新型冠狀病毒感染的肺炎
防治知識手冊
Handbook of Prevention and Treatment of the Pneumonia Caused by the Novel Coronavirus (2019-nCoV）

天津市互聯(lián)網(wǎng)信息辦公室
微醫(yī)互聯(lián)網(wǎng)總醫(yī)院
微醫(yī)天津互聯(lián)網(wǎng)醫(yī)院
2020年1月

Cyberspace Administration of Tianjin
WeDoctor Digital General Hospital
WeDoctor Tianjin Digital Hospital
January 2020

目錄

第一部分 病原特點(diǎn)
1.什么是冠狀病毒？
2.冠狀病毒有什么樣的理化特性?
3.可感染人的冠狀病毒有哪些?
4.什么是新型冠狀病毒感染的肺炎?
5.感染新型冠狀病毒的患者臨床表現(xiàn)有哪些?
6.有針對新型冠狀病毒的疫苗嗎?
7.與患者密切接觸者如何定義?
8.為什么要對密切接觸者醫(yī)學(xué)觀察14天?
9.如果接到疾控部門通知，您是一位密切接觸者，該怎么辦?
10.新型冠狀病毒感染能治療嗎?
11.新型冠狀病毒感染重癥病例基本的應(yīng)對策略有哪些?

第二部分 疫情形勢
12.當(dāng)前疫情發(fā)展態(tài)勢是什么?
13.為什么短短幾天增加了這么多確診病例?
14.防控疫情的關(guān)鍵在哪里?
15.當(dāng)前防控最有效的辦法是什么?
16.新型冠狀病毒傳染源是什么?
17. 新型冠狀病毒人傳人嗎?
18.人會通過哪些途徑被傳染?
19.新型冠狀病毒會變異嗎?
20.新型冠狀病毒感染是否會像SARS一樣兇猛?

第三部分 防控常識
21.新型冠狀病毒感染肺炎的病例監(jiān)測措施主要有哪些?
22.如何預(yù)防被新型冠狀病毒感染?
23.接觸動物有什么特別需要注意的事項(xiàng)?
24.當(dāng)出現(xiàn)了發(fā)熱、咳嗽等癥狀時，一定要去醫(yī)院嗎？

Contents

Part I Pathogen Characteristics
1. What are coronaviruses?
2. What are the physical and chemical characteristics of the coronavirus?
3. What are the coronaviruses that can infect people?
4. What is pneumonia caused by the novel coronavirus?
5. What are the clinical manifestations of someone infected with a novel coronavirus?
6. Is there a vaccine for a novel coronavirus?
7. How to define whether a person is in close contact with the patients?
8. Why should close contacts be observed for 14 days?
9. If you are informed by the disease control department that you are a close contact, what should you do?
10. Can the novel coronavirus infection be treated?
11. What are the basic coping strategies for severe cases of novel coronavirus infection?

Part II Epidemic Situation
12. What is the current situation of epidemic evolution?
13. Why are confirmed cases increasing so quickly in just a few days?
14. What is the key to prevent and control the outbreak?
15. What is the most effective way to prevent and control the outbreak at present?
16. What is the infection source of novel coronavirus?
17. Can novel coronaviruses be transmitted from person to person?
18. By which ways will people be infected?
19. Will the novel coronavirus mutate?
20. Will the novel coronavirus infection be as fierce as SARS?

Part III Prevention and Control Knowledge
21. What are the main monitoring measures for pneumonia caused by the novel coronavirus?
22. How to prevent the novel coronavirus infection?
23. What should be paid special attention to when coming into contact with animals?
24. When there are fever, cough, and other symptoms, do you have to go to the hospital?

第一部分病原特點(diǎn)
Part I Pathogen Characteristics

1.什么是冠狀病毒?
1. What are coronaviruses?

