The document provides background information on coronaviruses and the 2019 novel coronavirus (2019-nCoV) outbreak that began in Wuhan, China in late 2019. It discusses coronaviruses in general, describing their structure and how some have evolved to infect humans. It then summarizes details about the initial 2019-nCoV outbreak cases linked to a seafood market, the virus's origins in bats and possible intermediate hosts, its spread between humans, and global responses to the outbreak.
INTRODUCTION OF COVID-19, ORIGIN OF COVID-19, STRUCTURE OF COVID-19, CAUSES OF CORON VIRUS, SYMPTOMS OF COVID-19, TYPICAL SYMPTOMS OF COVID-19, MODE OF TRANSMISSION, PEOPLE WHI ARE AT HIGHER RISK, WHY COVID-19 IS SAID T BE AS THE PANDEMIC BY WHO?, PREVENTION, WHAT TO DO, WHAT NOT TO DO, MYTHS AND FACTS OF COVID-19 SPREADING, SOME OTHER CONSEQUENCES OF COVID-19, MOST IMPORTANT POINTS OF COVID-19, COVID-19 VACCINES INTRODUCTION, TYPES OF VACCINES , COVAXIN, COVISHIELD, COVID VACCINE REGISTERATION, WHO CAN REGISTER, WHO SHOULDNT TAKE VACCINE SHOTS, STEP BY STEP GUIDE FOR REGISTERATION, COMPARISON BETWEEN COVAXIN AND COVISHIELD,
In 1743, when disease was presumed to be astral in origin, European newspapers reported on a contagious influence (influenza in Italian) that was being visited on the citizens of Rome. Two hundred years later, Wilson Smith and colleagues would isolate an influenza A virus, one of the members of the orthomyxovirus family. Swine influenza virus (SIV) or S-OIV (swine-origin influenza virus) is any strain of the influenza family of viruses that is endemic in pigs. As of 2009, the known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2, and H2N3. Swine influenza (also called Pig influenza, swine flu, hog flu and pig flu) is an infection by any one of several types of swine influenza virus. In all, 50 cases are known to have occurred since the first report in medical literature in 1958, which have resulted in a total of six deaths. Of these six people, one was pregnant, one had leukemia, one had Hodgkin disease and two were known to be previously healthy. Despite these apparently low numbers of infections, the true rate of infection may be higher, since most cases only cause a very mild disease, and will probably never be reported or diagnosed. This article presents the scenario of the 2009 H1N1 influenza, popularly known as “swine flu” and the data from inpatient admissions in Indraprastha Apollo Hospitals, Delhi, for the duration October 2009 to January 2010.
INTRODUCTION OF COVID-19, ORIGIN OF COVID-19, STRUCTURE OF COVID-19, CAUSES OF CORON VIRUS, SYMPTOMS OF COVID-19, TYPICAL SYMPTOMS OF COVID-19, MODE OF TRANSMISSION, PEOPLE WHI ARE AT HIGHER RISK, WHY COVID-19 IS SAID T BE AS THE PANDEMIC BY WHO?, PREVENTION, WHAT TO DO, WHAT NOT TO DO, MYTHS AND FACTS OF COVID-19 SPREADING, SOME OTHER CONSEQUENCES OF COVID-19, MOST IMPORTANT POINTS OF COVID-19, COVID-19 VACCINES INTRODUCTION, TYPES OF VACCINES , COVAXIN, COVISHIELD, COVID VACCINE REGISTERATION, WHO CAN REGISTER, WHO SHOULDNT TAKE VACCINE SHOTS, STEP BY STEP GUIDE FOR REGISTERATION, COMPARISON BETWEEN COVAXIN AND COVISHIELD,
In 1743, when disease was presumed to be astral in origin, European newspapers reported on a contagious influence (influenza in Italian) that was being visited on the citizens of Rome. Two hundred years later, Wilson Smith and colleagues would isolate an influenza A virus, one of the members of the orthomyxovirus family. Swine influenza virus (SIV) or S-OIV (swine-origin influenza virus) is any strain of the influenza family of viruses that is endemic in pigs. As of 2009, the known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2, and H2N3. Swine influenza (also called Pig influenza, swine flu, hog flu and pig flu) is an infection by any one of several types of swine influenza virus. In all, 50 cases are known to have occurred since the first report in medical literature in 1958, which have resulted in a total of six deaths. Of these six people, one was pregnant, one had leukemia, one had Hodgkin disease and two were known to be previously healthy. Despite these apparently low numbers of infections, the true rate of infection may be higher, since most cases only cause a very mild disease, and will probably never be reported or diagnosed. This article presents the scenario of the 2009 H1N1 influenza, popularly known as “swine flu” and the data from inpatient admissions in Indraprastha Apollo Hospitals, Delhi, for the duration October 2009 to January 2010.
