropriate public health agencies notified. This modified 3I Tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing persons with suspected or confirmed 2019-nCoV.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Huang, C" uniqKey="Huang C">C Huang</name></author><author><name sortKey="Yeming, W" uniqKey="Yeming W">W Yeming</name></author><author><name sortKey="Xingwang, L" uniqKey="Xingwang L">L Xingwang</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Gamage, Sd" uniqKey="Gamage S">SD Gamage</name></author><author><name sortKey="Kralovic, Sm" uniqKey="Kralovic S">SM Kralovic</name></author><author><name sortKey="Roselle, Ga" uniqKey="Roselle G">GA Roselle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Majestic, C" uniqKey="Majestic C">C Majestic</name></author><author><name sortKey="Burns, Mj" uniqKey="Burns M">MJ Burns</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Alassaf, W" uniqKey="Alassaf W">W Alassaf</name></author><author><name sortKey="Burns, Mj" uniqKey="Burns M">MJ Burns</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Shastry, S" uniqKey="Shastry S">S Shastry</name></author><author><name sortKey="Mzahim, B" uniqKey="Mzahim B">B Mzahim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Almadhyan, A" uniqKey="Almadhyan A">A Almadhyan</name></author><author><name sortKey="Burns, Mj" uniqKey="Burns M">MJ Burns</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Shastry, S" uniqKey="Shastry S">S Shastry</name></author><author><name sortKey="Burns, Mj" uniqKey="Burns M">MJ Burns</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Farah, J" uniqKey="Farah J">J Farah</name></author><author><name sortKey="Thihalolipavan, S" uniqKey="Thihalolipavan S">S Thihalolipavan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cheng, T" uniqKey="Cheng T">T Cheng</name></author><author><name sortKey="Mzahim, B" uniqKey="Mzahim B">B Mzahim</name></author><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, N" uniqKey="Chen N">N Chen</name></author><author><name sortKey="Zhou, M" uniqKey="Zhou M">M Zhou</name></author><author><name sortKey="Dong, X" uniqKey="Dong X">X Dong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Li, Q" uniqKey="Li Q">Q Li</name></author><author><name sortKey="Guan, X" uniqKey="Guan X">X Guan</name></author><author><name sortKey="Wu, P" uniqKey="Wu P">P Wu</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Paules, Ci" uniqKey="Paules C">CI Paules</name></author><author><name sortKey="Marston, Hd" uniqKey="Marston H">HD Marston</name></author><author><name sortKey="Fauci, As" uniqKey="Fauci A">AS Fauci</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Boatright, C" uniqKey="Boatright C">C Boatright</name></author><author><name sortKey="Hancock, J" uniqKey="Hancock J">J Hancock</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Boatright, C" uniqKey="Boatright C">C Boatright</name></author><author><name sortKey="Hancock, J" uniqKey="Hancock J">J Hancock</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rothe, C" uniqKey="Rothe C">C Rothe</name></author><author><name sortKey="Schunk, M" uniqKey="Schunk M">M Schunk</name></author><author><name sortKey="Sothmann, P" uniqKey="Sothmann P">P Sothmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Barbisch, D" uniqKey="Barbisch D">D Barbisch</name></author><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author><author><name sortKey="Shih, F Y" uniqKey="Shih F">F-Y Shih</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cyranoski, D" uniqKey="Cyranoski D">D Cyranoski</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Munster, Vj" uniqKey="Munster V">VJ Munster</name></author><author><name sortKey="Koopmans, M" uniqKey="Koopmans M">M Koopmans</name></author><author><name sortKey="Van Doremalen, N" uniqKey="Van Doremalen N">N van Doremalen</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Koenig, Kl" uniqKey="Koenig K">KL Koenig</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Woodside, J" uniqKey="Woodside J">J Woodside</name></author><author><name sortKey="Rebmann, T" uniqKey="Rebmann T">T Rebmann</name></author><author><name sortKey="Williams, C" uniqKey="Williams C">C Williams</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">West J Emerg Med</journal-id><journal-id journal-id-type="iso-abbrev">West J Emerg Med</journal-id><journal-id journal-id-type="publisher-id">WestJEM</journal-id><journal-title-group><journal-title>Western Journal of Emergency Medicine</journal-title></journal-title-group><issn pub-type="ppub">1936-900X</issn><issn pub-type="epub">1936-9018</issn><publisher><publisher-name>Department of Emergency Medicine, University of California, Irvine School of Medicine</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32191174</article-id><article-id pub-id-type="pmc">7081861</article-id><article-id pub-id-type="doi">10.5811/westjem.2020.1.46760</article-id><article-id pub-id-type="publisher-id">wjem-21-184</article-id><article-categories><subj-group subj-group-type="heading"><subject>Endemic Infections</subject><subj-group subj-group-type="heading"><subject>Original Research</subject></subj-group></subj-group></article-categories><title-group><article-title>2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Koenig</surname><given-names>Kristi L.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="af1-wjem-21-184">*</xref><xref ref-type="aff" rid="af2-wjem-21-184">†</xref></contrib><contrib contrib-type="author"><name><surname>Beÿ</surname><given-names>Christian K.</given-names></name><degrees>BS</degrees><xref ref-type="aff" rid="af3-wjem-21-184">‡</xref></contrib><contrib contrib-type="author"><name><surname>McDonald</surname><given-names>Eric C.