冠狀病毒是自然界廣泛存在的一大類病毒。是目前已知核糖核酸(RNA)病毒中基因組最大的病毒，該病毒形態(tài)在電鏡下觀察類似于王冠而得名。冠狀病毒僅感染脊椎動物，與人和動物的多種疾病有關(guān)，可引起人和動物呼吸道、消化道和神經(jīng)系統(tǒng)疾病。
Coronavirus is a kind of virus widely existing in nature. It is the largest known RNA virus in the genome and is named coronavirus, as its form is similar to the crown under the electron microscope. Coronavirus only infects vertebrates and is related to many diseases of humans and animals. It can cause respiratory tract, digestive tract, and nervous system diseases of humans and animals.

2.冠狀病毒有什么樣的理化特性?
2. What are the physical and chemical characteristics of the coronavirus?

冠狀病毒對熱敏感，56℃30分鐘、乙醚、75%乙醇、含氯消毒劑、過氧乙酸和氯仿等脂溶劑均可有效滅活病毒。
Coronavirus is sensitive to heat and can be effectively inactivated by 56 ℃ for 30 minutes, ethyl ether, 75% ethanol, chlorine-containing disinfectant, peracetic acid, and chloroform.

3.可感染人的冠狀病毒有哪些?
3. What are the coronaviruses that can infect people?

迄今為止，除新型冠狀病毒外，共發(fā)現(xiàn)6種可感染人類的冠狀病毒(HCoV-229E、HCoV-OC43、SARS-CoV、HCoV-NL63、
HCoV-HKU1和MERS-CoV)。其中4種在人群中較為常見，致病性較低，一般僅引起類似普通感冒的輕微呼吸道癥狀。另外2種是我們熟知的SARS (嚴(yán)重急性呼吸道綜合征) 冠狀病毒和MERS (中東呼吸綜合征) 冠狀病毒。

So farI in addition to the new coronavirus, we have found six kinds of coronaviruses such like HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HCoV-HKU1, and MERS-CoV that can infect humans. Four of them are common in the population, with low pathogenicity, generally only causing mild respiratory symptoms similar to the common cold. The other two are well-known SARS (Severe Acute Respiratory Syndrome) coronaviruses and MERS (Middle East Respiratory Syndrome) coronaviruses.

4.什么是新型冠狀病毒感染的肺炎?
4. What is the pneumonia caused by a novel coronavirus?

新型冠狀病毒感染的肺炎是2019年12月在中國中部湖北省武漢市發(fā)現(xiàn)的，證實(shí)由一種新型冠狀病毒引起的急性呼吸道傳染病。此新型冠狀病毒是以前從未在人體中發(fā)現(xiàn)的冠狀病毒新毒株，世界衛(wèi)生組織將該冠狀病毒命名為2019-nCoV，即新型冠狀病毒。
Pneumonia caused by the novel coronavirus was found in central China’s Wuhan City, Hubei Province in December 2019. It has been proved to be an acute respiratory infectious disease caused by a new type of coronavirus. The new coronavirus is a new strain of coronavirus that has not yet been previously found in the human body. The World Health Organization named the coronavirus 2019-nCov, namely a new coronavirus.

5. 感染新型冠狀病毒的患者臨床表現(xiàn)有哪些?
5. What are the clinical manifestations of someone infected with a novel coronavirus?

以發(fā)熱、乏力、干咳為主要表現(xiàn)。鼻塞、流涕等上呼吸道癥狀少見。約半數(shù)患者多在一周后出現(xiàn)呼吸困難，嚴(yán)重者快速進(jìn)展為急性呼吸窘迫綜合征、膿血癥休克、難以糾正的代謝性酸中毒和出凝血功能障礙。值得注意的是重癥、危重癥患者病程中可為中低熱，甚至無明顯發(fā)熱。部分患者起病癥狀輕微，可無發(fā)熱，多在1周后恢復(fù)。多數(shù)患者預(yù)后良好，少數(shù)患者病情危重，甚至死亡。
Fever, weakness and dry cough are the main manifestations. Nasal obstruction, runny nose and other upper respiratory symptoms are rare. About half of the patients develop dyspnea after one week, and the severe cases develop rapidly into ARDS (Acute Respiratory Distress Syndrome), septic shock, difficult-to-tackle metabolic acidosis and bleeding and coagulation dysfunction. It should be noted that the course of severe and critical patients can be moderate to low fever or even no obvious fever. Some patients have mild onset symptoms. These patients may have no fever and recover after 1 week. Most patients have a good prognosis, while a few patients are in critical condition or even death.