Everything we need to know about COVID-19PrincessExtra
These slides is uploaded for information and as a partial requirement of Philippine Women's University in Master of Nursing (MAN); Subject: Nursing Practicum
Influenza a emergency prepardness for healthcare facilitiesMoustapha Ramadan
The data presented are per 4th of March 2017 and subject to changes.
The presentation aims to provide the basic infection control requirement for healthcare facilities during large influenza epidemic or pandemic
this ppt is on corona virus. in this ppt u will read about that what is corona from where does it started and where it ended, what are the symptoms and precautions of corona virus, and abt vaccines also.
corona is a pandemic disease in the world so many people are died because of this disease, it's not coming in a particular structure. it's having a different type of structure . how to prevent this disease maintain social distance, maintain hand hygiene, wear masks .nowady vaccines are available covishield ,covaxin, Pfizer, sputnik vaccine etc...this mainly helpful to prevent the corona
A review on COVID-19, enlist all the details and information that i know about the current pandemic. i hope you found it informative. i am B.pharm student and currently searching for good job in Pharma Sector. if you want more presentation on any topic then i will deliver it to you, just take a step ahead and make a call on my phone number or you can whatsapp me. I always here to help.
Contact No. 8279242736
E.mail i'd : jain.gaurav402@gmail.com
The new corona virus is a respiratory virus which spreads primarily through droplets generated when an infected person coughs or sneezes, or through droplets of saliva or discharge from the nose. To protect yourself, clean your hands frequently with an alcohol-based hand rub or wash them with soap and water.
Influenza is comonly referred to as flu is an infectious viral disease caused by RNA Virus of the family Ortho-Myxoviridae (the Influenza Virus), that affect bird and mammals.
Common symptoms are Chills, fever, sorethroat, muscle pain, severe headache, coughing, fatigue and general discomfort.
Although confused with other influenza like illnesses, especially the common cold, influenza is a more severe disease.
Everything we need to know about COVID-19PrincessExtra
These slides is uploaded for information and as a partial requirement of Philippine Women's University in Master of Nursing (MAN); Subject: Nursing Practicum
Influenza a emergency prepardness for healthcare facilitiesMoustapha Ramadan
The data presented are per 4th of March 2017 and subject to changes.
The presentation aims to provide the basic infection control requirement for healthcare facilities during large influenza epidemic or pandemic
this ppt is on corona virus. in this ppt u will read about that what is corona from where does it started and where it ended, what are the symptoms and precautions of corona virus, and abt vaccines also.
corona is a pandemic disease in the world so many people are died because of this disease, it's not coming in a particular structure. it's having a different type of structure . how to prevent this disease maintain social distance, maintain hand hygiene, wear masks .nowady vaccines are available covishield ,covaxin, Pfizer, sputnik vaccine etc...this mainly helpful to prevent the corona
A review on COVID-19, enlist all the details and information that i know about the current pandemic. i hope you found it informative. i am B.pharm student and currently searching for good job in Pharma Sector. if you want more presentation on any topic then i will deliver it to you, just take a step ahead and make a call on my phone number or you can whatsapp me. I always here to help.
Contact No. 8279242736
E.mail i'd : jain.gaurav402@gmail.com
The new corona virus is a respiratory virus which spreads primarily through droplets generated when an infected person coughs or sneezes, or through droplets of saliva or discharge from the nose. To protect yourself, clean your hands frequently with an alcohol-based hand rub or wash them with soap and water.
Influenza is comonly referred to as flu is an infectious viral disease caused by RNA Virus of the family Ortho-Myxoviridae (the Influenza Virus), that affect bird and mammals.
