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Just curious if any states have protocols for what to do if a probable case (epi linked w/ appropriate symptoms) is tested and tests negative. Do you keep them as probable or remove them based on the negative? If you remove them, do you have a specific time period that negative test must occur? Any info would be greatly appreciated :) Thanks!
Comments & Events
maria del rosario
Here's what West Virginia is proposing (draft):
Confirmatory Testing to Rule Out Probable Cases
The interim position statement for COVID-19, interim-20-ID-01, entitled “Standardized Surveillance Case Definition and National Notification for 2019 Novel Coronavirus Disease (COVID-19)” created a standardized case definition for COVID-19 which included a “Confirmed” and a “Probable” case classification. The “Probable” case classification required that no confirmatory laboratory testing for COVID-19 was performed (e.g., a negative PCR result was not obtained for the case). The interim position statement did not provide clarification on an appropriate timeframe from illness onset date to confirmatory laboratory testing collection date to rule out a “Probable” case of COVID-19.
The purpose of this guidance is to help clarify the use of confirmatory laboratory testing performed for COVID-19 to rule out probable cases and provide a recommended timeframe for a negative confirmatory laboratory test for COVID-19 to rule out “Probable” cases of COVID-19. According to the CDC, the likelihood of recovering replication-competent virus declines after the onset of symptoms with no replication-competent virus being recovered beyond 10 days from symptom onset date for patients with mild to moderate COVID-19.
Based on this information, “Probable” cases of COVID-19 that receive a negative confirmatory laboratory test result for COVID-19 which was collected within 10 days from symptom onset date should be re-classified as “Not A Case” for surveillance purposes. It is important to emphasize that a surveillance case definition is used to quantify cases in a standardized way and is not meant to be used as a clinical diagnosis. Re-classifying a case from “Probable” to “Not A Case” does not imply that the case should not complete their quarantine or isolation and follow recommended public health actions. The case should also continue to follow their healthcare provider’s recommendations.
thank you,
maria
Notified 214 people
Steven Rekant (OR),EIS Officer
In Oregon, we are not using negative tests to remove people of the Presumptive/Probable category. It's partly driven by concerns about test sensitivity. It's far shorter and this piece is just mentioned in the footnote; the relevant section of our Investigative Guidelines is below.
Take care, Steve Rekant
Presumptive Case
A presumptive case is a person without a positive COVID-19 RT-PCR, NAAT, or antigen test result[1], with:
· An acute illness featuring at least two of the following: shortness of breath, cough, fever, new loss of smell or taste, radiographic evidence of viral pneumonia;
AND
· No more likely alternative diagnosis;
AND
· Within the 14 days before illness onset, lived in the same household or congregate setting, had close contact (see §7) with a confirmed case, or is identified as having been exposed in an outbreak.
[1] Even with a negative test, a person with an identified epi-link, compatible symptoms, and no more likely diagnosis is still considered a presumptive case.
Confirmatory Testing to Rule Out Probable Cases
maria
Take care,
Steve Rekant
Presumptive Case
[1] Even with a negative test, a person with an identified epi-link, compatible symptoms, and no more likely diagnosis is still considered a presumptive case.