How 2019-nCoV Spreads

Much is unknown about how 2019-nCoV, a new coronavirus, spreads. Current knowledge is largely based on what is known about similar coronaviruses. Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERSSARS, and now with 2019-nCoV.

Most often, spread from person-to-person happens among close contacts (about 6 feet). Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. It’s currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes.

Typically, with most respiratory viruses, people are thought to be most contagious when they are most symptomatic (the sickest).

It’s important to note that how easily a virus spreads person-to-person can vary. Some viruses are highly contagious (like measles), while other viruses are less so. There is much more to learn about the transmissibility, severity, and other features associated with 2019-nCoV and investigations are ongoing. This information will further inform the risk assessment.

Symptoms

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For confirmed 2019-nCoV infections, reported illnesses have ranged from people with little to no symptoms to people being severely ill and dying. Symptoms can include:

  • Fever
  • Cough
  • Shortness of breath

Prevention

There is currently no vaccine to prevent 2019-nCoV infection. The best way to prevent infection is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • Follow CDC’s recommendations for using facemask.
    • CDC does not recommend that people who are well wear facemask to protect themselves from respiratory viruses, including 2019-nCoV.
    • Facemask should be used by people who show symptoms of 2019 novel coronavirus, in order to protect others from the risk of getting infected. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
    • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

For information about handwashing, see CDC’s Handwashing website

For information specific to healthcare, see CDC’s Hand Hygiene in Healthcare Settings

These are everyday habits that can help prevent the spread of several viruses. CDC does have specific guidance for travelers.

Treatment

There is no specific antiviral treatment recommended for 2019-nCoV infection. People infected with 2019-nCoV should receive supportive care to help relieve symptoms. For severe cases, treatment should include care to support vital organ functions.

People who think they may have been exposed to 2019-nCoV should contact your healthcare provider immediately.

What to do if you are sick with 2019 Novel Coronavirus (2019-nCoV)

Recently Returned Travelers from China

If you were in China in the last 14 days and feel sick with fever, cough, or difficulty breathing, you should:

  • Seek medical advice – Call ahead before you go to a doctor’s office or emergency room. Tell them about your recent travel and your symptoms.
  • Avoid contact with others.
  • Do not travel while sick.
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
  • Wash your hands with soap and water immediately after coughing, sneezing or blowing your nose. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

Steps to help prevent the spread of 2019-nCoV if you are sick

If you are sick with 2019-nCoV follow the steps below to help prevent 2019-nCoV from spreading to people in your home and community.

Stay home except to get medical care

You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas. Do not use public transportation, ride-sharing, or taxis.

Separate yourself from other people in your home

As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available.

Call ahead before visiting your doctor

If you have a medical appointment, call the healthcare provider and tell them that you have or may have 2019-nCoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.

Wear a facemask

You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room.

Cover your coughs and sneezes

Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can and wash your hands with soap and water for at least 20 seconds. If soap and water are not available, immediately clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty.

Clean your hands

Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid sharing personal household items

You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people in your home. After using these items, they should be washed thoroughly with soap and water.

Monitor your symptoms

Seek prompt medical attention if your illness is worsening (e.g., shortness of breath or difficulty breathing). Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, 2019-nCoV infection. Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people from getting infected or exposed. Ask your healthcare provider to call the local or state health department. Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate.

Discontinuing home isolation

Patients with confirmed 2019-nCoV infection should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments. Current information on 2019-nCoV is limited; thus, home precautions are conservative and based on general recommendations for other coronaviruses, like Middle Eastern Respiratory Syndrome (MERS).



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