Common symptoms are Chills, fever, sorethroat, muscle pain, severe headache, coughing, fatigue and general discomfort.
Although confused with other influenza like illnesses, especially the common cold, influenza is a more severe disease.
Some quick facts and numbers on Coronavirus (COVID-19) Slide Marvels
We pulled together some quick facts on Coronavirus.
Slide Marvels is a leading Presentation Design Company having experience of many years. We are a professional team of presentation designers who have already worked in major consulting firms like McKinsey & Co., Boston Consulting Group and Deloitte to mentioned some of them.
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Corona viruses are a group of viruses that infect human & birds. Human corona virus is enveloped, single stranded, positive sense RNA virus. Only seven strain of corona virus are infect man, in which four are circulating in human population.
Novel corona virus 2019 (nCoV2019) is a newly identified human corona virus that has 94% similarity of SARS corona virus. The outbreak of this virus was reported to on 31 December, 2019. The WHO declared the outbreak as a public health emergence of international concern on 23 January. prevention is better than cure.
No vaccine is available.
There is no vaccine available to prevent this infection,
Travel-related infectious diseases on the rise
International travel has an important role in the transmission of emerging and re-emerging infectious diseases across geographical areas.
Since 1980, the world has been threatened by different waves of emerging disease epidemics.
In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries.
It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment.
As many as 43%–79% of travelers to low- and middle-income countries become ill with a travel-related health problem.
Although most of these illnesses are mild, some travelers become sick enough to seek care from a health care provider.
Corona virus was first identified as a cause of the common cold in 1960. Until 2002, the virus was considered a relatively simple, nonfatal virus.Over the last three decades there have been three attacks of three different coronaviruses, SARS-CoV, MERS CoV and the recent one 2019 novel coronavirus (2019-nCoV).
Before March 2020, many people saw pandemics as a thing of the past. Then came COVID-19. Scientists still do not know exactly where the virus that caused it — SARS-CoV-2 — came from, but it soon reached almost every country worldwide. Over 2 years, the virus has evolved, producing several variants. In this Special Feature, we look at the evolution of SARS-CoV-2 and ask what lessons scientists have learned.
PinterestAlthough having two glasses of wine may seem innocuous, experts say some leading brands contain more sugar than recommended. Peter Meade/Getty Images
• Two glasses of some wines contain more than the recommended daily limit of sugar and more calories than a hamburger.
• However, alcohol is exempt from food and drink labeling rules, so consumers are mostly unaware of calorie and sugar loads.
• Health experts are pushing for clear nutritional labeling on alcoholic products to help reduce sugar and alcohol consumption.
The Alcohol Health Alliance UK (AHA), representing over 60 health organizations, recently commissioned an independent laboratory to test 30 bottles of red, rose, white, sparkling, and fruit wines sold in the United Kingdom for sugar content.
The resulting analysis, which appears on the AHA’s website, revealed a “wide variation of sugar and calories between products.”
Before March 2020, many people saw pandemics as a thing of the past. Then came COVID-19. Scientists still do not know exactly where the virus that caused it — SARS-CoV-2 — came from, but it soon reached almost every country worldwide. Over 2 years, the virus has evolved, producing several variants. In this Special Feature, we look at the evolution of SARS-CoV-2 and ask what lessons scientists have learned.
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, in the Hubei Province of China. It is rapidly spreading, resulting in an epidemic throughout china, followed by an increasing number of cases in other countries throughout the world. In February 2020, the WHO designated the disease COVID 19, which stands for corona viruses 2019. The virus that causes COVID 19 is designated severe acute respiratory syndrome coronavirus 2 SARS COV 2 previously, it was referred to as 2019 nCoV. Anushka Bharti | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandul "COVID-19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46439.pdf Paper URL : https://www.ijtsrd.com/pharmacy/pharmaceutics/46439/covid19/anushka-bharti
Similar to Novel corona virus 2019 (2019 - nCov) (20)
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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9. Human coronaviruses were first identified in the mid-1960s, are so
named because of the crown-like appearance of their virus particles
when seen under an electron microscope (corona, meaning crown).
Coronaviruses are a diverse group of viruses that infect and cause
disease in humans and other animals.
