Interim Criteria to Guide Testing of
Persons Under Investigation (PUIs)
for Coronavirus Disease 2019 (COVID-19)
To provide information about what’s happening with COVID-19 in Texas, public
health laboratories will use the following criteria to prioritize testing. Some
commercial laboratories have testing available for situations that don’t meet these
criteria explicitly.
Clinical Features

&

Epidemiologic Risk

Fever or signs/symptoms of lower
respiratory illness (e.g., cough or
shortness of breath)

AND

Any person, including health care
workers 2, who has had close
contact 3 with a laboratoryconfirmed 4 COVID-19 patient within 14
days of symptom onset

Fever1 and signs/symptoms of lower
respiratory illness (e.g., cough or
shortness of breath) 5

AND

A history of travel from affected
geographic areas 6 (see below) within 14
days of symptom onset
OR
An individual(s) with risk factors that
put them at higher risk of poor
outcomes 7

Fever1 and signs/symptoms of lower
respiratory illness (e.g., cough or
shortness of breath) requiring
hospitalization5

AND

No source of exposure has been
identified

1

Fever may be subjective or confirmed.
For healthcare personnel, testing may be considered if there has been exposure to a
person with suspected COVID-19 without laboratory confirmation. Because of their often
extensive and close contact with vulnerable patients in healthcare settings, even mild signs
and symptoms (e.g., sore throat) of COVID-19 should be evaluated among potentially
exposed healthcare personnel. Additional information is available in CDC’s Interim U.S.
Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with
Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019
(COVID-19).
1
2

Version 5.0 – Released 3/11/2020

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 3

Close contact is defined as—
a) being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged
period of time; close contact can occur while caring for, living with, visiting, or sharing a
healthcare waiting area or room with a COVID-19 case,
– or –
b) having direct contact with infectious secretions of a COVID-19 case (e.g., being
coughed on).

If such contact occurs while not wearing recommended personal protective equipment (PPE)
(e.g., gowns, gloves, National Institute for Occupational Safety and Health (NIOSH)certified disposable N95 respirator, eye protection), criteria for PUI consideration are met.
Additional information is available in CDC’s updated Interim Infection Prevention and
Control Recommendations for Patients with Confirmed COVID-19 or Persons Under
Investigation for COVID-19 in Healthcare Settings.
Data to inform the definition of close contact are limited. Considerations when assessing
close contact include the duration of exposure (e.g., longer exposure time likely increases
exposure risk) and the clinical symptoms of the person with COVID-19 (e.g., coughing likely
increases exposure risk as does exposure to a severely ill patient). Special consideration
should be given to healthcare personnel exposed in healthcare settings as described in
CDC’s Interim U.S. Guidance for Risk Assessment and Public Health Management of
Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with
COVID-19.
4
Documentation of laboratory confirmation of COVID-19 may not be possible for travelers
or persons caring for COVID-19 patients in other countries.
5
Clinicians are strongly encouraged to test for other causes of respiratory illness (e.g.,
influenza).
6
Affected areas are defined as geographic regions where sustained community transmission
has been identified. Relevant affected areas will be defined as a country with at least a CDC
Level 2 Travel Health Notice. See all COVID-19 Travel Health Notices. It may also include
geographic regions within the United States where documented community transmission
has been identified.
7
Other symptomatic individuals such as, older adults (age ≥ 65 years) and individuals with
chronic medical conditions and/or an immunocompromised state that may put them at
higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive
medications, chronic lung disease, chronic kidney disease).

Version 5.0 – Released 3/11/2020

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