#PleaseShare #COVID19
#武漢肺炎防疫重點英文版

According to the WHO and Chinese officials, the incubation period of the novel corona virus between disease exposure to the onset of symptoms ranges from 2 to 12 days (7 days on average).

However,based on the general view,the incubation period of COVID-19could be up to 14 days.

Based on the current literature related toCOVID-19, the clinical expression ofCOVID-19caninclude fever, weakness, respiratory symptoms (mainly dry cough) and in some cases,breathing difficulties can follow.

About 1 to 2 percent of the patients might develop severe pneumonia, adult respiratory distress syndrome (ARDS), multiple organ failure or shock, leading to death.Most of the deceased patients had concurrent chronic disease such as diabetes, liver disease, kidney disease or cardiovascular disease.

*Prevension
There is no vaccine to prevent corona virus infections. Daily preventative steps to take include avoiding affected regions, avoiding local hospitals or clinics unless necessary, avoiding eating uncooked meat or eggs,avoiding being in contact with animals and dead animals,and maintain good health habits.

Steps to practice good health habits are as follows:

Please keep your hands clean and wash your hands with soap frequently. If soap and water are not available, use an alcohol-based hand sanitizers.

However, soap and water should be used preferentially if hands are visibly dirty. You should wash your hands immediately after coughing or sneezing; after using the toilet; and if your hands touch any secretions from your respiratory tract, stool or body fluids such as urine. In addition, please refrain from touching your eyes, nose and mouth with your hands.

Pay attention to respiratory tract hygiene and cough etiquette.

a. If you have respiratory symptoms, please wear a medical-grade face mask and keep at least 1 meter away from others while talking to them.

b. If your hands touch any secretions from your respiratory tract, please wash your hands with soap and water thoroughly.

c. If you develop a cough or other respiratory symptoms, you should wear a medical face mask. When your mask is contaminated by secretions of nose or mouth, please fold it, throw it into the trash immediately, and wear a new one.

d. You should cover your mouth and nose with a tissue or handkerchief when coughing or sneezing. If you don’t have a tissue or handkerchief, cough or sneeze into your upper sleeve.

*Use of masks
a. Medical-grade face masks are mainly used for preventing the spread of disease and protect people around you. People are advised to wear medical masks when you go to see a doctor or accompany a patient; when you have symptoms of respiratory infections; and if you go out with people with weak immune systems or chronic disease. You should wash your hands frequently to protect yourself from catching illness in other situations.

b. To wear a medical mask properly, you should ensure that the water-repellent side (usually green) faces outwards. You should not remove your mask when talking, coughing or sneezing to prevent the spread of disease. You should replace your face mask if it is visibly soiled.

c. Steps to put on a medical face mask:
i. Open the package and examine if the mask is damaged.

ii. Put the elastic bands around both ears, fit the metallic strip over the nose bridge and extend the mask to cover your chin.

iii. Press firmly down on the metallic strip so that it fits around your nose

iv. Ensure that there are no gaps

d. You don’t need a face mask in open spaces, including walking on the streets or doing outdoor exercises.

*What to do while sick
If you have flu-like symptoms, including fever, headache, runny nose, sore throat, cough, muscle aches, fatigue/tiredness, and sometimes diarrhea. After your symptoms develop, you should rest, take and record your temperature regularly, drink water and eating nourishing food, observe your condition and take symptom-relieving drugs such as pain relievers/fever reducers to observe if they work.

You should rest at home for at least 24 hours after the symptoms improve.

You should seek medical attention if your fever lasts longer than 24 hours or is accompanied by other symptoms, such as purulent nasal discharge and purulent sputum, severe vomiting or shortness of breath.

You should inform the doctor of any history of travel, occupation, contact, and cluster (TOCC) when seeking medical attention.

You should follow the triage arrangement at the hospital if you have a fever to ensure efficient medical care and the health of medical personnel.

You should avoid going to school or work, attending gatherings and visiting crowded or poorly-ventilated public spaces while sick. You should avoid using public transportation to prevent the spread of disease if you need to go outside.

While staying at home, you should stay in a specific room, keep good airflow in the house, and avoid close contact with other people in your home, such as eating at the same table, kissing, hugging or sexual contact.

People living with the sick person should also pay attention to personal hygiene, wash hands frequently and refrain from touching eyes, nose and mouth with hands. Babies, children and the elderly or people with compromised immune system in the same household must keep at least 1 meter away from the sick person.

If the living environment requires disinfection, you can apply 1:100 diluted bleach (500 ppm).

