The First Locally Acquired Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in a Healthcare Worker in the Paris Area

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To the Editor—An outbreak of 2019 novel coronavirus (2019-nCoV) has spread from Wuhan, China [1, 2]. On 3 January 2020, 6 cases were confirmed in France. We report the first locally acquired case of 2019-nCoV in a healthcare worker (HCW). The patient, a 53-year-old man, works as general practitioner, visiting up to 30–40 patients per day in the Paris area. On 23 January, he provided care to Chinese tourists with influenza-like illness. The patients, from Wuhan, were visiting Paris with a tour group traveling through Europe (Italy, Switzerland, and France) since 15 January. The 2 patients had no fever, little cough, and normal lung auscultation. The Taiwanese tour guide provided translation for the 2 patients and appeared to be asymptomatic. They left France on 25 January with the group. On 27 January, the Regional Health Agency informed the physician, who was asymptomatic and working without any respiratory precaution, that the tour guide had tested positive for 2019-nCoV in Taiwan. On 28 January, the physician presented with a sore throat and a 38°C fever but no respiratory signs. He self-medicated with amoxicillin and oseltamivir. On the 29 January, the patient was transferred to an isolation room in the dedicated unit of our department with a slight headache and myalgia. The physical examination was normal. The blood standard tests revealed only a white blood cell count of 3.5 giga/L. Nasopharyngeal swab and induced sputum were collected. A FilmArray Respiratory Panel 2 plus (Biomerieux) detected no respiratory pathogens. The viral RNA from 2019-nCoV was detected in both respiratory samples by the use of 2 reverse transcriptase–polymerase chain reaction (RT-PCR) assays, a first-line screening assay targeting the E gene and a confirmatory assay targeting the RdRp gene [3]. Additional specimens that were collected and tested during the following days showed other viral carriage sites (Table 1). Only paracetamol was prescribed. The 2019-nCoV RT-PCR signal in nasopharyngeal swab remained positive at the same level since diagnosis but no with clinical deterioration 12 days after the contact. Results of the 2018 Novel Coronavirus Real-time RT-PCR From 29 January to 4 February 2020 in Different Clinical Specimens From the First Healthcare Worker Infected in France Ct values were obtained with real-time RT-PCR targeting the E gene, as previously described [3]. Abbreviations: Ct, crossing threshold; NT, not tested; RT-PCR, reverse transcriptase–polymerase chain reaction; 2019-nCoV, 2019 novel coronavirus. Results of the 2018 Novel Coronavirus Real-time RT-PCR From 29 January to 4 February 2020 in Different Clinical Specimens From the First Healthcare Worker Infected in France Ct values were obtained with real-time RT-PCR targeting the E gene, as previously described [3]. Abbreviations: Ct, crossing threshold; NT, not tested; RT-PCR, reverse transcriptase–polymerase chain reaction; 2019-nCoV, 2019 novel coronavirus. Occurrence of further contamination and management among other tour group members are unknown. French Public Health Services focused on contact tracing to avoid secondary cases among patients visited by the physician. Fortunately, to date, none of the tested contacts were found to be positive for 2019-nCoV. This case report confirms the risk of transmission of 2019-nCoV to HCWs in France, as already evidenced in Wuhan where 3.6% of the first 417 cases were HCWs [4]. We strongly recommend that all HCWs use contact and respiratory precautions when visiting patients with respiratory symptoms and/or flu-like illness in all areas with presumed ongoing community transmission of 2019-nCoV. Acknowledgments. The authors thank the patient, the nurse, and the clinical staff of the Infectious Diseases and Virology Departments of Pitié-Salpêtrière Hospital who provided care for the patient. Potential conflicts of interest. A.-G. M. reports grants and personal fees from ViiV Healthcare, grants and personal fees from Gilead, grants and personal fees from Merck Sharp & Dohme (MSD), and grants and personal fees from Janssen, outside the submitted work; V. C. reports grants and personal fees from ViiV Healthcare, grants and personal fees from Gilead, grants and personal fees from MSD, and grants and personal fees from Janssen, outside the submitted work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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