Xiaobian recently received a report from a friend: "After turning negative for more than two weeks, it was tested positive, does "Fuyang" in the short term mean that antiviral drugs are ineffective? Is it a secondary infection with this virus? ”
Is "Fuyang" a "secondary infection" of the same strain in the short term? How to distinguish between "Fuyang" and "secondary infection"? Director Yang Shuoying of the Department of Respiratory and Critical Care Medicine of the Second Affiliated Hospital of Xi'an Jiaotong University told us that "Fuyang" does have a certain incidence rate. Studies of previous original strains have found that the re-positive rate fluctuates by 5%-15%, and there is not much research on the specific re-positive rate of the Omicron strain. However, "Fuyang" is by no means a "secondary infection" of the same strain, and "Fuyang" and "secondary infection" need to be strictly distinguished.
What is the difference between the definition of "Fuyang" and "secondary infection"?
Director Yang told us, first of all, we must be clear about the difference between the definition of "Fuyang" and "secondary infection"? Fuyang means that the symptoms of the infected person basically disappeared, and after the nucleic acid test and antigen test turned negative, but after testing again, it was found to be positive again. It is generally believed that some fragments of the virus were detected at this time, but it was not a complete virus, it had no symptoms and infectiousness, and it had no impact on people's normal life. Therefore, basically counting, such people of "Fuyang" do not need to be treated again, mainly pay attention to rest, reasonable diet and nutrition can be.
So what does secondary infection mean? This refers to the fact that the first coronavirus infection has completely recovered, but a second coronavirus infection has occurred, which is often caused by variant strains of the new coronavirus. Secondary infection is a reinfection after people have recovered, it is not in a sense "Fuyang", but equivalent to a new infection, such infection is usually symptomatic, and the CT value of nucleic acid is low, the viral load is high, such infection is contagious. Therefore, patients with secondary infection need to be treated again, and personal protection should be strictly done, self-isolation should be done, and the risk of epidemic transmission should be reduced.
How to distinguish "Fuyang" from secondary infection in terms of time?
Director Yang told us that generally speaking, "Fuyang" occurs within one month after "Yangkang". If you have been more than 1 month and you are positive for nucleic acid, then you have the possibility of secondary infection. The time frame for defining secondary infection varies from country to country, but the basic condition is that it is confirmed and then separated by a certain period of time. The European Centre for Disease Control and Prevention believes that true secondary infection can only be diagnosed when the virus of the first infection has been completely cleared and there is enough time to develop an immune response. The UK defines the interval between secondary infections, which is at least 90 days. In the United States, the interval is 60-90 days.
How to avoid and reduce the risk of secondary infection or even multiple infection?
Director Yang told us that a Swedish study showed that if people received a dose of the new crown vaccine after being infected with the new crown, the risk of reinfection in the first 2 months was 58% lower than that of natural immunity. Another large sample size was studied in Israel, and they also confirmed that the mRNA vaccine BNT162b2 in patients who recovered from the new crown can significantly reduce the incidence of reinfection. 82% vaccine protection in the 16-64 age group; 60% of people over 65 years old; Two doses of mRNA vaccine after infection can further reduce the risk of reinfection in the first 2 months by 69% compared to natural immunity.
Now many patients are asking, how long after "Yangkang" can I be vaccinated? Download two studies of Israeli recovered people who were vaccinated at least 3 months after infection. The recommended vaccination interval for those who have recovered from new crown infection by international authorities is generally 3 to 6 months, and some countries directly recommend that the interval between adult and high-risk children with infection recovery is 1 month. Then in the mainland, as well as health institutions in Hong Kong, Macao and Taiwan, most of the recommended intervals for vaccination of recovered people are also 3 to 6 months. At the same time, considering the vaccination needs of special groups, Hong Kong has given a recommended vaccination interval of 30 days for people with no vaccination history and low immunity.
Director Yang also reminded us that the current situation is still very tense, we must remember to wear masks, wash hands frequently, avoid gathering, this is our most basic protective measures, plus regular work and rest, balanced nutrition, combination of work and rest, and maintain a good attitude, which are important magic weapons to improve resistance.
This Wednesday at 19:00, the special program of the "Breathe Comfortably, Lung Life" famous doctor series special program is very honored to invite Professor Cao Bin, chairman-elect of the Respiratory Disease Branch of the Chinese Medical Association and vice president of China-Japan Hospital, who is guiding the treatment of new crown severe diseases across the country, as a guest in the "Happy Breathe - Let Life Become Its Beauty" science popularization live broadcast room, and authoritatively explain "Are your antibiotics used correctly?" ”。 In order to understand the content of this issue, we also specially invited Dr. Niu Hongtao and President Cao from the Department of Respiratory and Critical Care Medicine of China-Japan Hospital to talk about this topic.
Expert Profile Yang Jianying
Director of the Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University. First-level chief physician, professor, doctoral student and postdoctoral supervisor; Young and middle-aged experts with outstanding contributions to national health; Leader of the national innovation team of "Sanqin Scholars"; Ministry of Education New Century Outstanding Talents; Famous doctor and teacher of Xi'an Jiaotong University; Member of Respiratory Branch of Chinese Medical Association; Member of the Standing Committee of the Respiratory Branch of the Chinese Medical Doctor Association; Member of Respiratory Branch of Chinese Preventive Medicine Association; Chief expert of "Qin Chuangyuan" innovation-driven project; Chairman of the Tumor Individualization Diagnosis and Treatment Professional Committee of Shaanxi Anti-Cancer Association; Editorial board member of 8 journals, including Chinese Journal of Tuberculosis and Respiratory; He presided over 4 projects of the National Natural Science Foundation of China, published 208 papers as the first or corresponding author, including 83 papers included in SCI, won 1 first prize and 2 second prizes of Provincial Science and Technology Progress Award as the first completer, edited 1 monograph, and participated in the formulation of 20 guidelines and consensus on the diagnosis and treatment of lung cancer.