At present, with the sudden drop in temperature after the onset of winter, respiratory diseases have entered a period of high incidence. Respiratory diseases refer to diseases caused by pathogens from the nasal cavity, throat, trachea and bronchi and other respiratory tract infections of the human body, mainly transmitted by patients or infected people through droplets. Experts said that this year, there is a superposition and coexistence of a variety of respiratory pathogens in the children's population, which brings a certain amount of pressure to the medical treatment. Influenza infections in older age groups have increased this week, and more attention needs to be paid to it.
In view of the recent booming sales of a variety of viral antigen self-test kits and the shortage of oseltamivir influenza specific drugs, experts also gave corresponding suggestions and tips.
Chaoyang Hospital fever clinic photographed by reporters.
Kiki, who is now in kindergarten and has been experiencing bacterial infection, mycoplasma infection and influenza A since the beginning of November, and is still recovering at home. In the process of taking turns to take care of Kiki, the family members also contracted influenza A one after another.
Kiki's mother burned to 382 degrees, went directly to the hospital, influenza A, syncytial and other viruses were all tested, and at that time it showed that none of them were infected, and the blood picture was still normal. However, the doctor said that many of the recent blood pictures are co-infected with bacteria and viruses, and the virus may cause a drop in white blood cells. Therefore, the doctor judged that Qiqi's mother was still infected with the virus, but it had not yet developed and could not be detected. That night she began to burn to 388 degrees, has not been feverish, after doing a test by myself, I found that the flu A was positive.
Qiqi's mother recalled that most of the children's infusion and consultation environment were gathered together, and she heard that all the children in the hospital were coughing, and there was a high probability that they were infected with influenza A in the process.
Photographed by a reporter from the Department of Respiratory Medicine of Beijing Institute of Pediatrics.
At present, the incidence of Mycoplasma pneumoniae infection in children has begun to show a downward trend, but the incidence of influenza has shown a significant upward trend. Li Tong, chief physician of the Department of Infectious Diseases of Beijing You'an Hospital, once said that compared with the frequent occurrence of respiratory diseases in the autumn and winter of previous years, there are more cases of superimposed and mixed infections of multiple respiratory pathogens in children this year.
Superimposed infection, it is possible to cross-infect, or he was infected with one first, and then infected by other friends with another. Li Tong once said that it is not excluded that some people are infected in the process of seeking medical treatment because of the waiting time and contact with other pathogens infected people. At present, there are many types of pathogens, and when people gather, there is a possibility of exchanging pathogens, resulting in a person may be infected with two or even more at the same time, or it may be infected with multiple pathogens one after another.
Photographed by a reporter from the Department of Respiratory Medicine of Beijing Institute of Pediatrics.
Due to the common symptoms of fever and cough in respiratory diseases, when some children have symptoms of fever, parents will be anxious and take their children on intravenous drips. In this regard, Wei Tianli, deputy chief physician of the Department of Pediatrics of Beijing Friendship Hospital affiliated to Capital Medical University, suggested that we must follow the doctor's diagnosis and treatment plan.
Mainly observe the child's mental reaction, if the body temperature can come down after taking the antipyretic medicine, then we will use the medicine at home according to the doctor's instructions for two or three days. It is impossible to take any medicine and immediately take it like a fever reducer, and it will go off in two hours. Inflammation is a slow subsidence process, and the immune response is also a slow response process, so it takes a while. Wei Tianli said that he could observe at home for two or three days.
Patients lined up at the nasopharyngeal swab collection window of the Beijing Institute of Pediatrics, photographed by reporters.
At present, among the many pathogens of infection, only influenza A has a specific drug. But in general, the course of the viral infection takes at least three to five days, after which it recovers on its own, and the drugs used are mainly to relieve symptoms. Some children with respiratory illnesses have a cough that lasts for a long time, and some parents give their children cough suppressants. Li Tong, chief physician of the Department of Infectious Diseases of Beijing You'an Hospital, once pointed out that the cough is mainly because the residual virus in the upper respiratory tract can cause airway hyperreactivity, which is more sensitive to the surrounding environment, and the symptoms can generally be relieved after one to two weeks.
