As winter enters, temperatures drop, and patients with various types of respiratory diseases including influenza, mycoplasma pneumoniae infection, bacterial infection, etc. have recently increased. How to identify different respiratory diseases? What kind of disease is Mycoplasma pneumoniae infection? How should the public, especially the “old and young” people, respond scientifically? Many experts answered the hot public concerns.
The prognosis is good, no need to worry
“The child had a cough and fever a few nights ago. We took the child to the emergency room and determined that it was Mycoplasma pneumoniae infection. After a few days of treatment, the child is obviously much better now.” In the pediatric outpatient hall of Beijing Chaoyang Hospital Affiliated to Capital Medical University, Ms. Li and The husband was waiting for a doctor with his half-year-old baby. “The child is still young, and each infusion can only be prescribed for one day. Before the infusion, the doctor must decide whether to change the dressing based on the child’s condition. This is safer for the child.”
“Autumn and winter are seasons of high incidence of respiratory diseases. Recently, we have clinically observed an increase in the number of influenza patients and patients with Mycoplasma pneumoniae infection, especially in children.” Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital Affiliated to Capital Medical University Chief physician He Hangyong said that the number of pediatric outpatient clinics in the hospital has increased significantly recently. The daily number of pediatric outpatient visits in the three campuses of Beijing Chaoyang Hospital, including the main campus, Shijingshan campus and Changying campus, can reach a total of about 1,000 people. In order to effectively reduce the waiting time of children and reduce multiple trips to the clinic for consultation and other issues, each campus of Chaoyang Hospital has optimized and adjusted medical services through measures such as adding additional doctors, flexible scheduling, and flexible allocation of clinics.
“Influenza A and B viruses, respiratory syncytial virus, rhinovirus, metapneumovirus, adenovirus, mycoplasma pneumoniae, etc. are all common respiratory pathogens in winter.” Director of the Beijing Institute of Respiratory Diseases and Affiliated to Capital Medical University in Beijing Tong Zhaohui, deputy director of Chaoyang Hospital, said that monitoring data from the National Influenza Center shows that various parts of China are gradually entering the influenza epidemic season, and the currently circulating influenza strains are mainly the H3N2 subtype.
After the COVID-19 epidemic, some people feel that there are more respiratory infectious diseases around them. How should the public view this problem?
“Every winter is the season of high incidence of respiratory infections. Common Mycoplasma pneumoniae and respiratory viruses, especially influenza viruses, are more active than summer or spring, leading to a significant increase in the number of infected people. The characteristics of these diseases are the same as in previous years, and the prognosis is good, so there is no need to worry. “Tong Zhaohui said that during the COVID-19 epidemic, due to everyone’s strict respiratory prevention and control measures, the incidence of acute respiratory diseases including mycoplasma, influenza and other acute respiratory diseases dropped compared with other years. As prevention and control enters the normalization stage, the incidence rate of these diseases has returned to the pre-epidemic level this year. This is normal, so everyone feels that respiratory diseases have increased this year. In the past three years, the global monitoring of mycoplasma infection rates has been at a low level. Considering that Mycoplasma pneumoniae itself has its own epidemic pattern, with cyclical epidemics occurring every 3 to 7 years, we should pay attention to the epidemic trend of mycoplasma pneumonia in children this year. Taking personal protection is the key to prevention.
Tong Zhaohui said that acute respiratory infection is a common respiratory disease. The symptoms caused by Mycoplasma pneumoniae, new coronavirus, influenza virus, etc. are similar. The etiological diagnosis can be clarified through antigen and nucleic acid testing. “It is recommended that you confirm the etiology before taking medication. Avoid substance abuse.”
The “three-piece package” of mycoplasma medication is risky
Recently, “Mycoplasma pneumoniae infection” has been a hot search topic. What exactly is Mycoplasma pneumoniae?
“Mycoplasma pneumoniae is a prokaryotic microorganism, between bacteria and viruses. Compared with bacteria, mycoplasma does not have a cell wall structure, so drugs that act on the cell wall, such as penicillins and cephalosporins, cannot kill it. He Hangyong introduced that macrolide antibiotics, such as azithromycin, erythromycin, roxithromycin, etc., are mostly used in the treatment of mycoplasma infections.
Tong Zhaohui introduced that Mycoplasma pneumoniae is one of the common pathogens of respiratory tract infections. It is prevalent in autumn and winter in the north and in summer and autumn in the south. Fever and cough are the main clinical manifestations. At the onset, it manifests as severe, paroxysmal, and irritating symptoms. A dry cough may be accompanied by headache, runny nose, sore throat, earache, etc. Compared with previous years, Mycoplasma pneumoniae infection has shown a trend among younger people this year, but the condition has not worsened significantly.
Tong Zhaohui revealed the recent detection rate of his medical institution: in terms of the proportion of mycoplasma infections, 5.59% of adults and 40.34% of children; in terms of influenza virus infections, 29.67% of adults and 40.34% of children were infected. 4.94%.