10. Coronaviruses are large, enveloped, positive-strand RNA viruses that
be divided into 4 genera: alpha, beta, delta, and gamma, of which alpha
and beta CoVs are known to infect humans.
Four HCoVs (HCoV 229E, NL63, OC43, and HKU1) are endemic globally
and account for 10% to 30% of upper respiratory tract infections in
adults.
11. Coronavirus Infections—More Than Just the Common Cold
Human coronaviruses (HCoVs) have long been considered inconsequential
pathogens, causing the “common cold” in otherwise healthy people.
Until recently, HCoVs received relatively little attention due to their mild
phenotypes in humans.
12. However, in the 21st century, 2 highly pathogenic HCoVs—severe acute
respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory
syndrome coronavirus (MERS-CoV) — emerged from animal reservoirs to
cause global epidemics with alarming morbidity and mortality.
In December 2019, yet another pathogenic HCoV, 2019 novel coronavirus
(2019-nCoV), was recognized in Wuhan, China, and has caused serious
illness and death.
13.
14.
15. Coronaviruses are ecologically diverse with the greatest variety seen in
bats, suggesting that they are the reservoirs for many of these viruses.
Peridomestic mammals may serve as intermediate hosts, facilitating
recombination and mutation events with expansion of genetic diversity.
16.
17.
18. Coronaviruses are a family of viruses causing infection in humans and a
variety of animals including birds and mammals such as camels, cats
and bats.
When animal coronaviruses evolve, infect people and then spread
between humans, it can lead to outbreaks such as what happened with
MERS-CoV and SARS.
19. Several known coronaviruses are circulating in animals that have not
yet infected humans.
To date, seven coronaviruses have been shown to also infect and cause
illness in humans.
20. People around the world commonly get infected with human
coronaviruses 229E, NL63, OC43, and HKU1.
Sometimes coronaviruses that infect animals can evolve and make
people sick and become a new human coronavirus.
Three recent examples of this are 2019-nCoV, SARS-CoV, and MERS-CoV.
21. In the case of SARS, the virus jumped from bats to civet cats before
gaining the ability to infect humans. In the case of MERS, camels
served as the intermediate host.
32. Background
The current outbreak of the 2019-nCoV virus started in Wuhan City,
Hubei Province, China.
While the first cases were reported as early as December 8, 2019, the
outbreak gained global attention on December 31, 2019, when the
World Health Organization (WHO) was alerted to “several cases of
pneumonia” by an unknown virus.
33. The new virus was soon identified as a novel corona virus and named
2019-nCOV.
The 2019-nCoV identified in China is a new strain of coronavirus that
has not been previously identified in humans.
It belongs to the family of viruses that include the common cold and
viruses such as SARS and MERS.
48. In the case of 2019-nCoV outbreak, reports state that most of the first group
of patients hospitalized were workers or customers at a local seafood
wholesale market which also sold processed meats and live consumable
animals .
The study of the genetic code of 2019-nCoV reveals that the new virus is most
closely related to two bat SARS-like coronavirus samples from China
49. "Bats being the native host of the Wuhan CoV (coronavirus) would be the
logical and convenient reasoning, though it remains likely there was
intermediate host(s) in the transmission cascade from bats to humans,“
When the researchers performed a more detailed bioinformatics analysis
of the sequence of 2019-nCoV, it suggests that this coronavirus might
come from snakes (snake is the most probable wildlife animal reservoir).
50. From bats to snakes
Snakes often hunt for bats in wild. Reports indicate that snakes were
sold in the local seafood market in Wuhan, raising the possibility that
the 2019-nCoV might have jumped from the host species — bats — to
snakes and then to humans at the beginning of this coronavirus
outbreak
51. The novel corona virus, is likely originated in a wet market in the city of
Wuhan.
The markets put shoppers, vendors, and live and dead animals in close
proximity, which raises the risk of a disease outbreak, since corona
viruses are zoonotic diseases (meaning they can jump from animals to
people).
52.
53.
54. Craze for exotic meat
The food market where the deadly virus surfaced offered a range of
exotic wildlife for sale, including live foxes, crocodiles, wolf puppies,
giant salamanders, snakes, rats, peacocks, porcupines, camel meat
other game.