The cough itself is a self-protection mechanism, and after a respiratory infection, the cough lasts more than the fever for 3-5 days or even 7-10 days. If you find that after the child's body temperature returns to normal, the cough is aggravated, or even shortness of breath, breathing is labored, which obviously affects the rest, and you should seek medical attention in time. If the cough symptoms no longer worsen after the use of antipyretic drugs and the body temperature is normal, there is a tendency to gradually relieve after a few days, it is in the process of gradual **.
Li Tong once said that cough is due to the necrotic cells and secretions caused by previous infection in the airway, which need to be discharged through the mechanism of coughing, so it is necessary to encourage expectoration through cough in order to recover faster, and antitussive drugs cannot be used blindly. "Using some phlegm-reducing medicines, drinking plenty of water, and using a humidifier can all help improve cough and phlegm symptoms. ”
In addition, it is not recommended to go to the hospital immediately after symptoms appear, because within three days of the onset of the disease, many hospitals may not be able to detect antibodies and mycoplasma, and the positive rate of the test will be higher in 3-5 days, and the reference value is relatively high.
Photographed by a reporter from Beijing Institute of Pediatrics.
With the arrival of the high incidence of respiratory diseases, many hospitals have taken measures to expand their capacity. Beijing Tongren Hospital increased the number of pediatric patients this week to ease the pressure of parents and children. Beijing Friendship Hospital's online diagnosis and treatment has also recently added a WeChat "Jingtong" mini-program entrance, so that more patients can achieve online diagnosis and treatment without leaving home and avoid cross-infection of the virus.
Beijing Tongren Hospital has increased the number source of pediatrics from the Internet.
Beijing Friendship Hospital has added a WeChat "Jingtong" mini program entrance provided by Friendship Hospital.
Once a child has symptoms such as fever and cough, how to judge whether he needs to seek medical attention immediately, and how to choose the right medicine by himself?Wei Tianli, deputy chief physician of the Department of Pediatrics at Beijing Friendship Hospital, said that parents must pay attention to avoiding cross-infection of their children in the environment with high virus content in specialized children's hospitals.
If the symptoms are mild, it is recommended to go to the pediatric department of a primary medical and health institution or a general hospital first, or you can choose online diagnosis and treatment. For children over the age of three, after taking antipyretic medicine or physical cooling body temperature, the mental state is the same as usual, and it is recommended to observe at home.
If parents are particularly uneasy, they can go to a community hospital or a secondary hospital. Nowadays, there are still many secondary hospitals for pediatrics, especially during the day. Go for a blood test and give a rough assessment. Wei Tianli said that now many hospitals have opened etiological testing, doing some screening of influenza A and B, nucleic acid testing of adenovirus and syncytial virus, including early antigen detection of mycoplasma. If you have a long cough, you can also do an antibody test, and the hospital can give some symptomatic suggestions. Nowadays, many hospitals have opened a network number source, which is relatively sufficient, and the child's mental state is well responded, giving some clinical suggestions and programs.
Internet diagnosis and treatment is provided by Friendship Hospital.
In the interview, the reporter found that there are indeed many cases of parents like Qiqi's family taking care of their children who are infected with mycoplasma or influenza A. The results of multi-source surveillance showed that the main pathogens of recent respiratory infectious diseases were different in different age groups, but influenza was the main circulating pathogen in all age groups.
In the early hours of Wednesday morning, an elderly man suddenly fell at home and was rushed to Chaoyang Hospital by 120. The old man only had a runny nose at first, but when he got up the next night, he fell to the ground and couldn't get it up. "120 came to take a temperature of 375 degrees, but the blood oxygen is low, and the blood oxygen is only 92, so I was sent to the emergency department immediately. Ms. Deng, a family member of the old man, said.
Beijing Chaoyang Hospital fever clinic reporter shooting.
Li Ran, deputy chief physician of the Department of Infection and Clinical Microbiology at Beijing Chaoyang Hospital affiliated to Capital Medical University, said that the number of adults suffering from influenza has increased significantly in the past two weeks. Compared to previous years, the number of patients did not increase significantly, but the peak time was a month earlier.
For young people, the influenza virus itself is a self-limiting disease, and fever and cough only need to be treated symptomatically, and they can be cured without antiviral drugs. In fact, what needs to be done is to drink a lot of water and rest, especially in the case of high fever, to replenish enough fluids, fully rest, take antipyretic medicine for fever, take some medicine to relieve cough, medicine to dissolve phlegm, and treat the symptoms.
