Symptoms of coronavirus: what to look for, who to contact if you get sick and how to treat it

China’s mystery new coronavirus is spreading fast. More than 2,700 people are known to be infected and at least 80 deaths have been recorded.

The bulk of cases have been confined to China but the virus is gradually spreading further afield. So far cases have been confirmed in more than 13 countries, including France, Australia and the United States.

At least 70 people have been tested in the United Kingdom and Public Health England (PHE) think it “likely” the virus will soon be discovered here, though all tests have been negative to date.

Experts have been warning for years that the world is long overdue a major disease outbreak, and so it is sensible to be prepared.

This practical guide is designed to keep you safe and will be updated daily. It is underpinned with advice from leading experts from the NHS and beyond.

What are coronaviruses?

Coronaviruses are a family of viruses that originate in animals before making the jump to humans. Seven, including the new virus, have been found in humans, with four causing only mild, common cold-like symptoms.

But two – Middle East respiratory syndrome (Mers) and severe acute respiratory syndrome (Sars) – are much more severe, having killed more than 1,500 people between them.

Around 15 to 20 per cent of hospital cases are severe and the current death rate stands at about two per cent. This is quite high but it may be because authorities are not aware of milder cases of the disease.

What are the symptoms of the new coronavirus?

According to the NHS and the WHO, symptoms of the Wuhan coronavirus usually include:

• Feeling tired

• Difficulty breathing

• A high temperature

• A cough and/or sore throat

These symptoms are similar to other respiratory diseases including the common cold, itself a type of coronavirus. So if you have symptoms consider the following:

• Have you travelled in the last two weeks to a high risk area?

• Have you been in contact with someone who has?

When should I seek medical help?

If you have travelled to Wuhan City in China (or another significantly affected area)  in the last two weeks, or have been in contact with someone who has and feel unwell, call NHS 111 for advice now.

Do NOT go straight to a doctor's surgery or hospital as, if you have the virus, you risk spreading it to others.

How are coronaviruses transmitted?

Like other coronaviruses – such as the common cold – the virus is spread via droplets when a person coughs or sneezes. It can also be spread when someone touches a contaminated surface such as a door handle.

Hospitals are also key locations for "super spreading" events - when a single patient infects many people. When patients arrive in hospital with vague respiratory symptoms health workers may not know they need to take special precautions such as wearing masks or keeping them away from other patients.

The outbreak originates from animals and the source is thought to be a seafood market in Wuhan which also traded in other live animals such as marmots and bats.

How can I protect myself from catching the new coronavirus?

Hand hygiene is the first and most important line of defence.

Like cold and flu bugs, the new virus is thought to be spread via droplets when a person coughs or sneezes.  The droplets land on surfaces and are picked up on the hands of others and spread further. People catch the virus when they touch their infected hands to their mouth, nose or eyes.

It follows that the single most important thing you can do to protect yourself is to keep your hands clean by washing them frequently with soap and water or a hand sanitising gel.

Also try to avoid touching your mouth, nose or eyes with unwashed hands – something we all do unconsciously on average about 15 times an hour.

Other tips include:

• Carry a hand sanitiser with you to make frequent cleaning of hands easy

• Always wash your hands before you eat

• Be especially careful in busy airports and other public transport systems about touching things and then touching your face

• Carry disposable tissues with you and always cover your nose and mouth when you cough or sneeze before disposing of the tissue carefully (catch it, bin it, kill it)

• Do not share snacks from packets or bowls that others are dipping their fingers into

• Avoid shaking hands or cheek kissing if you suspect viruses are circulating

• Regularly clean, not just your hands, but commonly used surfaces and devices you touch or handle

Is it just droplets from the nose and mouth that spread the new virus?

Probably not, but they are by far the most common risk.

The NHS is advising doctors that the virus is also likely to be contained in other bodily secretions including in blood, faeces and urine.

Here again, hand and surface hygiene is the key.

How could it affect my family, especially children?

Children are a major vector for the spread of droplet-based viruses because they interact physically so much with each other and are not the best at keeping themselves clean.

However, you can greatly lower the risk that children pose of spreading disease by:

• Explaining to them how germs spread and the importance of good hand and face hygiene

• Keeping household surfaces clean, especially kitchens, bathrooms and door handles

• Using clean cloths to wipe surfaces, so you don't transfer germs from one surface to another

• Giving everyone their own towel and making sure they know not to share toothbrushes etc

• Keep your home dry and airy (bugs thrive in musty environments)

What about face masks, do they work?

Paper face masks are not generally recommended by the NHS for ordinary citizens – with good reason.

They are ill-fitting and what protection they might initially provide soon expires. Worse, over time they can become moist providing the perfect environment for germs to thrive in. They also become a hazard for others if carelessly discarded.

However, an exception to this would be if you were displaying symptoms such as coughing or sneezing – then a mask may help prevent you spreading the virus to others in busy locations.

In hospitals, healthcare workers treating patients with the virus will wear masks but these are specialist devices and there are strict protocols they must follow to ensure they remain safe and effective.

Can the new coronavirus be treated?

There is no simple cure for for the new coronaviruses – just as there is no cure for the common cold.

In more severe cases, the virus causes pneumonia, an infection that inflames the lungs and causes breathing difficulty. This is where the main danger lies.

Viral pneumonia cannot be treated with antibiotics and, for the moment at least, there are no antiviral drugs for this particular virus.

Instead doctors focus on supporting patients' lung function as best they can. They may be given oxygen or placed on a breathing machine (ventilator) in the most severe cases.