Authorities believe the virus likely came from "wild animals at the
seafood market" .
55. Many exotic species are still widely consumed in China or other Asian
countries where they are considered a delicacy - like the civet or some
rats or bats - or for purported health benefits unproven by science.
Severe Acute Respiratory Syndrome, or SARS, was linked to Chinese
consumption of civet meat.
The 2019-nCoV outbreak is another reminder that people should limit
the consumption of wild animals to prevent zoonotic infections.
56. First SARS, now the Wuhan coronavirus. Here’s why China should ban its
wildlife trade forever.
Both coronaviruses are linked to live animal markets, where sick,
injured and dying animals are sold as exotic foods but end up
transmitting disease.
For too long, wildlife traders have been allowed to hide behind empty
claims of medicine or conservation. It’s time to ban the unsavoury trade
permanently.
57.
58.
59.
60.
61.
62. The Huanan Seafood Wholesale Market in Wuhan, closed on January 1, is thought to be ground
zero in the spread of the deadly coronavirus named 2019-nCoV.
63.
64.
65. It's being passed between humans
The WHO said that it believed an animal source was the "primary source"
of the outbreak, and Wuhan authorities identified a seafood market as
the centre of the epidemic.
There was evidence the virus is now passing from person to person, without
any contact with the now-closed market.
84. TheWHO defines a global emergency — formally, a Public Health Emergency
of International Concern — as “an extraordinary event which is determined
to constitute a public health risk to other States through the international
spread of disease and to potentially require a coordinated international
response.”
Despite the emergency declaration, the WHO is not recommending any
restrictions on travel or trade at this time.
Countries should implement evidence-based public health policies, combat
misinformation, share data, and work together to stop the spread of the virus
94. Human to human transmission has been confirmed. Researchers
and public health officials determine how contagious a virus is by
calculating a reproduction number, or R0.
The R0 is the average number of other people that one infected
person will infect, in a completely non-immune population.
The World Health Organization said that the preliminary R0
(reproduction number) estimate is 1.4 to 2.5, meaning that every
person infected could infect between 1.4 and 2.5 people.
95.
96. Person-to-person spread of 2019-nCoV is occurring. Chinese officials
report that sustained person-to-person spread in the community is
occurring in China.
Person-to-person spread in the United States has not yet been
detected, but it’s likely to occur to some extent.
97.
98.
99. "An initial first impression is that this is significantly milder than
SARS," "That's reassuring. On the other hand, it may be more
transmissible than SARS, at least in the community setting.“
For now, 2019-nCoV appears to have a lower fatality rate than the
SARS virus, but it is certainly appears to be spreading quicker.
100.
101. How does it compare with SARS or MERS?
MERS was first identified in Saudi Arabia in 2012, and around 34% of people
reported as infected with the virus have died (858 of 2494 cases). Its R0 is less
than one.
The SARS outbreak of 2002-03led to 8098 identified cases and 774 deaths
(9.6%). It has an R0 of 2-5.7
The good news is that the data to date suggest that this virus may have a lower
mortality than SARS
102.
103. Incubation Period of 2019-nCoV
1-14 days after exposure (Most cases remain asymptomatic during this
period)
The virus has been noted to have a long incubation period of 1-14 days,
with patients remaining asymptomatic until the occurrence of the
disease.
China has confirmed human-to-human transmission, and said the virus is
infectious during its 1-14 day incubation period -- in other words, before
the first symptoms appear.
107. Risk Factors of 2019-nCoV
From the data collected by the CDC, the persons at risk are:`
1. Elderly persons above the age of 50 persons with underlying diseases
like diabetes, Parkinson’s disease, cardiovascular diseases.
2. Demographically, it can also be stated that the persons living in China
around Wahun town are most at risk, especially those working&
shopping from Animal markets within the localities; and persons
traveling into and out of Wahun.
3. Hospital-acquired infection- Health care workers caring for patients with
the 2019-nCoV
108.
109.
110.
111.
112.
113.
