Covid-19 Prevention Handbook (1/3)
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A Handbook of 2019-nCoV Pneumonia Control and Prevention

A Handbook of 2019-nCoV Pneumonia Control and Prevention

Chief Editor ZHOU WANG

Subeditor Wang Qiang 、Hu Ke

Hubei Science and Technology Press

Editor

(Preface to surname's brush painting)

Wang Qiang Wuhan University of Science and Technology

Wang Mengmei People's Hospital of Wuhan University

Xiang Xiaochen Wuhan University of Science and Technology

Li Gang Wuhan Center for Disease Control and Prevention

Zhang Yongxi, Zhongnan Hospital, Wuhan University

Chen Weimin, Zhongnan Hospital, Wuhan University

Chen Siyang Wuhan University of Science and Technology

Jin Xiaomao Wuhan Center for Disease Control and Prevention

Zhou Wang Wuhan Center for Disease Control and Prevention

Xiafen Hu Wuhan University of Science and Technology

Zhao Yang People's Hospital of Wuhan University

Hu ke People's Hospital of Wuhan University

Guo Kaiwen Wuhan University of Science and Technology

Jenna Wuhan University People's Hospital

About The Author

Zhou Wang, MD, Chief Physician (Level 2), Wuhan Center for Disease Control and Prevention.In 2005 and 2006, he was a senior visiting scholar at the University of Pennsylvania in the United States. In 2003, he was selected into the 213 Talent Program of Wuhan Municipal People's Government. In 2015, he was selected into the Huang He Talent Program of Wuhan Municipal Party Committee.Of huazhong university of science and technology and wuhan university, professor, director of Chinese association of STD prevention and control of AIDS, executive director of the preventive medicine association, hubei province, wuhan branch of Chinese preventive medical association vice President and secretary-general, STD AIDS society in wuhan city, director of the committee, the Chinese preventive medical journal and journal of virus disease in China communications editors, etc.

Ø Zhou Wang long engaged in professional work of epidemiology and control of infectious diseases, has successively undertaken by the national institutes of health, the bill and Melinda gates foundation, the national WeiJianWei and provincial WeiJianWei institutions funded research projects, scientific research achievements obtained the progress prize in science and technology of province and city four, as the first author or corresponding author has published more than 50, including more than 20 SCI/SSCI journals.

About The Author

Ø wang qiang, m.d., Ph.D., school of medicine, professor of wuhan university of science and technology.2015/2016 Visiting Scholar, MD Anderson Cancer Center, University of Texas, USA.Now he is also the standing member (secretary general) of the Tumor and Microecology Committee of the Chinese Anti-Cancer Association.Vice Chairman of Blood Branch of Rehabilitation Society of Chinese Anti-Cancer Association;Standing member of the Immunology Branch of China Association of Traditional Chinese Medicine, vice chairman of the Youth Committee;Standing member of the 10th Council of Hubei Immunology Society;Member of the 6th Committee of Microbiology and Immunology Branch of Hubei Medical Association.

wang qiang long engaged in infection, immunity and tumor microenvironment, Chinese university students AIDS prevention interventions work, successively undertaken by the Ministry of Education, provincial department and provincial education department and other agencies funded research projects, scientific research and technology progress prize provincial one, by the first author or corresponding author has published more than 20, including SCI/SSCI journals more than 10 papers, editor in chief of three textbooks.

About The Author

Ø hooker, () in hubei province people's hospital of wuhan university people's hospital of respiratory and critical care medicine 2. Professor, chief physician, doctoral supervisor.

Ø presided over by the national natural science fund project 4, the national key research and development plan on the surface of the chronic obstructive pulmonary disease diagnosis and treatment of complications and merging technology research, a corpus. He has published more than 100 papers as the first author or corresponding author.

Ø involved in hubei province since the infectious atypical pneumonia in 2003 all previous clinical treatment of emergent public health events.

Foreword

Novel coronavirus infection pneumonia epidemic has brought serious threat to people's health. Adhering to calm response, decisive decision, scientific treatment strategy is a magic weapon to ensure the victory of epidemic prevention and control.However, the prevention and control of such a sudden epidemic need the support of scientific knowledge and the participation of the public. Only by united efforts can we finally defeat the disease and control the epidemic.