Why are children more susceptible to Mycoplasma pneumoniae infection? He Hangyong said that this is because children’s immune systems are immature and the non-specific and specific immune functions of the respiratory tract are not perfect. For example, children’s nasal cavity and airway ciliary movement and cough reflex are weak. At the same time, Mycoplasma pneumoniae itself is highly transmissible and can be spread through respiratory droplets or close contact. However, schools and kindergartens have high crowd density and the pathogen is easy to spread quickly.
“For school-age children who have been diagnosed with Mycoplasma pneumoniae infection, they should still insist on resting at home, and it is not recommended to go to school while sick.” He Hangyong said that this is not only conducive to the child’s early recovery, but also the protection of other children in the school. At the same time, it is recommended that schools frequently open windows for ventilation while ensuring indoor temperature, and guide children to do good hand hygiene and maintain a certain social distance.
Recently, recommendations for the diagnosis and treatment of mycoplasma infections such as the “three-piece mycoplasma medication set: azithromycin + ibuprofen + guafenabenamine” have appeared on the Internet. Are these three drugs effective for Mycoplasma pneumoniae infection? Can patients self-medicate based on this advice?
“There are certain reasons for choosing these three drugs, but each child’s condition is different and the drugs they need are also different. Using them without authorization may bring unnecessary risks. It is still necessary to use the drugs under the guidance of a doctor or pharmacist.” He Hangyong reminded Cold and fever are not necessarily mycoplasma pneumonia. You need to go to a regular hospital for diagnosis before using the corresponding drugs. “For patients with mycoplasma infection, azithromycin can directly eliminate the pathogen, but it is a prescription drug, and its drug resistance is The rate is relatively high, so it should be used under the guidance of a doctor; ibuprofen is an analgesic and antipyretic drug. When a patient develops high fever, it is generally recommended to use antipyretic drugs when the temperature is 38.5 degrees Celsius and above, and warm water bathing can be used below 38.5 degrees Celsius. and other physical cooling methods; leucomethamine is a compound medicine that has multiple effects such as relieving coughs, clearing the nose, relieving sore throats, and reducing phlegm.”
“Although Mycoplasma pneumoniae has ‘pneumonia’ in its name, Mycoplasma pneumoniae infection ≠ Mycoplasma pneumonia. Only when Mycoplasma pneumoniae invades the lower respiratory tract can Mycoplasma pneumonia occur.” He Hangyong reminded that Mycoplasma pneumonia is mainly characterized by fever and cough, and cough is usually A dry cough that can last from weeks to months. However, some children have atypical symptoms, and younger children are more likely to have this condition. If parents find that their children have severe coughing, shortness of breath, wheezing, poor mental status, or persistent high fever, they should go to the hospital in time and take a chest X-ray if necessary.
Taking preventive cold medicine is not advisable
Winter and spring are the seasons of high incidence of respiratory infectious diseases such as influenza. He Hangyong reminded that whether it is influenza, new coronavirus or Mycoplasma pneumoniae infection, the actual symptoms after infection in adults are generally mild, but children, the elderly and patients with underlying diseases have relatively poor resistance, and are likely to develop into pneumonia and severe illness. Risk groups.
“For people at high risk of severe illness, it is critical to make accurate differential diagnosis at an early stage and use targeted medications in a timely manner.” He Hangyong suggested that if key groups develop symptoms of pneumonia or other upper respiratory tract infections such as high fever, severe cough, and yellow sputum, they should It is necessary to go to the hospital promptly, detect pathogens, and use medicine correctly.
“When the number of circulating pathogens increases, the probability of mixed infections will also increase, so special attention must be paid to prevention.” He Hangyong emphasized that vaccination is the most effective and economical way to prevent infectious diseases, and influenza vaccination can effectively reduce infections. , the risk of illness and severe illness, the public, especially the “old and young” group, is recommended to actively receive influenza vaccination if there are no contraindications and meet the vaccination conditions.
Recent monitoring data from the National Influenza Center shows that influenza activity in both southern and northern provinces of my country has continued to increase. Therefore, some people want to prevent respiratory diseases by taking isatis root, Ganmao Ling and other drugs. Is this approach reliable?
“This approach is not advisable and unnecessary. Improper use or excessive use of drugs may produce a series of side effects, which may harm health.” He Hangyong emphasized that the focus of preventing respiratory diseases is to improve the body’s resistance, and it is recommended that the public adopt it in daily life. Scientific prevention methods reduce the risk of infection and transmission.
He Hangyong reminded that a healthy lifestyle is an important guarantee for enhancing physical fitness and improving body resistance. It is necessary to ensure adequate sleep, adequate nutrition and appropriate physical exercise. At the same time, attention should be paid to improving personal and household hygiene habits to reduce the risk of infection, such as covering the mouth and nose with tissues, towels or elbows when coughing or sneezing, paying attention to hand hygiene, and washing hands frequently; maintaining a clean environment at home and in the workplace Keep the room clean, open windows regularly for ventilation, and family members should wear masks when caring for patients with respiratory infections. For high-risk groups such as the elderly, children, pregnant women, and patients with chronic diseases, they should try to avoid going to crowded public places. If they must go, it is recommended to wear a mask and change it in time.