114. The epidemiological and clinical criteria that should prompt laboratory
testing of suspected cases of 2019-nCoV. The criteria include:
Epidemiological criteria Clinical criteria
Any person with travel-history to Wuhan City,
China in the 14 days before the onset of illness
Any person with clinical symptoms compatible
with severe acute respiratory infection seeking
healthcare or admitted to hospital with clinical
or radiological evidence of pneumonia
(or) Any person being in close contact with a
laboratory-confirmed case of 2019-nCoV in the
14 days before the onset of illness
(or) Any person with fever or recent history of
fever (>=38°C) and acute respiratory infection
(sudden onset of respiratory infection with one
or more of the following symptoms: shortness of
breath, cough or sore throat)
115.
116. Criteria to initiate testing for 2019-nCoV
Any person fulfilling the criteria for a suspect case should be tested for
2019-nCoV. The laboratory test should be initiated immediately.
it is likely that respiratory specimens collected early after symptoms’
onset would yield higher virus concentrations.
Rapid collection and testing of appropriate specimens from suspected
cases is a priority.
117. Samples to be collected
1. Respiratory samples (nasopharyngeal and oropharyngeal swab in
ambulatory patients and sputum (if produced) and/or
endotracheal aspirate or bronchoalveolar lavage in patients with more severe
respiratory disease).
2. Serum for serological testing, acute sample and convalescent sample (this
is additional to respiratory materials and can support the identification of the
true agent, once serologic assay is available).
118. Recommendations for specimen collection Lower respiratory specimens likely
have a higher diagnostic value than upper respiratory tract specimens for
detecting 2019-nCoV infection.
If patients do not have signs or symptoms of lower respiratory tract disease
or if specimen collection for lower respiratory tract disease is clinically
indicated but the collection is not possible, upper respiratory tract
specimens such as a nasopharyngeal aspirate or combined nasopharyngeal and
and oropharyngeal swabs should be collected.
119. Patients that meet the case definition for suspected 2019- nCoV
should be screened for the virus with RT-PCR.
If case management requires, screen also for other common causes of
respiratory illness according to local guidelines.
As coinfections can occur, all patients that meet the case definition
should be tested for 2019-nCoV regardless of whether a conventional
respiratory pathogen is found.
120. If initial testing is negative in a patient who is strongly suspected to have
2019-nCoV infection, the patient should be resampled and specimens
collected from multiple respiratory tract sites (sputum, endotracheal
aspirate).
A single negative test result, particularly if this is from an upper respiratory
tract specimen, does not exclude infection.
Repeat sampling and testing, lower respiratory specimen is strongly
recommended in severe or progressive disease.
121. Remarks:
Use appropriate PPE for specimen collection (droplet and contact
precautions for URT specimens; airborne precautions for LRT specimens).
When collecting URT samples, use viral swabs (sterile Dacron or rayon,
not cotton) and viral transport media. Do not sample the nostrils or
tonsils.
In a patient with suspected novel coronavirus, especially with pneumonia
or severe illness, a single URT sample does not exclude the diagnosis, and
additional URT and LRT samples are recommended.
122. Remarks:
LRT (vs. URT) samples are more likely to be positive and for a longer
period.
Clinicians may elect to collect only LRT samples when these are readily
available (for example, in mechanically ventilated patients).
Sputum induction should be avoided due to increased risk of
increasing aerosol transmission.
123. Remarks:
Dual infections with other respiratory viral infections have been found in
SARS and MERS cases.
Both URT and LRT specimens can tested for other respiratory viruses,
such as influenza A and B (including zoonotic influenza A), respiratory
syncytial virus, parainfluenza viruses, ect.
LRT specimens can also be tested for bacterial pathogens, including
Legionella pneumophila.
124. In hospitalized patients with confirmed nCoV infection, repeat URT and
LRT samples should be collected to demonstrate viral clearance.
The frequency of specimen collection will depend on local circumstances
but should be at least every 2 to 4 days until there are two consecutive
negative results (both URT and LRT samples if both are collected) in a
clinically recovered patient at least 24 hours apart.
125.
126.
127.
128.
129.
130.
131.
132.
133. Clinical management of severe acute respiratory infection when
novel coronavirus (2019-nCoV) infection is suspected
1. Triage: recognize and sort all patients with SARI associated with 2019-
nCoV infection at first point of contact with health care system (such as
the emergency department).