6.有針對新型冠狀病毒的疫苗嗎?
6. Is there a vaccine for a novel coronavirus?
針對新疾病，目前尚無可用疫苗。開發(fā)新疫苗可能需要相當(dāng)長時間。
There is no vaccine available for the new disease. It may take a long time to develop a new vaccine for it.

7. 與患者密切接觸者如何定義?
7. How to define whether a person is in close contact with the patient?

密切接觸者是指與病例共同居住、學(xué)習(xí)、工作或其他有密切接觸的人員；診療、護(hù)理、探視病例時未采取有效防護(hù)措施的醫(yī)護(hù)人員、家屬或其他與病例有類似近距離接觸的人員；病例同病室的其他患者及陪護(hù)人員；與病例乘坐同一交通工具并有近距離接觸人員；現(xiàn)場調(diào)查人員調(diào)查后經(jīng)評估認(rèn)為符合條件的人員。
Close contacts refer to people who live, study, work or have close contact with the case; medical staff, family members or other people who have similar close contact with the case without taking effective precautions when diagnosing, treating, nursing or visiting the case; other patients and caregivers in the same ward with the case; people who take the same vehicle with the case and have close contact with the case; and people who are evaluated as the qualified by the field investigators.

8.為什么要對密切接觸者醫(yī)學(xué)觀察14天?
8.Why should close contacts be observed for 14 days?
參考其他冠狀病毒所致疾病潛伏期，此次新型冠狀病毒病例相關(guān)信息和當(dāng)前防控實(shí)際，將密切接觸者醫(yī)學(xué)觀察期定為14天，并對密切接觸者進(jìn)行居家醫(yī)學(xué)觀察。
Referring to the incubation period of other diseases caused by coronaviruses, the new coronavirus case-related information, and current prevention and control practice, the medical observation period of close contacts was set as 14 days, and the close contacts should be observed at home.

9.如果接到疾控部門通知，您是一位密切接觸者，該怎么辦?
9.If you are informed by the disease control department that you are a close contact, what should you do?
按照要求進(jìn)行居家醫(yī)學(xué)觀察，不用恐慌，不要隨便外出，做好自我身體狀況觀察，定期接受醫(yī)生的隨訪，如果出現(xiàn)發(fā)熱、咳嗽等異常臨床表現(xiàn)，及時向當(dāng)?shù)丶膊☆A(yù)防控制機(jī)構(gòu)報告，在其指導(dǎo)下到指定醫(yī)療機(jī)構(gòu)進(jìn)行排查、診治等。
You can carry out home medical observation as required. Don't be panic. Don't go out casually, and do a good job of observing your physical condition. Receive regular follow-up visits from doctors. In case of abnormal clinical manifestations such as fever and cough, report to local disease prevention and control institutions in time, and under their guidance, go to designated medical institutions for troubleshooting, diagnosis, and treatment, etc.

10. 新型冠狀病毒感染能治療嗎?
10. Can the novel coronavirus infection be treated?
世界衛(wèi)生組織已發(fā)布了針對疑似新型冠狀病毒感染造成嚴(yán)重急性呼吸道感染的臨床處置指南。目前對于新型冠狀病毒所致疾病缺乏特異治療方法，但采用國家衛(wèi)健委推出的診療方案，采用一些抗病毒藥物可能具有一定效果。另外，結(jié)合SARS的治療經(jīng)驗(yàn)教訓(xùn)，充分發(fā)揮我國獨(dú)特的醫(yī)療體系優(yōu)勢，采用中西醫(yī)結(jié)合可能具有重要的價值。此外，對感染者的輔助護(hù)理可能非常有效。
The World Health Organization (WHO) has released a clinical guideline for severe acute respiratory tract infection caused by suspected novel coronavirus infection. At present, there is no specific treatment for the disease caused by 2019-nCoV. But using the diagnosis and treatment launched by the National Health Commission, using some antiviral drugs to treat patients may have a certain effect. In addition, combined with the experience and lessons of SARS treatment, we can know that we could give play to the unique advantages of China's medical system by using the combination of traditional Chinese and Western medicine which may have important value. In addition, supplementary care for infected people may be very effective.