"COVID - 19 prevention manual" to enhance the public and related professionals to COVID - 19 the understanding and the understanding, to guide individual prevention, to reduce the risk of transmission for the purpose, with concise words and clear pictures of the problems with professional COVID - 19 and doubt, both focus on the current focus of attention problems, and pay attention to solve specific details in the prevention, is now in urgent need of COVID - 19 to prevent the spread of books.

"COVID - 19 prevention manual" to enhance the public and related professionals to COVID - 19 the understanding and the understanding, to guide individual prevention, to reduce the risk of transmission for the purpose, with concise words and clear pictures of the problems with professional COVID - 19 and doubt, both focus on the current focus of attention problems, and pay attention to solve specific details in the prevention, is now in urgent need of COVID - 19 to prevent the spread of books.

Director of Wuhan Municipal Health Commission

In January, 2020

introduction

Since the middle of December, 2019, wuhan, China in the short term appeared with fever, fatigue, coughing, breathing disorders as the main symptoms of unexplained pneumonia cases, the government, the health administrative departments at all levels attach great importance to the rapid organization for disease control and prevention institutions, medical institutions and research institutes to carry out the investigation, treatment and collaborative research and quickly determine the pathogen of this kind of cases for will be coronavirus, the world health organization (WHO) identified and named 2019 - nCoV, the former is called COVID - 19 due to pneumonia.

In order to enhance the public and related professionals to COVID - 19 this new understanding and the understanding of the disease, to guide the individual prevention, reduce the risk of transmission, the centers for disease control and prevention in wuhan city rich experience of prevention and treatment of infectious diseases expert, pathogenic organisms and immune professional researchers, and a line 3 armour hospital clinical expert, emergency has compiled "COVID - 19 prevention manual". The book is divided into six parts: understanding the coronavirus, understanding the risk of transmission, early detection and treatment, personal hygiene protection, hygiene requirements in the workplace, and infectious disease related knowledge. It answers the public's questions in the process of fighting against Covid-19 in a well-illustrated and easy-to-understand way. As long as we work together, overcome difficulties and prevent them scientifically, we will be able to control the epidemic and spread of Covid-19.

Due to the hasty preparation of the time, the new disease related to the lack of cognitive, ax is a sense!

Covid-19 Prevention Handbook Writing Group

In January, 2020

catalogue

Understanding coronavirus and understanding the risk of transmission

Three early detection and early treatment of four personal health protection

Health of five places requires knowledge of infectious diseases

01 Recognize the coronavirus

Biological characteristics, pathogenicity, transmission routes, epidemic status

1. What are respiratory viruses?

Viruses associated with respiratory infection are viruses that invade the respiratory tract and proliferate in the epithelial cells of the respiratory tract, causing local infection of the respiratory tract or pathological changes in tissues and organs other than the respiratory tract.

2. What are the common respiratory viruses?

It mainly includes influenza viruses of orthomyxoviridae, parainfluenza viruses of paramyxoviridae, respiratory syncytial virus, measles virus, mumps virus, Hendra virus, Nipah virus and human metapneumovirus, rubella viruses of drymoviridae, rhinoviruses of small RNA viruses, SARS coronavirus of coronavirae, etc. In addition, adenovirus, reovirus, coxsackie virus and ECHO virus, herpes virus can also cause respiratory tract infections.

3. What is a coronavirus?

Coronavirus, for both single strand RNA virus is chain segment, belongs to the nest virus (nidovirales) coronavirus families (Coronaviridae) are coronavirus subfamily (Orthocoronavirinae), according to serotype and genomic characteristics coronavirus subfamily were divided into , beta, gamma and delta four genera. Coronaviruses are members of the Coronaviridae family (Coronaviridae). They get their name from the corolla shaped projections that protrude from the virus envelope.

4. What is the shape of the coronavirus?

Coronaviruses are enveloped, and the particles are round or oval, often pleomorphic, with a diameter of 50-200m.

