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Coronavirus disease (COVID-19): Further Recommendations

There have now been more than 80,000 cases of COVID-19 reported globally, with the majority occurring in mainland China. There have been three confirmed cases in South Australia. Two cases had travelled from Wuhan (Hubei Province, China) before travel restrictions were applied, and one case recently returned from the Diamond Princess Cruise Ship.

Many symptomatic returning travellers are testing positive for other respiratory illnesses, predominantly rhinovirus. More than 1500 coronavirus tests have been done on people with respiratory illness in SA, with no further positives.

Novel Coronavirus infection updated recommendations

Case definition: suspected cases require BOTH epidemiological AND clinical criteria

  • Epidemiological criteria: at least one of the following
    • Travel to (including transit through) mainland China in the 14 days before the onset of illness OR
    • Close or casual contact in the 14 days before illness onset with a confirmed case of COVID-19
  • Clinical criteria: at least one of the following
    • Fever OR
    • Acute respiratory infection
  • For “case” or “close contact” definition see CDNA National Guidelines

Areas of interest

  • Areas of interest now include Iran, Italy, and South Korea in addition to Hong Kong, Indonesia, Japan, Singapore, and Thailand.
  • Clinicians should consider testing people with clinical signs/symptoms of COVID-19 who have travelled to these areas (excluding airport transit) in the 14 days before onset of symptoms.
  • If the decision is made to test, advise the person to remain in home isolation pending results.

Australian Government Smart Traveller

No changes to isolation recommendations

See Public Health Alert of 18 February 2020 for details.

Medical practitioners are advised to:

  • Follow updated Infection Control Guidelines Flowchart
  • Refer to previous Public Health Alert of 12 February 2020 for further details of PPE, infection control and specimen collection
  • If absent/mild respiratory symptoms use contact and droplet precautions for specimen collection:
    • PPE i.e. gloves, long sleeved gown, surgical mask and protective eye wear.
    • Use a single room with the door closed and stand slightly to the side of the patient whilst collecting.
  • If severe respiratory symptoms (suggestive of pneumonia) send to hospital for assessment (after informing emergency department). Airborne precautions should be used for specimen collection:
    • PPE i.e. gloves, long sleeved gown, fit checked P2/N95 mask and protective eye wear.
    • Use a single room with the door closed (left vacant for 30 minutes) or a negative pressure room.
  • Send specimens to SA Pathology.
  • Do not send patients to a general pathology collection centre.
  • Where appropriate PPE and/or facilities are not available for specimen collection, SA Pathology can provide a domiciliary service for in home testing; doctors must ring 8222 3000 to arrange this service. These need to be pre-approved by CDCB (phone 1300 232 272).
  • Do not test patients for ‘medical clearance’ certificates for schools or workplaces.
  • If the decision is made to test, advise the person to remain in home isolation pending results.
  • Notify suspected and confirmed cases by phone to CDCB on 1300 232 272.

Refer to the Australian Government webpages for further information.

For further information see SA Health
Australian Government Department of Health website
World Health Organization website

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