That is, household chlorine bleach (a 5-6% sodium hypochlorite solution, providing 50,000–60,000ppm available chlorine) is diluted in water at 1:100 to clean object surfaces, such as doorknobs, desks and switches.

You can use disposable teaspoons (one teaspoon is about 20 cc), small Yakult bottles (one bottle is about 100 cc) and large plastic bottles (one bottle is about 1,250 cc) and follow the instructions below to make diluted bleach: �

a. Large amount: mix 100 cc of bleach (5 teaspoons or 1 small Yakult bottle) in 10 liters of water (8 large plastic bottles) and fully stir the solution before using.

b. Small amount: pour 10 cc of bleach into 1 liter of water and fully stir the solution before using.

For more information:
https://www.cdc.gov.tw/File/Get/HAvRHGs_EjKeROHYmzWm5w

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最近還是常常遇到病人去耳鼻喉科看診，因為被抽吸出黃鼻涕，就告知有鼻竇炎，開了三天抗生素。 家長對於用藥有疑慮所以來詢問意見。

小兒科的教科書聖經(Nelson)上，針對急性細菌性鼻竇炎的定義是 :
Persistent symptoms of upper respiratory tract infection, including nasal discharge and cough, for >10-14 days without improvement, or severe respiratory symptoms, including temperature of at least 39 °C and purulent nasal discharge for 3-4 consecutive days, suggest a complicating acute bacterial sinusitis.
意思是，持續十到十四天的上呼吸道感染症狀，沒有好轉，或是連續三到四天的膿黃鼻涕加上發燒，要考慮細菌性鼻竇炎。

另外，兒科醫學會的兒童急性細菌性鼻竇炎診治指引節錄，給大家參考 :


18歲以下兒童出現下列任一診斷條件時，可作為急性細菌性鼻竇炎之診斷參考

@ 持續出現黃綠膿鼻涕且維持超過72小時，尤其有發燒時（註：需為連續72小時以上出現的鼻部分泌物均為黃綠膿鼻涕，間斷出現者不符本條件）。

@出現黃綠膿鼻涕或嚴重鼻塞，並有最近出現的口臭（halitosis）。

@呼吸道感染症狀改善後，出現發燒、頭痛、黃綠膿鼻涕等惡化症狀 (反覆發病；double sickening)。

@有流鼻涕或鼻塞等鼻部症狀，並於上頜竇、篩竇、額竇區域出現疼痛性紅腫。

影像檢查：

@急性細菌性鼻竇炎的診斷不需依賴影像檢查，當診斷有疑義時，可進行鼻竇X光檢查以供治療參考。

@懷疑有化膿性併發症，或改用後線抗生素治療48-72小時未改善時，可考慮施行電腦斷層攝影（computed tomography）或磁振造影檢查（magnetic resonance image），以施打顯影劑的電腦斷層攝影為優先。

抗生素治療：

@沒有併發症的兒童細菌性鼻竇炎可用口服抗生素治療，但額竇鼻竇炎（frontal sinusitis）較容易有顱內併發症，宜一開始就使用注射抗生素。

@出現眼窩併發症或顱內併發症與其他嚴重感染時，宜一開始就使用靜脈注射抗生素，其抗菌範圍宜涵蓋金黃色葡萄球菌。

@抗生素治療有效時，鼻竇炎症狀應在48-72小時內改善。

@抗生素治療時間以症狀改善至少7天為原則，一般為10-14天，治療效果不佳或鼻竇有明顯積膿現象者可考慮延長治療時間。

綜合以上所述，建議家長除非有發燒，七天以內的黃鼻涕不用緊張，可以先觀察症狀治療，因為統計上只有不到10%是細菌性鼻竇炎造成。 請記得病毒也會造成鼻竇炎，千萬不要見黃鼻涕就開抗生素，搞得家長緊張兮兮。 另外，如果開始吃抗生素，三天內一般會明顯改善 ，請記得一定要吃到症狀改善後七天，也就是至少療程十到十四天喔！

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Back pain, joint pain, limb swelling, inflammation, shoulder pain, otitis, otitis, phee.
How to do it
1. Rinse with water and allow air to dry.
2. Pound the leaves, stems, young flowers, pound with a pinch of table salt and olive oil.
3. Pound them thoroughly.
4. Put a scotch cover on the wound. Wrap it up Tied with rubber bands We will have a compress for massage, rubbing the pain, swelling, inflammation.
Properties
1. Reduce pain, swelling, inflammation of the knee joints, arms, legs for better and cured. Should be done regularly and continuously.
2.Relieve ear pain Purulent ear infection By using custody bus Dip the liquid and bring to a shift in the ear for 2-3 days continuously improved and cured
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