5. What is the structure of a coronavirus?

S protein is located on the surface of the virus and forms a rod-like structure. As one of the main antigenic proteins of the virus, it is the main structure used for typing. N protein wraps the viral genome and can be used as diagnostic antigen. The understanding of physical and chemical properties of coronavirus mainly comes from the study of SARS-CoV and MERS-CoV.

6. How are coronaviruses classified?

Most coronaviruses infect animals. At present, coronaviruses isolated from humans mainly include common coronavirus 229E, OC43 and SARS coronavirus (SARS-CoV). Known to infect human coronavirus has six kinds: 229 e, of the genus  NL63, beta OC43, HKU1, the Middle East of the genus respiratory syndrome coronavirus (MERS - CoV) and associated coronavirus in patients with severe acute respiratory syndrome (SARS - CoV). The coronavirus isolated from the lower respiratory tract of patients with pneumonia of unknown cause in Wuhan is a novel coronavirus, named by WHO as 2019-NCoV.

The genome sequences of six known novel coronavirus (2019-NCoV) are almost identical, and in terms of gene sequence homology, the novel coronavirus is closer to SARS-CoV than to MERS-CoV. Novel coronavirus can now be placed in the genus β, which in evolutionary tree is close to, but not identical to, SARS-CoV and MERS-CoV.

7. Which wild animals can carry the coronavirus?

Many wild animals may carry pathogens and act as vectors for some infectious diseases. Civet cats, bats, bamboo rats, badgers, etc., are common hosts of coronavirus.

The outbreak of viral pneumonia in Wuhan has many similarities with the outbreak of SARS in Guangdong in 2002. Both occurred in winter, and both originated from contact with live animals traded in animal markets, and both were caused by unknown coronavirus.

Because the evolutionary neighbors and outgroups of novel coronavirus have been found in various bats, it is speculated that the natural host of novel coronavirus in Wuhan may also be bats. As was the case with the SARS coronavirus in 2002, novel coronavirus is likely to have an unknown intermediate host vector in transmission from bats to humans.

Do not eat wild animals or fresh food that has not been tested in quarantine, such as meat sold at roadside stalls, and do not risk it for the sake of "tasting".

8. How does a coronavirus move from animal to human?

The virus groups of novel coronavirus and SARS-CoV are both bat coronaviruses (HKU9-1), and many coronaviruses associated with human infection with coronaviruses are bat, and the natural host of many coronaviruses is bat. The bat is probably the original host of novel coronavirus from Wuhan, and through evolution and mutation, it has completed the bat-intermediate host-human transmission. However, there may be more intermediate hosts, from bats to humans, that have not yet been identified.

Pathways of coronaviruses from animals to humans and humans: contact transmission and droplet transmission.

9. Which coronaviruses cause pneumonia in humans?

HKU1、SARS-CoV、MERS-CoV、2019-nCoV:Can cause pneumonia in humans.

10. What is the resistance of coronavirus?

The coronavirus is sensitive to heat. For 30 minutes at 56℃, ether, 75% alcohol, chlorine-containing disinfectant, peracetic acid, chloroform and other lipid solvents can effectively inactivate the virus. Chloroxidine is not effective in inactivating the virus.

11. Do you know the pathogenicity of coronavirus?

Coronaviruses mainly infect adults and older children and cause the common cold and laryngitis. Some strains can also cause diarrhea in adults. The virus is transmitted by droplets and can also be transmitted by faecal-oral route. It is mainly popular in winter and spring. The average incubation period of the disease is 3-7 days.

To measure the severity of a virus, one looks at its fatality rate and the other looks at its infectivity. Compared with SARS, the 2019-NCOV is relatively mild in these two aspects. Novel coronavirus has been lethal, but the fatality rate has not been determined, but its high risk may be lower than SARS virus, in a state of control.

12. What is the immunity of coronavirus?

After the disease, the patient's immunity is not strong, unable to defend against the reinfection of the same virus.

13. Severe Acute Respiratory Syndrome -- SARS.

SARS- COV can cause severe acute respiratory syndrome (SARS). The main symptoms of SARS are fever, cough, headache, muscle pain and symptoms of respiratory infection. Most SARS patients heal or cure themselves, with a case fatality rate of about 14%, especially among people over 40 years of age or with underlying medical conditions such as coronary heart disease, diabetes, asthma and chronic lung disease.

