There are long queues in outpatient and emergency departments in many hospitals. Is this autumn and winter the peak of fever？

　　BEIJING, Beijing, October 30th (Shao Meng) Fever, cough and sore throat … … With the arrival of the high incidence season of respiratory infectious diseases in autumn and winter, many people report that they or their children have symptoms of respiratory infection. According to media reports, pediatric outpatient and emergency departments, fever clinics and infusion rooms in many hospitals are crowded with patients.

　　A recent visit by Zhongxin. com found that the number of outpatient and emergency departments in many hospitals has increased to varying degrees, and some patients said that they had been in the emergency department for five or six hours. Most of the patients are children, but there are also many adults, especially the elderly. Besides mycoplasma pneumonia infection, influenza and Covid-19 infection, it also includes bacterial infection and norovirus infection.

　　Experts remind that it is necessary to be alert to the mixed infection of mycoplasma pneumoniae with adenovirus, streptococcus pneumoniae and other pathogens that cause respiratory infections.

　　The fever clinic is lined up, and the pediatric emergency department is full.

　　"No.895." At 4 o’clock on the afternoon of October 24, Ms. Shao completed the blood collection with her son who had been coughing for 10 days. When they arrived at the peripheral blood collection window of Beijing Children’s Hospital at noon, there was a long queue outside, and the number bar reminded, "There are 95 people in front of you."

　　"He started coughing a little on the 17th, and went to the hospital here in Daxing on the 19th. He had a blood test, and his blood routine was normal, and the antibody against Mycoplasma pneumoniae was negative. However, due to more mycoplasma pneumonia recently, doctors also prescribed anti-inflammatory drugs, cough medicine and azithromycin. However, after taking the medicine for 5 days, the child’s cough became more and more serious. He could cough up many times at night, so he took him here to have a look. " Ms. Shao told Zhongxin. com that she robbed for three days before she "missed" the number of a fever and cough clinic. "The doctor said that some bacterial infections belong to acute bronchitis."

　　Also surprised by the number of patients was Ms. Tao’s family. When they came to the Children’s Hospital affiliated to the Capital Institute of Pediatrics (referred to as "Pediatric Institute") from Tongzhou, Beijing at noon on the 18th, the number of emergency departments had already reached more than 900. "Who would have thought that this is not Spring Festival travel rush, but the Children’s Research Institute." Ms. Tao is emotional. In the photos she sent, the hall for taking medicine and charging was crowded.

　　Ms. Tao told Zhongxin. com that her child is 5 years old and is in the middle class in kindergarten. Just a few days after the National Day holiday, the child woke up from a nap with a temperature of 38.8℃ and began to cough. On October 12th and 15th, I saw a doctor in a nearby hospital. "I did two routine blood tests, and the antibody against Mycoplasma pneumoniae was negative. The doctor said it was a virus infection and prescribed azithromycin and cough medicine."

　　Although the child no longer had a high fever after 3 days, he still coughed and wheezed badly. After atomization and taking medicine had no obvious effect, Ms. Tao hung up the expert number of the Institute of Pediatrics. The doctor believed that the child seemed to have induced asthma due to cough and fever. "There are 24 students in their class, and now half of them don’t go to class, some have a fever and cough, and some are afraid to go for fear of infection."

　　A similar situation has also appeared in the southern region, and it is not only children who are "recruited". "Our hospital has analyzed the situation of patients with fever and cough in the fever clinic and found that the number of patients in the fever clinic has increased in the past six months." Lu Hongzhou, director of the National Infectious Diseases Clinical Medical Research Center and president of Shenzhen Third People’s Hospital, said in an interview with Zhongxin. com.

　　"The younger you are, the greater the risk of mixed infection."

　　The epidemic of mycoplasma pneumoniae infection is not over yet, and the flu season has begun. According to the epidemic situation of Covid-19 infection released by China CDC on October 9th, the proportion of influenza-like cases in outpatient (emergency) clinics in sentinel hospitals nationwide increased from 3.4% in the 35th week in 2023 to 4.6% in the 38th week and 4.5% in the 39th week. According to the monitoring data of the weekly influenza report of China National Influenza Center, as of October 15th, the positive rate of influenza virus detection in some southern provinces continued to rise, and 42 outbreaks of influenza-like cases were reported nationwide.

　　According to the Technical Guide for Influenza Vaccination in China (2023-2024) issued by CDC, China may face the risk of interaction or co-epidemic of influenza and other respiratory infectious diseases this winter and next spring. Zhongxin. com has noticed that many ip users in Beijing, Shanghai, Guangdong and Jiangsu have recently shared their experiences of being infected with swine flu and bacterial infections.

　　Pediatric doctors and nurses in Beijing Tiantan Hospital have been very busy recently. A pediatrician in the hospital told Zhongxin. com that the number of waiting patients in pediatric clinics may be four or five hundred per day, which is three or four times higher than before. "It’s not the turning point. At present, mycoplasma pneumoniae infection is the main infection, and some infants are easy to be infected with viruses and bacteria. Syncytial virus, adenovirus, parainfluenza virus and rhinovirus are scattered, and there are not many cases at present. A stream and B stream have also started to be positive recently. "

　　Zhongxin. com saw at the China-Japan Friendship Hospital at 3 pm on the 24th that there were almost no vacant seats in the emergency waiting hall, and most of the elderly people were waiting for treatment. From time to time, there were several coughs, and many people were waiting outside the fever clinic. In the pediatric outpatient and emergency department, the waiting number has reached 158. Many children snuggle up to their families with stranded needles in their hands. Coughing and crying came and went, and some young children were put in the stroller and parked in the aisle.