11.新型冠狀病毒感染重癥病例基本的應(yīng)對策略有哪些?
11. What are the basic coping strategies for severe cases of novel coronavirus infection?
預(yù)檢分診，識別并分類嚴(yán)重急性呼吸道感染(SARI)患者；立即實(shí)施正確的感染預(yù)防與控制措施(IPC)；早期支持治療與監(jiān)控；采集臨床標(biāo)本用于實(shí)驗(yàn)室診斷；處理低氧性呼吸衰竭及急性呼吸窘迫綜合征(ARDS)；膿毒性休克的管理；并發(fā)癥的預(yù)防；抗病毒治療；妊娠患者的特別注意事項(xiàng)。
Set up pre-examination triage, so that the patients with severe acute respiratory infection (SARI) can be identified and classified; immediately implement the correct infection prevention and control measures (IPC); early support treatment and monitoring; collect clinical specimens for laboratory diagnosis; deal with hypoxic respiratory failure and acute respiratory distress syndrome (ARDS); management of septic shock; prevention of complications; antiviral treatment; special precautions for pregnant patients.

第二部分 疫情形勢
Part II Epidemic Situation

12.當(dāng)前疫情發(fā)展態(tài)勢是什么?
12. What is the current situation of epidemic evolution?

近期，湖北省武漢市等多個地區(qū)發(fā)生新型冠狀病毒感染的肺炎疫情。截至2020年1月30日24時，國家衛(wèi)生健康委收到31個?。ㄗ灾螀^(qū)、直轄市）和新疆生產(chǎn)建設(shè)兵團(tuán)累計報告確診病例9692例，現(xiàn)有重癥病例1527例，累計死亡病例213例，累計治愈出院病例171例，共有疑似病例15238例。目前累計追蹤到密切接觸者113579人(北京市核減21例），當(dāng)日解除醫(yī)學(xué)觀察4201人，共有102427人正在接受醫(yī)學(xué)觀察。累計收到港澳臺地區(qū)通報確診病例28例：香港特別行政區(qū)12例，澳門特別行政區(qū)7例，臺灣地區(qū)9例。
Recently, 2019-nCoV infected pneumonia outbroke in Wuhan City, Hubei Province, and other regions. As of at 24:00, January 30th, the National Health Commission received the information from 31 provinces (areas and cities) and Xinjiang Production and Construction Corps that there were 9,692 confirmed cases, of which 1,527 severe cases, 213 death cases, and 171 cases who have been cured.There are 15,238 suspected cases now. At present, there are 113,579 close contacts (Beijing removed 21 cases after double-check), and 4,201 people who have been removed from medical observation, 102,427 people who have been put under medical observation. 28 confirmed cases have been reported from Hong Kong, Macao and Taiwan, including 12 in Hong Kong Special Administrative Region, 7 in Macao Special Administrative Region, and 9 in Taiwan.

經(jīng)國務(wù)院批準(zhǔn)，國家衛(wèi)生健康委將新型冠狀病毒感染的肺炎納入《中華人民共和國傳染病防治法》規(guī)定的乙類傳染病，采取甲類傳染病的預(yù)防、控制措施；并納入《中華人民共和國國境檢疫法》規(guī)定的檢疫傳染病管理。
Upon approval from the State Council, the National Health Commission includes 2019-nCoV-infected pneumonia into category B infectious disease specified in the Law of the People's Republic of China on the Prevention and Treatment of Infectious Diseases, and prevention and control measures for category A infectious diseases are taken; quarantinable disease management specified in Frontier Health and Quarantine Law of The People's Republic of China are followed.

13. 為什么短短幾天增加了這么多確診病例?
13. Why are confirmed cases increasing so quickly in just a few days?
因?yàn)橛辛瞬《竞怂釞z測試劑盒。近日，國家相關(guān)科研機(jī)構(gòu)迅速研發(fā)出病毒核酸檢測試劑盒，核酸檢測試劑盒能通過PCR的方法快速確定病例的樣品中是否有特定的基因序列的存在。也就是說，新型冠狀病毒相當(dāng)于有了身份證，病例的樣品只要一對比就可以快速判斷。
Because a virus nucleic acid detection kit has been developed. Recently, the related national scientific research institutions developed a virus nucleic acid detection kit rapidly. The detection kit can confirm whether there is a specific gene sequence in case samples or not by using a PCR-based approach. In other words, a novel coronavirus can be identified by detection kit; samples of cases can be judged quickly by comparison.

