"Is the pandemic coming again? Everything was normal at work yesterday, but today I suddenly felt cold at work, and it exceeded 38 °C! ”
"My colleagues quickly fell and had a fever one by one, and I was the one who was instantly surrounded by the 'heat wave'..."
"From sore throat to headache, from soreness to fever, everything seems familiar, but testing antigens every day is still a bar..."
Recently, on social platforms, the theme of "fever" has once again attracted everyone's attention, which can't help but make people a little worried.
So, is there really a spike in fever cases now?
1. The data shows that there is no peak in the fever clinic
From the information of social networks, we can feel the anxiety and concern, but the national monitoring data may give us another perspective on the situation.
According to a report dated February 15, 2023 on the website of the Chinese Center for Disease Control and Prevention[1], the overall number of fever outpatient visits nationwide (excluding Hong Kong, Macao and Taiwan) reached a peak of 2.867 million on December 23, 2022, and then continued to decline; The number of visits after January 23, 2023 fluctuated at a low level, reaching 128,000 on February 13, a decrease of 95.5% from the peak.
Trends in the number of people treated in fever clinics (clinics) nationwide. The data comes from reports from 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps.
So what do front-line doctors say?
On February 18, People's Daily interviewed Hu Yang, deputy director of the Department of Respiratory and Critical Care Medicine at Shanghai Pulmonary Hospital. Dr Hu said that fever sufferers occur every day and does not feel a significant increase in the number of them recently. Of course, the fever clinic data is slightly lagging, and some fever patients will also be treated at home, so the fever clinic data may not reflect the full real situation in real time, but at least it can show that there is no so-called "soaring fever number" phenomenon.
However, even if you have a fever, you don't have to be too anxious, because some infectious diseases that are already common in winter and spring can also cause fever. We already know a lot about these infectious diseases and can prevent them, so let's talk about them in detail.
2. The risk of influenza A continues to increase, and vaccines are urgent
As early as more than a month ago, the US Centers for Disease Control and Prevention issued a reminder that the elderly and children should pay attention to influenza protection, because there was a peak of influenza infection at the end of the year, and the peak of infection was 52 weeks at the end of last year (the last month of 2022). In the fourth quarter of 2022, at least 20 million people in the United States were infected with influenza A virus (83% of the population with H3N2 and 17% with H1N1), of which 210,000 were hospitalized and 13,000 died from influenza (including 61 children).
CDC influenza surveillance report. Image source: Centers for Disease Control and Prevention
The situation is slightly different in China, and in the last three years (since March 2020), influenza has shown extremely low epidemic levels in the mainland. However, since the spring and summer of 2022, there has been an abnormal peak of epidemic in the southern part of the continent (reaching the highest level in the same period in the past 5 years). This outbreak is predominantly the H3N2 subtype of influenza A virus (consistent with last year's trend in the United States).
Influenza data reported by national notifiable infectious diseases, which have shown a downward trend since July 2022. Source: Chinese Disease Control and Prevention Administration, Chart: Chen Mochela.
Since the end of last year, experts have constantly reminded that the world is still in the midst of the pandemic, and medical resources may be tight for a period of time. According to the research and judgment of epidemic data, everyone needs to be prepared for the possible emergence of influenza and new crown virus infection superimposed epidemic risk.
Therefore, in the face of the recent trend of increasing fever, it is also necessary to consider the infection of influenza nail.
Fortunately, the flu vaccine maximizes the prevention of infection and the incidence of severe disease. The vaccine corresponding to this round of infection has been fully marketed in the mainland. Since enough antibodies can be produced 2-4 weeks after the flu vaccine. Therefore, both the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend that the sooner the vaccine is on the market, the better. Throughout the flu season, unexpired flu vaccines are still available as long as they have not been vaccinated, and it is recommended to get them as soon as possible at any time. During the same influenza season, people who have been fully vaccinated do not need to be vaccinated twice.
3. Diarrhea + fever? Be careful, too
In addition to the "Assassins", October to March of the following year is also the peak season for norovirus epidemics. The disease it causes is called norovirus diarrhea, commonly known as "winter vomiting disease", more precisely, its symptoms should be "vomiting and diarrhea".
Specific symptoms are age-related, children are more often manifested as vomiting, adults are mainly manifested as diarrhea, other digestive tract symptoms include nausea, abdominal pain, etc. However, there are systemic symptoms such as headache, fever, chills and muscle aches, which are similar to those of many other diseases.
Infection with norovirus, the symptoms are not severe, but it is very contagious. According to the introduction of Shenzhen CDC [6], as long as 18 virions, it can cause infection, and whether men or women, old and young, infected or not infected (norovirus mutation is also quite fast, and it is easy to be reinfected after infection), basically can be hit. Recently, it coincides with the school season, and it is inevitable that classmates and friends who have not seen each other for a long time get together to get close, and norovirus is particularly likely to cause widespread transmission in schools in this situation.
This state of high contagion, cluster infection, and similar clinical symptoms are indeed easy to think of "Fuyang". However, with good care and avoiding dehydration, the vast majority of people recover quickly.
4. Prevention and control is nothing more than a three-plank axe, pay attention at all times
Regardless of the type of infection, all infection prevention and control is nothing more than three directions: protecting susceptible people, controlling the source of infection, and interrupting the transmission route.
To put it bluntly, patients who may infect diseases should be isolated. If a student/child is infected, parents should be asked to take it home in time to rest, on the one hand, to facilitate the child's recovery, on the other hand, to avoid infecting other children, and return to school only after 3 days after the symptoms disappear, which is also suitable for adult workplaces; On the one hand, for vulnerable people, it is necessary to do a good job of protection, for influenza A and the new crown, it is necessary to do a good job of vaccination, hand hygiene, and wear masks if necessary.
Cutting off the transmission route means that the environmental hygiene should be done well, patients should vomit, diarrhea, environmental disinfection, ventilation to reduce the concentration of viruses in the air. It is especially reminded that norovirus may contaminate fruits and vegetables or shellfish and cause transmission, so clean and properly cook such ingredients.
Bibliography:
[1] Chinese Center for Disease Control and Prevention, "National Novel Coronavirus Infection Epidemic Situation"
[2] http://henan.china.com.cn/health/2023-02/19/content_42264258.htm
[3] https://www.cdc.gov/flu/weekly/
[4] https://www.cdc.gov/flu/weekly/index.htm
[5] Transcript of the press conference of the State Council Joint Prevention and Control Mechanism on August 10, 2022. http://www.nhc.gov.cn/xcs/xxgzbd/202208/c2be77648c8640f0bf9c9dfbfb9c8430.shtml
[6] https://mp.weixin.qq.com/s/X2A5OCnO38jBTXKHB-ixCw