From: Kirby Kruger, Section Chief Medical Services Section ND

2019 Novel Coronavirus (2019-nCoV) is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. Early on, many of the patients in the outbreak in Wuhan, China, reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread. However, a growing number of patients reportedly have not had exposure to animal markets, indicating person-to-person spread is occurring. To date, 11 individuals with 2019-nCoV have been reported in the United States, nine with travel to Wuhan, China and two household contacts of individuals with 2019-nCoV. No cases of 2019-nCoV have been reported in North Dakota.

The following individuals should be evaluated by a health care professional for 2019-nCoV:
• Ill with a fever, cough, or difficulty breathing AND have traveled from China in the last 14 days
OR
• Ill with fever, cough, or difficulty breathing AND have been identified by public health as a recent close contact of a confirmed 2019-nCoV case or had recent close contact with someone who is being evaluated for 2019-nCoV infection.

If you suspect a student or employee may have 2019-nCoV, please contact the NDDoH Division of Disease Control immediately at 701-328-2378 or 800-472-2180.

On February 3, 2020, the Centers for Disease Control and Prevention (CDC) released Guidance for Risk Assessment and Public Health Management of Persons with Potential 2019 Novel Coronavirus Exposure in Travel-associated or Community Settings. In accordance with this guidance, the North Dakota Department of Health (NDDoH) Division of Disease Control will be notified of and monitoring individuals who have traveled to North Dakota from China and/or individuals who have a known exposure to 2019-nCoV.

When notified of travelers from China or close contacts, the NDDoH will contact the individuals to assess their risk and symptoms. Symptoms of 2019-nCoV include fever, cough and shortness of breath. If symptomatic, they will be referred for medical evaluation and will be isolated (remain at home or in a comparable setting and avoid public activities). Asymptomatic individuals will be instructed to remain at home or in a comparable setting and avoid public activities (including childcare or school) for 14 days from their last known exposure. They will be educated about symptoms, advised to monitor for symptoms, and contacted daily by the NDDoH to check for symptoms.

What this means for child care facilities, schools and universities is that the NDDoH will be excluding individuals from attendance or work who have traveled on February 3, 2020 or later to the United States from China or are a known contact to an individual who has 2019-nCoV. The exclusion period is 14 days from last known exposure. The NDDoH will notify the child care, school or university that the student or employee should be excluded. Additionally, individuals who have tested positive for 2019-nCoV or who are symptomatic and have a history of travel to China within the past 14 days or are a known contact to someone with 2019-nCoV will also be excluded. Child cares, schools and universities should follow their own internal policies and procedures regarding student or employee exclusion, including continued care and/or education of the student.

There is no recommendation for people without symptoms arriving before February 3, 2020, to restrict their activities. All travelers from China arriving before February 3, 2020, can continue to attend school as long as they are asymptomatic. Schools do not need to take any special precautions beyond what is normally recommended to prevent the spread of germs in schools. You can help students and staff reduce their risk for getting and spreading viral respiratory infections, including the flu and the common cold, by encouraging them to take simple steps which will also prevent 2019-nCoV. These include:

• Wash hands often with soap and water for at least 20 seconds.
• Avoid touching eyes, nose, or mouth with unwashed hands.
• Avoid contact with people who are sick.
• Stay home while sick and avoid close contact with others.
• Cover mouth and nose with a tissue when coughing or sneezing, then throw the tissue in the trash and wash hands.
In addition, we recommend schools be sure to follow their regular cleaning and disinfection program.
• Clean hard surfaces (desks, tables, countertops, sinks) daily. Clean and disinfect frequently touched surfaces (door handles, faucets, railings), bathrooms and health rooms at least once a day. Use alcohol wipes to clean keyboards.
• Clean surfaces with fragrance-free soap or third-party certified cleaners. Thorough cleaning with soap and water will remove most microorganisms.
• Use EPA disinfectants on hard surfaces. Clean the surface first to remove all organic matter. Apply the proper concentration of disinfectant and allow the required wet contact time. Pay close attention to hazard warnings and instructions for using personal protective items such as gloves and eye protection. Use disinfectants in a sufficiently ventilated space.
• Disinfecting is the responsibility of school custodial staff. They are trained to use disinfectants in a safe and effective manner and to clean up potentially infectious materials and body fluid spills – blood, vomit, feces, and urine. Contact your custodian or school nurse if students are ill and your classroom needs cleaning and disinfection.

For more information about coronavirus, please visit www.health.nd.gov/coronavirus.
Please contact the NDDoH Division of Disease Control at 701-328-2378 or 800-472-2180 with any coronavirus-related questions.