Some provinces are now at an inflection point, and the flu is peaking?

Recently, many places in the north and south of the mainland have entered a period of high seasonal influenza, among which influenza A epidemics in many places have not only led to the closure of schools, but also brought pressure to hospital visits.

According to the national weekly influenza surveillance report for the tenth week (March 6~March 12) released by the National Influenza Center of China on March 16, the positive rate of influenza virus detection in the southern and northern provinces has slowed down. The positive rate of mainland influenza virus in week 10 increased by 11.7 percentage points compared with week 9, compared with 17.6 percentage points and 16.1 percentage points in the previous two weeks. At the same time, the growth rate of influenza-like outbreaks has also slowed, with 87 more cases in mainland China in week 10 than in week 9, compared with 330 and 282 cases in the previous two weeks.

On March 20, Wang Dayan, director of the National Influenza Center of the Institute of Virology of the Chinese Center for Disease Control and Prevention, publicly said that the flu has entered the peak period in mid-March, and although the overall level is still at a high level, the peak of influenza activity in some provinces has turned around and has begun to decline.

How to deal with this wave of fierce "A stream"? In this regard, Zhou Xin, Department of Respiratory and Critical Care Medicine of Shanghai First People's Hospital, told the 21st Century Business Herald that influenza is the abbreviation of influenza and is an acute respiratory infectious disease caused by seasonal influenza viruses. At present, the viruses that cause the seasonal epidemic of influenza are the H1N1 and H3N2 subtypes of influenza A viruses, and most of the "influenza A" appears in recent domestic news reports.

"The two subtypes of H1N1 and H3N2, which are popular this year, generally belong to Stream A. In general, all influenza viruses can cause death, and influenza A causes a little more harm to the human body than stream B. Zhou Xin introduced that the influenza incidence is mostly elderly and children, and there are cases of death from high-risk groups every year, but the mortality rate is not very high. In the face of influenza, it is especially necessary to strengthen the protection of key groups such as the elderly and children.

In fact, this Flu has led to the temporary suspension of classes for students in many schools. Spring is the high incidence season of influenza A every year, and it is crucial to standardize medical treatment and prevention in a timely manner. And when this peak of the A wave has passed has also become the focus of public attention.

Has the peak of Flu A arrived?

Since March, the continuous increase in the positive rate of influenza A has made the attention exceed the new crown. Many clinical experts said that the scale of the influenza epidemic is significantly larger than in previous years.

Wang Min (pseudonym) of Shanghai told the 21st Century Business Herald reporter that on March 15, she took her child who was still in kindergarten to the hospital, when the attending doctor told her that as a pediatric hospital, during the peak period of influenza A patients, there are thousands of patients who come to see in one day. "In every winter and spring, children have the highest probability of getting the flu, and if at school suddenly find that many children have fever and cold-like symptoms at the same time, you must be aware that the flu may be coming." At this time, you must go to the doctor in time and take corresponding prevention and control measures. The attending physician said.

At that time, many students in Wang Min's son's kindergarten class took leave because of fever, cough, runny nose, vomiting, diarrhea and other symptoms. "On the 14th, I began to have symptoms of fever, cough, and runny nose, so I could only take leave to rest at home." Wang Min said that after the child took leave, the teacher also issued a notice in the class group saying that 5 children in the class were diagnosed with influenza A in one day, so that everyone must pay attention.

A few days later, on the 20th, when Wang Min went to the hospital to give the child a follow-up consultation, the doctors were still busy. The attending doctor told Wang Min that not only in the emergency and fever clinics, but also in the outpatient internal medicine department began to accept patients with influenza A. "As for when the peak of influenza A will be reached, it is still unknown, but it needs to be clear that prevention and standardized treatment are a key key." The above-mentioned attending physician said.

When talking about the topic of influenza peak, Zhou Xin believes that whether this wave of influenza peak has passed depends on the region. Overall, there has been a downward trend in Shanghai, and the number of patients in fever clinics has obviously decreased in the past two days. From the available information, the situation in the north is still somewhat serious, and the influenza index is still high.

"Each region is different, generally a peak season in spring, often from the end of March to April, as the weather warms, the number of people sick with influenza will obviously decline." Zhou Xin said.

However, before the peak of influenza has passed, how to strengthen protection is still a key point. From the current clinical consensus, for infants, nurseries, schools and other key places, the elderly, etc., influenza vaccination can reduce the risk of serious complications, and influenza vaccination is also considered to be the most effective means to prevent influenza.