Peter Horby, professor of emerging infectious diseases and global health, at the Centre of Tropical Medicine and Global Health at the University of Oxford, said the disease bore all the signs of a "classic viral pneumonia".

"There are currently no antivirals for this, so care is just supportive, supporting the lungs and other organs until patients recover," he said.

Other symptoms such as fever and discomfort will be treated using common drugs such aspirin and ibuprofen.

Are some groups of people are more risk than others?

Information filtering out of China suggests that people of all ages are at risk of contracting the virus. Wuhan's health commission said in a statement that the 60 most recent cases range in age from 15 to 88.

However, as with most respiratory illnesses, it is likely to be the young and old who are most at risk once infected. People with a reduced chance of surviving pneumonia include:

• Those over age 65

• Children under the age of two

People with underlying health conditions or a weakened immune system

As data accumulates, a much clearer picture of the particular risk groups for the new virus will emerge and will be updated here.

Is there a vaccine for the new coronavirus?

There is currently no vaccine but researchers in the US, UK and China have already begun working on one, thanks to China's prompt sharing of the virus's genetic code.

However, any potential vaccine will not be available for up to a year and would most likely be given to health workers most at risk of contracting the virus first.

For now, it is a case of containment. China has started building several  1,000-bed hospitals to treat patients which it hopes to finish within days.

Capacity to treat patients who require both ventilation and isolation will also be the biggest challenge for the NHS if the virus takes off in the UK.

What advice has the UK government issued?

In addition to the advice on symptoms above, the British government has been advising against "all but essential" travel to Wuhan.

The Foreign and Commonwealth Office is also now looking at options to evacuate British citiziens in the area:

"We are working to make available an option for British nationals to leave Hubei province”, it said in a statement.

If you are a British national in Hubei Province and require assistance, please contact:

• 24/7 number: +86 (0) 10 8529 6600

• The FCO: (+44) (0)207 008 1500

The announcement follows a US decision over the weekend to charter a 230-seat plane and evacuate citizens in Wuhan.

What is happening at UK airports?

Public Health England has announced "enhanced monitoring of direct flights" from China and has a small rota of doctors is on hand at Heathrow to provide information and deal with possible cases.

In other major hub airports around the world, the authorities have gone further and are checking passengers temperatures on arrival and distributing hand sanitisers to combat the spread of the virus.

But screening cannot pick up everyone as the incubation period for contracting the virus and the onset of symptoms is between six to 10 days.

Professor David Heymann, infectious diseases expert at the London School of Hygiene and Tropical Medicine, said: “Temperature screening picks up people with fevers – but people can take aspirin if they want to travel and don’t want to get picked up. The best thing to do is educate people – if you’re sick you should tell a doctor,” he said.

What is the difference between a coronavirus and a flu virus?

Coronaviruses and flu viruses might cause similar symptoms but genetically they are very different.

“Flu viruses incubate very rapidly – you tend to get symptoms two to three days after being infected, but coronaviruses take much longer, ” said Professor Neil Ferguson, a disease outbreak scientist at Imperial College London.

“[With the] flu virus you become immune but there are lots of different viruses circulating. Coronaviruses don’t evolve in the same way as flu with lots of different strains, but equally our body doesn’t generate very good immunity,” he added.

What risks are presented if the coronavirus mutates?

Chinese officials have warned that the virus is already starting to mutate, which means there's a chance that the disease could start to infect many more people.

“The worry is that if you have a new virus that is exploring a human host it’s possible that they might mutate and spread more easily in humans,” Jonathan Ball, professor of molecular virology at the University of Nottingham, told The Telegraph.

The genetic sequence of the virus shows a slow mutation rate, said Prof Ferguson.

"Could it mutate to become more lethal and transmissible? That’s speculation," he said.

How does this coronavirus compare to past respiratory epidemics?

The 1918 Spanish Influenza – or H1N1 virus – remains the most devastating flu pandemic in modern history. The disease swept around the globe and is estimated to have caused between 50 and 100 million deaths.

A new version of the same virus was also behind the 2009 swine flu outbreak, which is thought to have killed as many as 575,400 people.

Other major influenza outbreaks include the Asian flu in 1957, which led to roughly two million deaths, and the Hong Kong flu 11 years later which killed one million people.

But coronavirus outbreaks have so far been far smaller. Sars eventually spread to 27 countries in total, infecting around 8,000 people and killing 700.

Mers on the other hand has proved less explosive but more tenacious – it first emerged in 2012 in Jordan, when it jumped from camels to humans, and then spread throughout the Arabian peninsula.

Around 2,500 cases of the disease have been identified so far and, while the disease hit a peak of more than 600 cases in 2014, there were still more than 190 cases last year. It is more deadly than Sars, and has claimed around 850 lives in total.

What can you do to limit the risk of catching the new coronavirus?

The risk to the UK is remains low. But anyone travelling to China and worried about catching the virus needs to take the basic hygiene precautions.

Maria Van Kerkhove, acting head of emerging infectious diseases at the WHO, said: “Coronaviruses typically cause respiratory symptoms so we recommend basic hand hygiene such as washing hands in soap and water and respiratory hygiene so when you sneeze, sneeze into your elbow.”

She cautioned against any unnecessary contact with live animals in China.

Nick Phin, deputy director of the National Infection Service at Public Health England, added: “Individuals should seek medical attention if they develop respiratory symptoms within 14 days of visiting Wuhan, either in China or on their return to the UK, informing their health service prior to their attendance about their recent travel to the city.”

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