14. Middle East Respiratory Syndrome (MERS) coronavirus - case fatality rate is higher than SARS.

MERS was a concentrated outbreak in Asia in 2015 and 2016, and bears too much resemblance to the SARS outbreak in 2003. Both are respiratory infections caused by a coronavirus, and the onset is relatively rapid. So what are the differences?

(1) They have different propagation speeds. In the more than two years between September 2012, when the first MERS case was identified, and May 2015, there were about 1,143 confirmed cases. Since the first case of SARS was discovered in 2003, the number of confirmed SARS cases in 32 countries and regions reached 8,422 in about six months.

(2) They are different in infectivity. It is generally believed that MERS does not spread easily from person to person, but SARS can spread rapidly from person to person.

(3) The harm is different. Although MERS is less infectious than SARS, it has a much higher fatality rate. The death rate among SARS confirmed cases is less than 10%; MERS has a mortality rate of nearly 40 percent, far higher than SARS.

15. What is novel coronavirus? Why does the virus spread?

The coronavirus causing the epidemic is a mutant novel coronavirus(genus β), designated by WHO as 2019- NCoV. On January 10, 2020, the first genome sequencing of the 2019-NCoV was completed, and the virus genome sequences of five samples were published successively.

Due to the antigenic mutation of the coronavirus, novel coronavirus was produced, and the population lacked immunity to the mutant virus strain, so the epidemic of Covid-19 could be caused.

02 Understand the risk of communication

Community - acquired pneumonia, source of infection, way of transmission, prevention

16. What is community-acquired pneumonia?

Community acquired pneumonia (CAP) refers to infectious parenchymal inflammation of the lung (including the alveolar wall, that is, lung interstitium in a broad sense) developed outside of the hospital, including pneumonia with pathogen infection with a defined incubation period and an average incubation period after hospitalization.

17. What are the clinical criteria for the diagnosis of community acquired pneumonia?

(1) Community incidence

(2) Pneumonia-related clinical manifestations:

Recent cough, expectoration, or exacerbation of existing respiratory disease, with or without purulent sputum/chest pain/dyspnea/hemoptysis;

fever;

Lung consolidation signs and/or wet rales;

WBC > 10×10^9/L or < 4×10^9/L, with or without neutrophil nuclei left shift.

(3) Imaging: Chest X-ray examination reveals new patchy invasive opacity, consolidation of lobes/segments, or interstitial changes, with or without pleural effusion. Any of the above 1-4 items plus imaging, excluding non-infectious disease can be diagnosed.

18. What pathogens cause common community-acquired pneumonia?

Bacteria are the main cause of community - acquired pneumonia. Streptococcal pneumonia is one of the most common bacterial pneumonia in the community. However, the most common pathogens that cause acute respiratory disease are viruses, or bacterial-viral infections. In particular, acute respiratory diseases caused by novel pathogens, such as novel coronavirus, could trigger epidemics or pandemics.

Pathogens: Mycoplasma pneumoniae and Streptococcus pneumoniae.

Others: Haemophilus influenzae, Chlamydia pneumoniae, Klebsiella pneumoniae and Staphylococcus aureus; Pseudomonas aeruginosa, Acinetobacter baumannii rare.

Special population: Gram-negative bacteria such as Klebsiella pneumoniae and Escherichia coli are more common.

The virus detection rate in ADULT CAP patients in China is 15%-34.9%, with influenza virus taking the first place, and others include parainfluenza virus, rhinovirus, adenovirus, human metapneumovirus, respiratory syncytial virus and coronavirus.

5.8%-65.7% of patients with positive virus tests may be infected with bacterial or atypical pathogens.

19. How does community-acquired pneumonia form an interpersonal cycle?

All pathogens that cause community-acquired pneumonia are theoretically at risk of human-to-human transmission. Pathways of pathogen transmission from the source of infection to the susceptible population: droplet transmission, contact transmission, airborne transmission.

Winter affected by climate and population movement (Spring Festival) and other factors, prone to respiratory infectious diseases local outbreak. Mainly through the patient cough, sneezing and other droplets directly spread.

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