14.防控疫情的關(guān)鍵在哪里?
14. What is the key to prevent and control the outbreak?
防治的關(guān)鍵是防止出現(xiàn)超級傳播者。武漢市減少輸出是非常重要的一個方面，武漢市會有很嚴(yán)格的篩查檢測措施，特別是體溫檢測，體溫高的不建議離開武漢市。2020年1月23日凌晨，武漢市采取了封城措施，這是至關(guān)重要的防控關(guān)鍵步驟。
The key is to prevent "super spreaders”. Reducing the outflow of the people in Wuhan City is very important, and strict screening detection measures are taken in Wuhan City, especially body temperature detection. Those who have high body temperature are not recommended to leave Wuhan. The city limited inflow and outflow of people on January 23, 2020，which was the key measures to prevent and control the outbreak.

15.當(dāng)前防控最有效的辦法是什么?
15. What is the most effective way to prevent and control the outbreak at present?
早發(fā)現(xiàn)、早報告、早診斷、早隔離、早治療是最有效的。對已經(jīng)確診的病人進(jìn)行有效隔離治療，減少接觸是極為重要的。
Early detection, early reporting, early diagnosis, early isolation, and early treatment are the most effective measures. It is extremely important for the confirmed cases to get an effective isolation treatment to decrease transmission.

16.新型冠狀病毒傳染源是什么?
16. What is the infection source of novel coronavirus?
目前新型冠狀病毒傳染源尚未找到。這次發(fā)現(xiàn)的新型冠狀病毒基因序列與SARS冠狀病毒接近，而SARS冠狀病毒已經(jīng)證實(shí)起源于野生動物(蝙蝠)攜帶的冠狀病毒，目前收治病例多數(shù)有武漢市"華南海鮮市場”暴露史，這個市場同時還銷售活體野生動物，攤主和顧客都有機(jī)會接觸野生動物攜帶的冠狀病毒。
The infection source of 2019-nCoV has not yet been found. The gene sequence of 2019-nCoV is similar to the SARS coronavirus. However, SARS coronavirus has been proved to stem from the coronavirus that wild animals (bat) carry. At present, most cases admitted have exposure history of "Huanan Seafood Market," where the wild animals were sold, and vendors and customers there have the chance to be in contact with wild animals-carried coronavirus.

17.新型冠狀病毒人傳人嗎?
17. Can novel coronaviruses be transmitted from person to person?
武漢市和廣東省均發(fā)現(xiàn)人傳人病例，截止到1月21日，武漢市已有15名醫(yī)務(wù)人員感染，這證實(shí)了疫情可以人傳人。
The cases by human-to-human transmission were found in Wuhan City and Guangdong Province; as of January 21, 2020, there were 15 health care workers infected in Wuhan City, which confirmed the virus could have human-to-human transmission.

18.人會通過哪些途徑被傳染?
18. By which ways will people be infected?
2020年1月27日，由國家衛(wèi)生健康委員會辦公廳、國家中醫(yī)藥管理局辦公室聯(lián)合印發(fā)的《新型冠狀病毒感染的肺炎診療方案（試行第四版）》指出，經(jīng)呼吸道飛沫傳播是主要的傳播途徑，亦可通過接觸傳播。
On January 27, 2020, the Diagnosis and Treatment of Pneumonia Infected by Novel Coronavirus (4th trial edition) pressed by the General Office of the National Health Commission and the General Office of the National Administration of Traditional Chinese Medicine points out that the main transmission route is droplet transmission, plus contact transmission.

19.新型冠狀病毒會變異嗎?
19. Will the novel coronavirus mutate?
新型冠狀病毒是以前從未在人體中發(fā)現(xiàn)的冠狀病毒新毒株，病毒變異仍需嚴(yán)密監(jiān)控。
The 2019-nCoV is a new strain of coronavirus that has not yet been previously found in human body, so the virus mutation still needs to be monitored closely.

