Active Monitoring of Persons Exposed to Patients with Confirmed COVID-19 - United States, January-February 2020.

In December 2019, an outbreak of coronavirus disease 2019 (COVID-19), caused by the virus SARS-CoV-2, began in Wuhan, China (1). The disease spread widely in China, and, as of February 26, 2020, COVID-19 cases had been identified in 36 other countries and territories, including the United States. Person-to-person transmission has been widely documented, and a limited number of countries have reported sustained person-to-person spread.* On January 20, state and local health departments in the United States, in collaboration with teams deployed from CDC, began identifying and monitoring all persons considered to have had close contact† with patients with confirmed COVID-19 (2). The aims of these efforts were to ensure rapid evaluation and care of patients, limit further transmission, and better understand risk factors for transmission.

Use of tobacco retail permitting to reduce youth access and exposure to tobacco in Santa Clara County, California.

OBJECTIVE: To target youth smoking, the impact of a local tobacco retail permit was evaluated on the number and location of tobacco retailers, and on the level of enforcement and compliance with tobacco sales regulations from 2010 to 2012 within unincorporated Santa Clara County, California. METHODS: Geographic Information Systems (GIS) mapping of each of 36 tobacco retailers pre- and post-intervention, observational surveys of tobacco retail environments pre- and post-intervention, and post-intervention enforcement surveys to measure location of sales, level of enforcement action, and compliance with laws governing sale of tobacco products were conducted. RESULTS: Eleven (30.6%) of the initial 36 retailers selling tobacco at the start of the intervention stopped selling tobacco post intervention. Of these 11 retailers, one was within 500feet of another retailer, and three were within 1000feet of a K-12 school. Ten (91%) of the retailers who stopped selling tobacco were non-traditional retailers. CONCLUSION: An immediate reduction in the number of stores selling tobacco occurred following implementation of tobacco retail permitting. Post-implementation, all retailers who underwent compliance checks were in compliance with laws prohibiting sales of tobacco to minors. Compliance with laws governing the sale of tobacco has potential to reduce access and use of tobacco products by youth.

Enhanced contact investigations for nine early travel-related cases of SARS-CoV-2 in the United States.

Coronavirus disease 2019 (COVID-19), the respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and has since become pandemic. In response to the first cases identified in the United States, close contacts of confirmed COVID-19 cases were investigated to enable early identification and isolation of additional cases and to learn more about risk factors for transmission. Close contacts of nine early travel-related cases in the United States were identified and monitored daily for development of symptoms (active monitoring). Selected close contacts (including those with exposures categorized as higher risk) were targeted for collection of additional exposure information and respiratory samples. Respiratory samples were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction at the Centers for Disease Control and Prevention. Four hundred four close contacts were actively monitored in the jurisdictions that managed the travel-related cases. Three hundred thirty-eight of the 404 close contacts provided at least basic exposure information, of whom 159 close contacts had ≥1 set of respiratory samples collected and tested. Across all actively monitored close contacts, two additional symptomatic COVID-19 cases (i.e., secondary cases) were identified; both secondary cases were in spouses of travel-associated case patients. When considering only household members, all of whom had ≥1 respiratory sample tested for SARS-CoV-2, the secondary attack rate (i.e., the number of secondary cases as a proportion of total close contacts) was 13% (95% CI: 4-38%). The results from these contact tracing investigations suggest that household members, especially significant others, of COVID-19 cases are at highest risk of becoming infected. The importance of personal protective equipment for healthcare workers is also underlined. Isolation of persons with COVID-19, in combination with quarantine of exposed close contacts and practice of everyday preventive behaviors, is important to mitigate spread of COVID-19.