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 6:00 PM
Updated: Jan 31, 2020 6:00 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.

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 667262

Reported Deaths: 12737
CountyCasesDeaths
Marion913541660
Lake48729891
Allen36175646
Hamilton32489398
St. Joseph30361514
Elkhart25536420
Vanderburgh21343382
Tippecanoe20240205
Johnson16485363
Porter16077281
Hendricks15955302
Clark12079182
Madison11810323
Vigo11699234
Monroe10440164
Delaware9899179
LaPorte9838201
Howard9127203
Kosciusko8600111
Bartholomew7531147
Hancock7471134
Warrick7456153
Floyd7269173
Wayne6661192
Grant6465158
Boone618691
Morgan6135129
Dubois5942112
Dearborn551570
Cass5489100
Marshall5456105
Henry544395
Noble513878
Jackson465967
Shelby463591
Lawrence4197113
Gibson405585
Harrison404065
Clinton397653
Montgomery391984
DeKalb388278
Miami358463
Knox357886
Whitley352438
Huntington350877
Steuben340455
Putnam334660
Wabash333976
Ripley328062
Adams326349
Jasper319343
White298553
Jefferson296574
Daviess286196
Fayette272756
Decatur271688
Greene262680
Posey261732
Wells259175
Scott252150
LaGrange242670
Clay241644
Randolph226577
Spencer219630
Jennings216944
Washington213327
Sullivan203839
Fountain202842
Starke190051
Owen184254
Fulton179937
Jay178828
Carroll176919
Perry174136
Orange171451
Rush165722
Vermillion161543
Franklin160135
Tipton150041
Parke140216
Pike128633
Blackford120727
Pulaski107844
Newton96832
Brown95340
Crawford92613
Benton92513
Martin80314
Warren76014
Switzerland7568
Union67510
Ohio54211
Unassigned0427

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 978471

Reported Deaths: 17501
CountyCasesDeaths
Franklin1130371251
Cuyahoga969331881
Hamilton739231067
Montgomery47536923
Summit40720831
Butler35859531
Lucas35802720
Stark29602826
Warren22593275
Lorain22218424
Mahoning19586551
Lake18564332
Clermont18541205
Delaware16614121
Licking15096194
Fairfield14653188
Trumbull14437424
Greene13664221
Medina13531237
Clark12394256
Wood11670170
Portage11140172
Allen10822216
Richland10376188
Miami10065194
Muskingum8244117
Columbiana8174210
Pickaway8096111
Tuscarawas8083232
Marion8021127
Wayne7939199
Erie6972146
Ross6178132
Geauga6118142
Hancock6032121
Scioto600988
Ashtabula6002154
Lawrence527886
Union516741
Darke5052116
Belmont5000137
Huron4862108
Jefferson4843137
Sandusky4800112
Washington475596
Seneca4738111
Athens466449
Mercer459781
Auglaize456682
Shelby442679
Knox4056105
Putnam400593
Madison395755
Fulton383461
Ashland383083
Brown375252
Defiance374088
Crawford360198
Logan357673
Preble354187
Clinton342755
Highland328551
Ottawa325471
Williams303568
Jackson292046
Champaign291149
Guernsey288945
Perry271348
Fayette270143
Morrow261637
Henry247961
Hardin247359
Holmes244497
Coshocton241156
Van Wert230357
Gallia223938
Adams218339
Pike217328
Wyandot212450
Hocking195154
Carroll182143
Paulding161134
Meigs136031
Noble129233
Monroe117637
Morgan102220
Harrison100731
Vinton76713
Unassigned00
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