A majority of U.S. states have rejected new Trump administration COVID-19 testing guidance in an extraordinary rebuke of the nation's top agency for disease prevention, according to officials at state health agencies and public statements reviewed by Reuters.

At least 33 states continue to recommend testing people who have been exposed to COVID-19 and have no symptoms, spurning guidance published by the U.S. Centers for Disease Control and Prevention (CDC) this week that said testing may be unnecessary. Sixteen states did not immediately respond to requests for comment and North Dakota said it had not made a decision.

Among the states breaking with the federal government are conservative-leaning Texas, Oklahoma and Arizona.