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Rapid Sentinel Surveillance for COVID-19 - Santa Clara County, California, March 2020.
MMWR Morb Mortal Wkly Rep. 2020 Apr 10; 69(14):419-421.MM

Abstract

On February 27, 2020, the Santa Clara County Public Health Department (SCCPHD) identified its first case of coronavirus disease 2019 (COVID-19) associated with probable community transmission (i.e., infection among persons without a known exposure by travel or close contact with a patient with confirmed COVID-19). At the time the investigation began, testing guidance recommended focusing on persons with clinical findings of lower respiratory illness and travel to an affected area or an epidemiologic link to a laboratory-confirmed COVID-19 case, or on persons hospitalized for severe respiratory disease and no alternative diagnosis (1). To rapidly understand the extent of COVID-19 in the community, SCCPHD, the California Department of Public Health (CDPH), and CDC began sentinel surveillance in Santa Clara County. During March 5-14, 2020, four urgent care centers in Santa Clara County participated as sentinel sites. For this investigation, county residents evaluated for respiratory symptoms (e.g., fever, cough, or shortness of breath) who had no known risk for COVID-19 were identified at participating urgent care centers. A convenience sample of specimens that tested negative for influenza virus was tested for SARS-CoV-2 RNA. Among 226 patients who met the inclusion criteria, 23% had positive test results for influenza. Among patients who had negative test results for influenza, 79 specimens were tested for SARS-CoV-2, and 11% had evidence of infection. This sentinel surveillance system helped confirm community transmission of SARS-CoV-2 in Santa Clara County. As a result of these data and an increasing number of cases with no known source of transmission, the county initiated a series of community mitigation strategies. Detection of community transmission is critical for informing response activities, including testing criteria, quarantine guidance, investigation protocols, and community mitigation measures (2). Sentinel surveillance in outpatient settings and emergency departments, implemented together with hospital-based surveillance, mortality surveillance, and serologic surveys, can provide a robust approach to monitor the epidemiology of COVID-19.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

32271724

Citation

Zwald, Marissa L., et al. "Rapid Sentinel Surveillance for COVID-19 - Santa Clara County, California, March 2020." MMWR. Morbidity and Mortality Weekly Report, vol. 69, no. 14, 2020, pp. 419-421.
Zwald ML, Lin W, Sondermeyer Cooksey GL, et al. Rapid Sentinel Surveillance for COVID-19 - Santa Clara County, California, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(14):419-421.
Zwald, M. L., Lin, W., Sondermeyer Cooksey, G. L., Weiss, C., Suarez, A., Fischer, M., Bonin, B. J., Jain, S., Langley, G. E., Park, B. J., Moulia, D., Benedict, R., Nguyen, N., & Han, G. S. (2020). Rapid Sentinel Surveillance for COVID-19 - Santa Clara County, California, March 2020. MMWR. Morbidity and Mortality Weekly Report, 69(14), 419-421. https://doi.org/10.15585/mmwr.mm6914e3
Zwald ML, et al. Rapid Sentinel Surveillance for COVID-19 - Santa Clara County, California, March 2020. MMWR Morb Mortal Wkly Rep. 2020 Apr 10;69(14):419-421. PubMed PMID: 32271724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid Sentinel Surveillance for COVID-19 - Santa Clara County, California, March 2020. AU - Zwald,Marissa L, AU - Lin,Wen, AU - Sondermeyer Cooksey,Gail L, AU - Weiss,Charles, AU - Suarez,Angela, AU - Fischer,Marc, AU - Bonin,Brandon J, AU - Jain,Seema, AU - Langley,Gayle E, AU - Park,Benjamin J, AU - Moulia,Danielle, AU - Benedict,Rory, AU - Nguyen,Nang, AU - Han,George S, Y1 - 2020/04/10/ PY - 2020/4/10/entrez PY - 2020/4/10/pubmed PY - 2020/4/11/medline SP - 419 EP - 421 JF - MMWR. Morbidity and mortality weekly report JO - MMWR Morb. Mortal. Wkly. Rep. VL - 69 IS - 14 N2 - On February 27, 2020, the Santa Clara County Public Health Department (SCCPHD) identified its first case of coronavirus disease 2019 (COVID-19) associated with probable community transmission (i.e., infection among persons without a known exposure by travel or close contact with a patient with confirmed COVID-19). At the time the investigation began, testing guidance recommended focusing on persons with clinical findings of lower respiratory illness and travel to an affected area or an epidemiologic link to a laboratory-confirmed COVID-19 case, or on persons hospitalized for severe respiratory disease and no alternative diagnosis (1). To rapidly understand the extent of COVID-19 in the community, SCCPHD, the California Department of Public Health (CDPH), and CDC began sentinel surveillance in Santa Clara County. During March 5-14, 2020, four urgent care centers in Santa Clara County participated as sentinel sites. For this investigation, county residents evaluated for respiratory symptoms (e.g., fever, cough, or shortness of breath) who had no known risk for COVID-19 were identified at participating urgent care centers. A convenience sample of specimens that tested negative for influenza virus was tested for SARS-CoV-2 RNA. Among 226 patients who met the inclusion criteria, 23% had positive test results for influenza. Among patients who had negative test results for influenza, 79 specimens were tested for SARS-CoV-2, and 11% had evidence of infection. This sentinel surveillance system helped confirm community transmission of SARS-CoV-2 in Santa Clara County. As a result of these data and an increasing number of cases with no known source of transmission, the county initiated a series of community mitigation strategies. Detection of community transmission is critical for informing response activities, including testing criteria, quarantine guidance, investigation protocols, and community mitigation measures (2). Sentinel surveillance in outpatient settings and emergency departments, implemented together with hospital-based surveillance, mortality surveillance, and serologic surveys, can provide a robust approach to monitor the epidemiology of COVID-19. SN - 1545-861X UR - https://www.unboundmedicine.com/medline/citation/32271724/Rapid_Sentinel_Surveillance_for_COVID_19___Santa_Clara_County_California_March_2020_ L2 - https://doi.org/10.15585/mmwr.mm6914e3 DB - PRIME DP - Unbound Medicine ER -