</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="af4-wjem-21-184">§</xref></contrib></contrib-group><aff id="af1-wjem-21-184"><label>*</label>County of San Diego, Health & Human Services Agency, Emergency Medical Services, San Diego, California</aff><aff id="af2-wjem-21-184"><label>†</label>University of California Irvine, Department of Emergency Medicine, Orange, California</aff><aff id="af3-wjem-21-184"><label>‡</label>University of California San Diego, La Jolla, California</aff><aff id="af4-wjem-21-184"><label>§</label>County of San Diego, Health & Human Services Agency, Public Health Services, San Diego, California</aff><author-notes><corresp id="c1-wjem-21-184">Address for Correspondence: Kristi L. Koenig, MD, County of San Diego, Health & Human Services Agency, Emergency Medical Services, 6255 Mission Gorge Rd., San Diego, CA 92120. Email: <email>kristi.koenig@sdcounty.ca.gov</email>.</corresp></author-notes><pub-date pub-type="ppub"><month>3</month><year>2020</year></pub-date><pub-date pub-type="epub"><day>31</day><month>1</month><year>2020</year></pub-date><volume>21</volume><issue>2</issue><fpage>184</fpage><lpage>190</lpage><history><date date-type="received"><day>28</day><month>1</month><year>2020</year></date><date date-type="rev-recd"><day>28</day><month>1</month><year>2020</year></date><date date-type="accepted"><day>30</day><month>1</month><year>2020</year></date></history><permissions><copyright-statement>Copyright: © 2020 Koenig et al</copyright-statement><copyright-year>2020</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p><pmc-comment>CREATIVE COMMONS</pmc-comment>This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link></license-p></license></permissions><abstract><p>2019 Novel Coronavirus (2019-nCoV) is an emerging infectious disease closely related to MERS-CoV and SARS-CoV that was first reported in Wuhan City, Hubei Province, China in December 2019. As of January 2020, cases of 2019-nCoV are continuing to be reported in other Eastern Asian countries as well as in the United States, Europe, Australia, and numerous other countries. An unusually high volume of domestic and international travel corresponding to the beginning of the 2020 Chinese New Year complicated initial identification and containment of infected persons. Due to the rapidly rising number of cases and reported deaths, all countries should be considered at risk of imported 2019-nCoV. Therefore, it is essential for prehospital, clinic, and emergency department personnel to be able to rapidly assess 2019-nCoV risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) Tool, originally conceived for the initial detection and management of Ebola virus and later adjusted for other infectious agents, can be adapted for any emerging infectious disease. This paper reports a modification of the 3I Tool for use in the initial detection and management of patients under investigation for 2019-nCoV. After initial assessment for symptoms and epidemiological risk factors, including travel to affected areas and exposure to confirmed 2019-nCoV patients within 14 days, patients are classified in a risk-stratified system. Upon confirmation of a suspected 2019-nCoV case, affected persons must immediately be placed in airborne infection isolation and the appropriate public health agencies notified. This modified 3I Tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing persons with suspected or confirmed 2019-nCoV.</p></abstract></article-meta></front><floats-group><fig id="f1-wjem-21-184" position="float"><label>Figure 1</label><caption><p>Koenig’s Identify-Isolate-Inform Tool adapted for 2019-nCoV.</p></caption><graphic xlink:href="wjem-21-184-g001"></graphic></fig><table-wrap id="t1-wjem-21-184" position="float"><label>Table 1</label><caption><p>Key disease features and implications.</p></caption><table frame="hsides" rules="groups"><thead><tr><th valign="top" align="center" rowspan="1" colspan="1">Scenario</th><th valign="top" align="center" rowspan="1" colspan="1">Special Considerations</th></tr></thead><tbody><tr><td valign="top" align="left" rowspan="1" colspan="1">Natural vs. human-generated (e.g., terrorism, industrial incident)</td><td valign="top" align="left" rowspan="1" colspan="1">Law enforcement in addition to public health investigation; crime scene investigation</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Contagion vs. contaminant/toxin vs. neither</td><td valign="top" align="left" rowspan="1" colspan="1">Mode of transmission; PPE type</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Transmissibility from person to person (i.e., R<sub>0</sub>)</td><td valign="top" align="left" rowspan="1" colspan="1">PPE requirements; need for declaration of PHEIC, need for surge capacity</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Potential for mutations</td><td valign="top" align="left" rowspan="1" colspan="1">Need for monitoring and updates on public health management guidance</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Sensitivity and specificity of testing</td><td valign="top" align="left" rowspan="1" colspan="1">Strategies for testing method and location (point-of-care, regional, national)</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">Contagious prior to symptom onset</td><td valign="top" align="left" rowspan="1" colspan="1">Amenable to quarantine; types of public health interventions needed to prevent spread</td></tr></tbody></table><table-wrap-foot><fn id="tfn1-wjem-21-184"><p><italic>PHEIC</italic>, Public Health Emergency of International Concern; <italic>PPE</italic>, personal protective equipment; <italic>R</italic><italic><sub>0</sub></italic>, Basic Reproduction Number: a mathematical prediction of disease contagiousness.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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