Zhou Xin said that in terms of flu prevention, vaccines are an important means. However, in general, influenza vaccination needs to be planned a year in advance. The current flu vaccine can basically cover stream A and stream B, and for the public, influenza vaccination definitely has a protective effect. In addition, if there are influenza patients in the family, certain preventive drugs can also be used for early influenza prevention management.

"Influenza (prevention) is a topic that is promoted every year. There are now drugs that fight the flu virus, so don't worry too much. Taking Sufuda as an example, such influenza treatment drugs can be diagnosed and used early, shorten the course of the disease, and greatly improve the quality of life of patients. Zhou Xin said.

Is there an adequate supply of flu medicine?

Before the peak of influenza has passed, the topic of drug supply is still attracting attention, which also makes Sofoda (mabaloxavir tablets) a "tight" drug for a while.

According to public information, Sufuda is mainly used to treat influenza A and B. Because only one dose of the drug can stop the virus detoxification within 24 hours, shorten the infection period and greatly reduce the duration of influenza symptoms, both the dose and the efficacy are better than oseltamivir, so Sufuda is also regarded as a new generation of "anti-influenza miracle drug".

Approved in China in April 2021 for the treatment of acute uncomplicated influenza patients aged 12 years and above, including those at high risk of influenza complications, and was included in the national medical insurance catalogue eight months after it was approved for marketing. In addition, according to Roche, the children's indication of Sufuda is expected to be approved in China in the near future. At the same time, China also participated in the global phase III clinical trial of Sufuda interrupting transmission.

According to a multicenter, randomized, double-blind, placebo-controlled phase III study of oseltamivir and sofonda published in the New England Journal of Medicine in September 2018, the reduction in viral load was greater after 1 day of initiation of treatment compared with placebo or oseltamivir; To stop viral shedding, Sofoda took only 24 hours, compared to 96 hours in the placebo group and 72 hours in the oseltamivir group.

Given its effectiveness, the supply issue of Sofuda has attracted much attention. In this regard, 21st Century Business Herald learned from Roche Pharmaceutical that in order to promote the accessibility of the domestic market of the drug, Roche Pharmaceutical and China Resources Pharmaceutical Business reached a strategic cooperation on the innovative anti-influenza drug Sufuda. According to the cooperation agreement between the two parties, Roche Pharma will continue to be responsible for the channel promotion of Speedfuda in the major hospital markets in China, and China Resources Pharmaceutical Commercial will be responsible for the channel promotion of Speedfuda's online and offline retail markets, as well as some sinking markets.

In addition to the problem of drug supply, standardized and rational treatment has also attracted much public attention, especially when it comes to the choice of drugs, there are also many people who have doubts about how to choose drugs reasonably. For example, what is the difference between Sofda and Tamiflu? How should I choose?

In this regard, Zhou Xin introduced that Sofoda and Tamiflu are two target drugs. Tamiflu is an inhibitor of neuraminidase and Sofoda is a cap structure-dependent endonuclease inhibitor, and the antiviral mechanisms of the two drugs are different. "People usually ask if two medicines can be taken at the same time? Theoretically yes, but we're not advocating it now. Because after the arrival of the flu, patients actually only need to choose to take 1 drug to block the virus from replicating. Zhou Xin introduced that the two drugs of Sofuda and Tamiflu can achieve antiviral effects, and it is not possible to simply evaluate which drug is better.

When the seasonal peak of influenza arrived, many influenza patients rushed to buy online and offline pharmacies after infection, and anti-influenza drugs also ushered in a peak in sales, and some pharmacies even ran out of stock.

Regarding the reserve of influenza drugs, many clinical experts have also said many times in public, especially for infected people with severe symptoms, elderly people at high risk of severe disease and people with underlying diseases can use antiviral drugs. Antivirals are used as early as possible, and work best within 48 hours. The overall safety of antiviral drugs is good, but there are some adverse effects, such as infants under 1 year of age cannot be used. Before using antiviral drugs, it is better to consult a doctor.

"If someone at home has flu-like symptoms, please let them rest at home, observe carefully, and if the condition tends to worsen, be sure to go to the hospital as soon as possible, and standardize the use of anti-influenza virus drugs under the guidance of doctors to reduce the risk of severe disease." Can not make their own decisions to use drugs indiscriminately, resulting in liver and kidney function damage. At the same time, patients and accompanying staff should also wear masks to avoid cross-infection. Some clinicians emphasized to the 21st Century Business Herald reporter.

Source丨21New Health21 original work

Author/Ji Yuanyuan

Editor/Xu Xu

Image/Figureworm