Consider 2019-nCOV as a possible etiology of SARI under certain
conditions
Triage patients and start emergency treatments based based on disease
severity.
134. Remarks
2019-nCoV infection may present with mild, moderate, or severe illness; the
latter includes severe pneumonia, ARDS,sepsis and septic shock.
Early recognition of suspected patients allows for timely initiation of IPC
Early identification of those with severe manifestations allows for immediate
optimized supportive care treatments and safe, rapid admission (or referral)
to intensive care unit according to institutional or national protocols.
135. 2. Immediate implementation of appropriate IPC measures
IPC is a critical and integral part of clinical management of patients and
should be initiated at the point of entry of the patient to hospital (typically
the Emergency Department).
Standard precautions should always be routinely applied in all areas of
health care facilities.
Standard precautions include hand hygiene; use of PPE to avoid direct
contact with patients’ blood, body fluids,secretions (including respiratory
secretions) and non-intact skin.
Standard precautions also include prevention of needle-stick or sharps
safe waste management; cleaning and disinfection of equipment; and
cleaning of the environment.
150. 3. Early supportive therapy and monitoring
Give supplemental oxygen therapy immediately to patients with SARI and
respiratory distress, hypoxaemia, or shock.
Remarks: Initiate oxygen therapy at 5 L/min and titrate flow rates to reach target
SpO2 ≥90% in non-pregnant adults and SpO2 ≥92-95 % in pregnant patients.
Children with emergency signs (obstructed or absent breathing, severe
respiratory distress, central cyanosis, shock, coma or convulsions) should receive
oxygen therapy during resuscitation to target SpO2 ≥94%; otherwise, the target
SpO2 is ≥90%.
All areas where patients with SARI are cared for should be equipped with pulse
oximeters, functioning oxygen systems and disposable, single-use, oxygen-
delivering interfaces (nasal cannula, simple face mask, and mask with reservoir
151. 4. Give empiric antimicrobials to treat all likely pathogens
causing SARI.
Give antimicrobials within one hour of initial patient assessment for patients
with sepsis
Empiric antibiotic treatment should be based on the clinical diagnosis
(community-acquired pneumonia, health care-associated pneumonia [if
infection was acquired in healthcare setting], or sepsis), local epidemiology
susceptibility data, and treatment guidelines.
152. Empiric therapy includes a neuraminidase inhibitor for treatment of
influenza when there is local circulation or other risk factors, including
travel history or exposure to animal influenza viruses.
Empiric therapy should be de-escalated on the basis of microbiology results
and clinical judgment.
153. Remarks
Patients with SARI should be treated cautiously with intravenous fluids,
because aggressive fluid resuscitation may worsen oxygenation, especially
in settings where there is limited availability of mechanical ventilation.
Do not routinely give systemic corticosteroids for treatment of viral
pneumonia or ARDS outside of clinical trials unless they are indicated for
another reason.
154. Closely monitor patients with SARI for signs of clinical deterioration, such
as rapidly progressive respiratory failure and sepsis,and apply supportive
care interventions immediately.
Remarks: Application of timely, effective, and safe supportive therapies is
the cornerstone of therapy for patients that develop severe
manifestations of 2019-nCoV.
155. Understand the patient’s co-morbid condition(s) to tailor the management
of critical illness;
Remarks: During intensive care management of SARI, determine which
chronic therapies should be continued and which therapies should be
stopped temporarily.
156. There is no current evidence from RCTs to recommend any
specific anti-nCoV treatment for patients with suspected or
confirmed 2019-nCoV infection.
157. Special considerations for pregnant patients
Pregnant women with suspected or confirmed 2019-nCoV infection
should be treated with supportive therapies as described above, taking
into account the physiologic adaptations of pregnancy
Emergency delivery and pregnancy termination decisions are challenging
and based on many factors: gestational age, maternal condition, and
fetal stability. Consultations with obstetric, neonatal, and intensive care
specialists (depending on the condition of the mother) are essential.
194. A militia member uses a digital thermometer to take a driver's temperature at
a checkpoint at a highway toll gate in Wuhan, China, January 23, 2020.
195.
196.
197. A worker monitors display screens for infrared thermometers as
part of traveler screenings at Hankou Railway Station in Wuhan,
China, January 21, 2020.