　　Lu Hongzhou introduced that after the National Day, the results of nucleic acid detection of respiratory pathogenic microorganisms in patients in his hospital showed that the highest positive rate of nucleic acid detection was mycoplasma pneumoniae (34.33%), followed by influenza A virus (12.17%) and influenza B virus (5.79%), respiratory adenovirus (2.76%) and respiratory syncytial virus (2.03%).

　　He reminded that adenovirus and streptococcus pneumoniae can be mixed with mycoplasma, and the younger the child, the greater the risk of mixed infection. If combined with mycoplasma infection, the symptoms of children will be aggravated, and parents should be vigilant.

　　Why are respiratory infectious diseases coming?

　　Reminders and media reports issued by disease control in many places show that the incidence of respiratory infectious diseases in China has increased overall recently, and mycoplasma pneumoniae infection is high at present. Why is this happening? Is it related to the previous COVID-19 pandemic?

　　In Lu Hongzhou’s view, the number of people infected with mycoplasma pneumoniae may increase significantly this year compared with previous years, which is in line with the epidemic law of mycoplasma. Before the epidemic in COVID-19, mycoplasma pneumoniae infection existed for many years, and there was a case peak every 3 to 7 years, and each epidemic lasted for 1 to 2 years. During the epidemic period, people wore masks, washed their hands frequently, kept social distance, etc. Mycoplasma pneumonia has been in a low epidemic, which also led to the increase of susceptible population and the deterioration of group immunity.

　　"Studies have shown that the low prevalence of mycoplasma may lead to the decline of children’s immunity to mycoplasma due to the lack of immune stimulation, and when they are exposed to mycoplasma again, there will be an immune overreaction, leading to a more serious outbreak. Now in the past three years, the epidemic policy has been adjusted, and when people come into contact with mycoplasma pneumoniae again, there will be an immune overreaction and an epidemic, especially for young children. " Lu Hongzhou said.

　　In response to the question that some netizens think that "respiratory diseases seem to be more serious than before", Lu Hongzhou explained that almost all infectious diseases were significantly reduced during the COVID-19 epidemic. Nowadays, all kinds of infectious diseases are relatively increasing, not just respiratory diseases.

　　He pointed out that the previous protective measures such as wearing masks and washing hands frequently were better, but now the mobility of people has increased significantly, and everyone’s travel protection is not in place or does not wear masks, which increases the risk of infection. In addition, due to the increase of detection methods and the attention paid by both doctors and patients to precise treatment, the number of detections has increased. And now the use of antibacterial drugs is more standardized and strict, especially for young children, so doctors pay more attention to the results of pathogenic inspection.

　　He believes that the above questions are caused by many factors, such as the decrease of people’s awareness of prevention and control after the epidemic, the increase of samples submitted for inspection, and the increase of detection methods, rather than just the COVID-19 epidemic.

　　Take multiple measures to meet the peak of respiratory diseases

　　Zhongxin. com noted that in the first half of this year, National Health Commission specially formulated and published the 2023 edition of "Guidelines for Diagnosis and Treatment of Mycoplasma Pneumonia in Children", which gave detailed guidance on the characteristics and treatment norms of Mycoplasma Pneumonia.

　　In order to alleviate the pressure of medical treatment, many hospitals are also taking actions to dynamically adjust their services by adding more staff, increasing the number of outpatient clinics, opening temporary outpatient clinics at night, adding new pediatric wards, and optimizing the medical treatment process. Lu Hongzhou introduced that the Third People’s Hospital of Shenzhen has increased the frequency of mycoplasma nucleic acid detection, and also established a deployment mechanism for fever clinics, so as to increase the number of medical staff in time to meet the needs of patients.

　　In terms of drug supply, with the recent high incidence of mycoplasma pneumoniae infection, the demand for macrocyclic lipid antibiotics such as azithromycin has increased. According to media reports, a number of listed pharmaceutical companies have responded on the investor interaction platform one after another, indicating that azithromycin and other related drugs are currently being produced and sold normally to meet market demand.

　　In response to seasonal influenza, CDC issued the Technical Guide for Influenza Vaccination in China (2023-2024), recommending that all ≥ People who are 6 months old and have no contraindications should be vaccinated against influenza. Various localities are also taking a number of measures to promote influenza vaccination, such as providing free vaccination for eligible elderly people.

　　At the peak of infection, what should individuals pay attention to? Lu Hongzhou said that from the current data, although the positive rate of mycoplasma pneumoniae nucleic acid detection has increased, it has not increased exponentially in general, and it has not yet reached the peak of infection. It is expected that the epidemic peak of mycoplasma infection may appear in winter, so parents should be prepared and take precautions at ordinary times. Although there is no vaccine for mycoplasma, there are vaccines for other respiratory diseases such as influenza. It is recommended to vaccinate to prevent the occurrence of complicated infections and severe cases. (End)