The man came in with a ‘persistent dry cough and a 2-day history of nausea and vomiting’
The Wuhan Huanan Wholesale Seafood Market, where a number of people related to the market fell ill with a virus, sits closed in Wuhan, China, Tuesday, Jan. 21, 2020. Heightened precautions were being taken in China and elsewhere Tuesday as governments strove to control the outbreak of the coronavirus, which threatens to grow during the Lunar New Year travel rush.
A man just back from Wuhan walked into a clinic in Washington state Jan. 19 complaining of a four-day cough.One day later, he was patient zero.
The 35-year-old is America’s first case of the coronavirus, public health investigators report.
The man came in with a “persistent dry cough and a 2-day history of nausea and vomiting.” It got worse by day six, according to the report in the New England Journal of Medicine.
On the sixth day, the man had “atypical pneumonia,” often called walking pneumonia. He needed oxygen, he had “ongoing fevers,” and remdesivir (an antiviral drug studied to treat Ebola) was used to treat him. That, the Journal report states, seemed to help.
“On hospital day 8 — illness day 12 — the patient’s clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air,” the report states.
His appetite improved. His dry cough lingered, but he was getting better.
The report states the man’s case “highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels” and how to quickly share information. And, the researchers added, that man did not go to the Huanan Seafood Wholesale Market, once considered the coronavirus epicenter.
But since that man visited family in Wuhan, China, COVID-19 has spread across the globe like an invisible wildfire.
As of Monday night, 375,458 people had been infected worldwide with 16,371 deaths — the most in Italy that reported more than 6,000 dead.
In the U.S., 43,449 have been infected and 545 have died. Massachusetts public health officials report nine deaths and 777 infections.
Dr. Paul Duprex, director of the Center for Vaccine Research at the University of Pittsburgh School of Medicine and formerly of Boston University School of Medicine, said it’s too late now to use the knowledge gained from the first patient to slow the spread of the coronavirus.
But, he told the Herald Monday, it can aid in testing the genetic sequence of the virus.
“It’s far more important to get tests done. There’s a bottleneck there now,” Duprex added. “But the genetic sequencing helps with the testing.”
Duprex is among those racing to come up with a vaccine for COVID-19. “We will play our part,” he tweeted about his work with the Coalition for Epidemic Preparedness Innovations.
The New England Journal of Medicine article adds that on Jan. 7 “Chinese researchers shared the full genetic sequence of (COVID-19) through the National Institutes of Health GenBank database.”
The bottom line, report those who treated the first case in the U.S., is that the virus is “not yet fully understood” — but they are tracing where people have been to make the right public health decisions.
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