20.新型冠狀病毒是否會像SARS一樣兇猛?
20. Will the novel coronavirus be as fierce as SARS?
研究顯示，新型冠狀病毒與SARS具有同源性，相似性約為70%，與MERS相似性約為40%。新型冠狀病毒與SARS相比傳染性較弱，但與人體呼吸道上皮細(xì)胞仍具有較強(qiáng)親和力，提示其對人體有一定感染能力。
The studies show that 2019-nCoV is homologous with SARS, with the similarity of about 70% and with MERS, about 40%. Compared with SARS, 2019-nCoV has weak infectivity, but a good affinity with human respiratory epithelial cells, indicating certain infectivity for humans.

第三部分 防控常識
Part III Prevention and Control Knowledge

21.新型冠狀病毒感染肺炎的病例監(jiān)測措施主要有哪些?
21. What are the main monitoring measures for the pneumonia caused by the novel coronavirus?

各級各類醫(yī)療機(jī)構(gòu)在新型冠狀病毒感染的肺炎監(jiān)測和日常診療過程中，應(yīng)提高對新型冠狀病毒感染的肺炎病例的診斷和報告意識，對于不明原因發(fā)熱、咳嗽等癥狀的病例，應(yīng)注意詢問發(fā)病前14天內(nèi)的行蹤或可疑暴露史，野生動物接觸史，及其與類似病例的密切接觸史。
In the course of pneumonia monitoring and daily diagnosis and treatment of 2019-nCoV infection, medical institutions at all levels and of various types should enhance the awareness of diagnosis and reporting of pneumonia cases of 2019-nCoV infection. For cases with fever, cough and other symptoms of unknown causes, they should pay attention to inquiring about the suspected exposure history within 14 days before the onset of the disease, the history of contact with wild animals, and the history of close contact with similar cases.

22.如何預(yù)防被新型冠狀病毒感染?
22. How to prevent the novel coronavirus infection?

(1)做好冬春季呼吸道傳染病預(yù)防
(1) Make efforts to prevent respiratory infectious disease in winter and spring

目前正處于冬春季傳染病高發(fā)季節(jié)，市民要增強(qiáng)衛(wèi)生健康意識，加強(qiáng)鍛煉，規(guī)律作息，提高自身免疫力。
It is presently in the high-incidence season of the winter and spring infectious diseases, the public should enhance health awareness, do more exercise, have a regular work and rest to improve their immunity.

注意保持室內(nèi)空氣流通，避免到封閉、空氣不流通的公眾場合和人多集中地方，外出時可佩戴口罩。
Keep proper indoor ventilation, avoid poorly ventilated and crowded places; medical masks shall be worn when going out.

外出回家后，及時洗手、洗鼻。如有發(fā)熱和其他呼吸道感染癥狀，特別是持續(xù)發(fā)熱不退，及時到醫(yī)療機(jī)構(gòu)就診。
Wash hands and nose when coming home. If fever and other respiratory symptoms, especially persistent fever occurs, go to hospitals as soon as possible.

(2)正確佩戴口罩
(2) Wear medical masks correctly

戴口罩是阻斷呼吸道分泌物傳播的有效手段。選擇醫(yī)用外科口罩能很好地預(yù)防呼吸道疾病。一次性醫(yī)用口罩佩戴時，要將折面完全展開，將嘴、鼻、下頜完全包住，然后壓緊鼻夾，使口罩與面部完全貼合。
Wearing medical masks is an effective way of interrupting respiratory droplets transmission. Medical masks can prevent respiratory diseases properly. When wearing disposable medical masks, fully unfold folded surface, and cover mouth, nose, and lower jaw entirely, then compress nose clip, so masks and face are in full contact with each other.

