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A day after officials reported Shannon County's first confirmed case of COVID-19, public health figures announced a second case in that county, as well as newly confirmed cases in Howell and Texas counties.

Thursday afternoon, officials with the Shannon County Health Center took to social media to announce a person who is a contact of the first patient in the county to be confirmed to have the coronavirus also tested positive. The newly-confirmed patient is younger than 20, said officials.

Neither of the cases is travel-related, said officials, explaining that means the patients did not travel from an area with widespread community transmission. 

Shannon County officials announced on Wednesday that a 27-year-old woman who lives in the county tested positive for the virus. 

HIPAA laws do not allow location identification for population areas smaller than 20,000, officials explained, noting that they have authorization from the Missouri Department of Health and Senior Services to inform the county, but they are not allowed to narrow it down to any community or area of the county.
 
That same afternoon, the Howell County Health Department posted a statement on social media announcing the sixth confirmation of the virus in the county, the first to be made since April 16.

The patient, a Mtn. View resident, frequented several Mtn. View businesses between May 18 and Tuesday, while potentially contagious, according to health officials.

The patient was reportedly at Signal gas station, between 5 a.m. and 2:30 p.m. May 18, 10 p.m. May 18 to 6 a.m. May 19, 4 a.m. to 3 p.m. May 20, 5 a.m. to 2:30 p.m. May 21 and May 22, 5 a.m. to 1 p.m. Monday and 5 a.m. to 2:30 p.m. Tuesday, according to the health department.

Other visits reported: between 6:30 and 7 p.m. May 20, Dollar General; between 2:30 and 3:30 p.m. May 21, Walmart; and between 5 and 6 p.m. Saturday, Los Amigos. All times are approximate.

On Thursday morning, health officials with the Howell and Texas county health departments announced they are collaborating on a joint investigation and follow-up after a southern Texas County resident was diagnosed with COVID-19.

The patient has had connections to both counties, hence the joint investigation, said Howell County Health Department Administrator Chris Gilliam in a statement emailed Thursday morning.

This is the first Texas County resident to be diagnosed with the respiratory disease. A previously reported confirmation of coronavirus was attributed to the county, but that patient had not been in Texas County for some months and was, in fact, out of state, officials determined.

An investigation into businesses visited by the patient within the first 48 hours of symptoms, between May 22 and Tuesday, turned up a total of six business interactions, all in Howell County.

This patient was also at Signal gas station, officials reported, between 4 a.m. and 2:30 p.m. and 5 and 7 p.m. May 22, and between 2 a.m. and noon Tuesday. The patient also reportedly visited Porters Flower Shop in Mtn. View between noon and 1 p.m. Saturday, and Walmart in West Plains between 11:30 a.m. and noon Sunday.

All four patients patients are following public health guidance to isolate at home until symptoms are resolved, said health officials. They have each been notified of their positive test results, and their identities are being kept confidential.

Nurses are continuing to inform close contacts of the Mtn. View resident to alert them and ensure those who are potentially exposed are monitoring the development of symptoms and following health guidance to contain the spread. Close contacts of the Texas County resident have already been notified.

Those who visited the locations frequented by the patients are at a low risk for contracting COVID-19, but should monitor themselves for symptoms, said Gilliam, adding that there is no need to self-quarantine or isolate unless symptoms develop.

Shannon County officials noted that the first patient to be diagnosed with COVID-19 in that county did not have any unknown contacts in the 48 hours prior to developing symptoms, and began her quarantine immediately on the same day as taking the test. The second patient was already in isolation in the 48 hours before developing symptoms, they added. 

Anyone who develops symptoms of COVID-19 should contact their healthcare provider regarding testing and take all necessary precautions to avoid exposing others, said health officials.

"It is important that each and every one of us continue to practice basic preventative measures to help decrease the spread of illness," emphasized Gilliam. The measures include avoiding contact with people who are sick, covering coughs and sneezes, proper hand-washing, cleaning frequently used surfaces, wearing a mask while out in public and staying home when sick, he added.

County agencies continue to diligently monitor the COVID-19 situation and help protect the public health of the community, said officials.

6 p.m. May 28: This article has been updated to add Shannon County's second confirmed case, announced Thursday, and information from county officials pertaining to that case and the first, announced Wednesday.

5 p.m. May 28: This article has been updated to add the second confirmed case announced Thursday, and the information pertaining to that case.

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