Beijing Chaoyang Hospital fever clinic reporter shooting.
What needs more attention is that the number of elderly people infected with influenza has shown an increasing trend since this week, mainly because there are more elderly people with underlying diseases. Fortunately, the flu symptoms are all mild at present, and there is no flu pneumonia. Li Ran said that it is also because influenza A (H3N2) produces relatively few influenza pneumonia, and there are fewer severe cases.
However, older people are weaker than younger people and may experience atypical symptoms, or trigger the underlying condition to develop into severe disease, so they should seek medical attention promptly after getting sick. Li Tong, chief physician of the Department of Infectious Diseases at Beijing You'an Hospital, once said that especially the elderly with underlying diseases, once they have respiratory tract infections, they are at a higher risk of becoming seriously ill. Influenza, for example, is more likely to develop pneumonia in older people and can lead to instability of underlying conditions.
Therefore, once the elderly have fever symptoms, it is recommended to be more active in testing. "The first thing is to rule out whether it is the flu, if it is the flu, the elderly should still be detected early, anti-virus as soon as possible, and reduce the risk of severe disease. Li Tong once said.
Beijing Chaoyang Hospital fever clinic reporter shooting.
For the current infection of mycoplasma or influenza A school-age children how to judge the situation, and whether there will be a question of virus infectivity after the first infectivity, Wei Tianli, deputy chief physician of pediatrics of Beijing Friendship Hospital, said that most children take the special drug oseltamivir for about two days, and the body temperature will have a downward trend, at this time the infectivity will be relatively small, the general body temperature is normal for about 3 days, and there are no respiratory symptoms, which is called clinical cure.
The contagiousness of mycoplasma is mainly in the early stage and early stage of the disease, and the contagiousness will be relatively large. Under normal circumstances, for example, if the body temperature is normal and the cough tends to improve, the contagiousness of mycoplasma will gradually decrease in about a week. "But it is not absolutely said that this period is not contagious at all, and it has a certain relationship with the immunity of the people who come into contact. Wei Tianli said.
Wei Tianli reminded that the initial immunity is still poor, and the risk of infection with other viruses is high, which is also the reason why many children are currently co-infected. Therefore, children are reminded to take protective measures for at least two weeks after **.
Beijing Institute of Pediatrics medicine window reporter shooting.
Regarding the recent shortage of oseltamivir and antigen self-test kits, which inhibit the activity of influenza viruses, Li Ran said that the best time for oseltamivir to be effective is between 48 hours and 72 hours, and if the infection exceeds 3 days, it is not meaningful to take specific drugs. At the same time, for the recent shortage and out-of-stock situation of antigen self-test kits, Li Ran said that if the test is positive, it is a reference, and you can take special drugs as soon as possibleHowever, if the test is negative, there is a possibility of false negative, and the result is not indicative.
Antigen self-test kits from the web.
In addition, regarding the prevention of respiratory diseases, Li Ran, deputy chief physician of the Department of Infection and Clinical Microbiology of Beijing Chaoyang Hospital, reminded that it is not necessary to blindly use drugs without infection, which not only has no effect on the prevention of infection, but may also cause other problems. To prevent respiratory diseases, we must first ventilate frequently, wash hands frequently, wear masks in crowded places, and get vaccinated against influenza, which is also an effective means to prevent influenza and reduce influenza-related severe disease.
Li Ran said that the peak of influenza generally lasts about a month, so it is expected that this wave of influenza will pass in mid-to-late December. Especially this year, the flu vaccine matches the virus very well, and some people will have a fever after vaccination, but the symptoms will definitely be milder than if they are not vaccinated.
This year's vaccine covers this year's epidemic strains, and there is no drift of antigens, and the flu vaccine can completely protect against it. For the two strains of influenza A (H3N2) that are currently circulating, including influenza B, they have a relatively good fit. Li Ran reminded that especially children and the elderly, it is recommended to get the flu vaccine as soon as possible, the chance of being infected after vaccination is small, and even if they are infected, the symptoms are relatively mild.
Reporter: Ren Xuejiao
Editor: Wang Chenchen