戴口罩前應(yīng)洗手，或者在戴口罩過程中避免手接觸到口罩內(nèi)側(cè)，減少口罩被污染的可能。分清楚口罩的內(nèi)外、上下，淺色面為內(nèi)，應(yīng)該貼著嘴鼻，深色面朝外；金屬條(鼻夾)一端是口罩的上方。
Wash hands before wearing medical masks or avoid touching the inner side of masks while wearing masks to reduce masks pollution risk. Distinguish the inside and outside and up and down of masks, i.e., the light surface is the inside of masks, which closes to mouth and nose, and the dark surface is the outside of masks; the metal strip (nose clip) side is the upside of masks.

要定期更換、不可戴反，更不能兩面輪流戴。
Replace masks regularly; avoid wearing reversely, and even both sides.

(3)正確洗手
(3) Wash hands properly

在餐前便后、外出回家、接觸垃圾、撫摸動物后，要記得洗手。洗手時，要注意用流動的水和使用肥皂(皂液)洗手，揉搓的時間不少于15秒
Remember to wash hands before eating, after toilet, coming home, coming into contact with garbage and touching animals. When washing hands, use running water and soap (liquid soap), with no less than 15 seconds for rubbing hands.

為了方便記憶，揉搓步驟簡單歸納為七字口訣: "內(nèi)-外-夾-弓-大-立-腕”。
For the convenience of memory, rubbing steps are as follows.

- Both hands rub with palm to palm
- Both hands cross and rub with palm to hand back
- Fingers cross and rub with palm to palm
- Fingers entwine and rub rotationally
- Rub hands rotationally with thumb in the palm
- Rub hands with fingertip in the palm
- Wash wrist

23.接觸動物有什么特別需要注意的事項(xiàng)?
23. What should be paid special attention to when coming into contact with animals?

避免接觸野生禽畜、野生動物及其排泄物和分泌物，避免購買活禽和野生動物；避免前往動物農(nóng)場和屠宰場、活禽動物交易市場或攤位、野生動物棲息地等場所。必須前往時要做好防護(hù)，尤其是職業(yè)暴露人群；避免食用野生動物。
Avoid coming into contact with wild livestock, wildlife, and their droppings and secretions, and avoid the purchase of live poultry and wildlife. Avoid visiting animal farms and slaughterhouses, live poultry and animal markets or stalls, wildlife habitats and so forth. People, especially occupationally exposed persons must take precautions when having to go the places mentioned above,. Avoid eating wild animals.

24.當(dāng)出現(xiàn)了發(fā)熱、咳嗽等癥狀時，一定要去醫(yī)院嗎？
24. When there are fever, cough and other symptoms, do you have to go to the hospital?

普通的感冒、流感、急性的上呼吸道感染、咽炎、支氣管炎及扁桃體炎都可能出現(xiàn)咽痛、咳嗽、鼻塞、流涕、打噴嚏等癥狀。當(dāng)出現(xiàn)以上癥狀時，一般判斷是普通的呼吸道感染。而感染新型冠狀病毒的患者臨床主要表現(xiàn)為發(fā)熱、乏力、干咳，較少出現(xiàn)鼻塞、流涕等上呼吸道癥狀。
The symptoms such as pharyngeal pain, cough, nasal congestion, runny nose, sneezing, and so on may occur in the common cold, influenza, acute upper respiratory tract infection, pharyngitis, bronchitis, and tonsillitis. When the above symptoms appear, it is generally a common respiratory tract infection. However, the patients infected with the 2019-nCoV mainly have fever, fatigue, and dry cough with less symptoms of the upper respiratory tract such as nasal congestion, runny nose.

當(dāng)出現(xiàn)了發(fā)熱、咳嗽等癥狀，而自己又無法準(zhǔn)確判斷時，建議通過微醫(yī)互聯(lián)網(wǎng)總醫(yī)院在線問診后再做決定。目前一些城市的醫(yī)院聚集了大量的呼吸道疾病患者，如果直接去醫(yī)院就診，不但不能有效的獲取有用信息，還容易造成交叉感染。
When a person has fever, cough, and other symptoms, and cannot accurately judge by himself, it is recommended to make a decision based on the WeDoctor's Digital general hospital online consultation. At present, hospitals in some cities gather a large number of patients with respiratory diseases. If they go to the hospital directly, they cannot effectively obtain useful information and are prone to get cross-infection.