Interviewee: Wang Xiaojuan, Director of the Department of General Medicine and Health Care Office, Beijing Chaoyang Hospital, Capital Medical University
Global Times health client reporter Niu Yulei
Da Song (pseudonym), who lives in Beijing, is 27 years old this year, and no matter his height or size, he is a proper "strong body" in the eyes of others. But just a few days ago, he was almost knocked down by an illness. "I had mild symptoms on Friday night, thinking it was a little cold that had cooled down, and I was going to carry it by relying on my young body. Unexpectedly, the next afternoon, he suddenly had a high fever of 38.8 °C. Dasong's girlfriend immediately placed an order to buy detection reagents for viruses such as new crown and flu, and only after testing did she find out that she had been recruited by "B Stream".
Recently, there has been a significant increase in the number of patients infected with "influenza B". Many people recorded their feelings of illness on social platforms: "persistent high fever that does not go away", "muscle and joint pain all over the body", "fatigue continues after turning negative"...... The weekly report for the 52nd week of 2023 (December 25, 2023-December 31, 2023) released by the Chinese Center for Disease Control and Prevention on January 4 also shows that although the current social infection cases are still dominated by influenza A, the proportion of influenza B is rising, with the north rising for 9 consecutive weeks, from 4.2% in week 44 to 47.3% in week 52, and the south rising for 6 consecutive weeks, from 11.6% in week 47 to 26.4% in week 52.
Judging from the patient's self-report, most people feel that the symptoms of the second flu are more serious than the new crown. Dasong said: "During the new crown, I had a fever for a long time, and I still had a fever for two days, up to 39.2 °C, taking ibuprofen didn't work at all, and it took a slight effect after changing to other antipyretics, but it was still 37.5 °C, and the low-grade fever was not stopped, and I have been feeling that the muscles and joints of the whole body are hurting for the past two days." At 7 p.m. on the third day of the illness, he burned at home until his consciousness was slightly blurred, "I felt like my head was going to explode." At that time, there were four doctors on the scene, Dasong was in line at No. 171, and there were about 40 numbers waiting in front of him, while another patient, who was only 10 minutes late, had reached No. 186.
"Yiliu is simply a 'king bomb'. Ms. Gao, who has been recruited for more than 10 days, detailed several aspects of the self-conscious B stream more serious than the new crown to the Global Times health client reporter. First, it's harder to get a diagnosis. Ms. Gao said that she prepared an antigen test at home during the new crown and was detected as soon as she had a fever, but this time, she went to the hospital three times in a row to finally be diagnosed, missing the best time to take antiviral drugs. Second, systemic symptoms are more severe. During the new crown, the body temperature rises slowly, and the second flu is an acute high fever; the fever can be reduced by taking medicine during the new crown, but the fever will rise again not long after taking the medicine; the physical discomfort is mild during the new crown, Ms. Gao said that she can stand firm and take care of herself, but after the second flu, she is in pain all over her body, and she almost faints when she goes to the hospital to see a doctor. Finally, it lasts longer. At the time of the new crown, Ms. Gao had a fever for 2 days, and although she had a "blade voice" in the back, she could still work normally, but this time the infection B flowed to the 10th day, but she was still weak and coughed with rales.
Wang Xiaojuan, director of the Department of General Medicine and Health Care Office of Beijing Chaoyang Hospital Affiliated to Capital Medical University, told reporters that influenza (including influenza A and influenza B) is mainly manifested by obvious systemic symptoms, such as sudden high fever, joint and muscle aches all over the body, and fever is continuous. Wang Xiaojuan said: "Persistent high fever, obvious joint and muscle pain, etc., will make everyone feel that the disease is 'more serious'. In addition, there are individual differences in how each person feels about the flu and the new coronavirus, and it cannot be judged that "influenza B is more serious".
"Influenza has existed for hundreds of years, and winter and spring are the high incidence seasons, that is, from November of the previous year to March of the following year, and the high incidence of influenza is not particularly different from that of previous years, and the pressure of the fever clinic in the hospital is still in a relatively stable state so far, and there is no particularly abnormal increase. Wang Xiaojuan explained that the influenza virus is constantly mutating and is different every year. Influenza vaccination is still an effective means to prevent influenza and reduce influenza-related severe disease and death, and high-risk groups such as the elderly, children, and people who work in public places are recommended to get influenza vaccination after October every year to strengthen their protection. Every year, the World Health Organization (WHO) predicts candidate influenza viruses in the northern and southern hemispheres, which serves as a bellwether for vaccine companies to produce vaccines. If the prediction is more accurate, the influenza vaccine strain and the epidemic strain are better matched, and the prophylaxis effect after vaccination will be better. "Although the proportion of influenza B patients has increased recently, this year's vaccine has not been 'off target', and the match between the epidemic strain of influenza and the vaccine strain is still relatively high. Wang Xiaojuan said that after the new crown, everyone pays more attention to fever, and the flu is also mainly fever, and it is heavier and longer than the new crown fever, so it will cause greater concern.
"It's important to learn more about how to deal with the flu and take measures if you get infected in your family or yourself. Wang Xiaojuan said that the judgment of influenza generally starts from two aspects. One look at the seasons. Winter and spring are the seasons with high influenza incidence, and if there is a persistent high fever at this time, it is necessary to consider whether it is influenza; If you have a friend around you who has been diagnosed and have close contact with the patient, has an acute fever of more than 38.5°C, has general pain and fatigue, and has mild respiratory symptoms, there is a high probability that you should consider influenza. If you suspect that it is influenza, you should go to the hospital for testing and confirmation as soon as possible, or you can buy a flu kit through online shopping platforms or offline pharmacies for self-testing.
The first step in the treatment of influenza is to use antiviral drugs, such as oseltamivir and mabaloxavir. Wang Xiaojuan introduced that 48 hours after the onset of the disease is the golden period of influenza treatment, when the virus replication is active, and the early use of antiviral drugs can inhibit the viral replication as soon as possible, and can also avoid high-risk groups (such as pregnant women, young children, obese people, and the elderly with underlying diseases, etc.) from developing viral pneumonia, respiratory failure and other serious diseases. If the patient has a persistent high fever or has poor immunity, antiviral drugs may be considered even for more than 48 hours. Secondly, some symptomatic drugs can also be used, such as antipyretics for high fever, cough suppressants for severe cough, and common cold medicines for runny nose, generally do not need to use antibiotics, but if there is yellow and thick sputum in the late stage of influenza, when bacterial infection is considered, antibiotics can also be used as appropriate under the guidance of a doctor.
In terms of the choice of antipyretics, Wang Xiaojuan also put forward suggestions: "It is necessary to look not only at the ingredients, but also at the dosage form. "All antipyretic analgesics have the same mechanism of action, but the dosage form affects the effect. Some drugs are sustained-release tablets, which will slowly release the active ingredient within 24 hours, 12 hours or several hours, and are not fast for sudden high fever reduction, and some drugs are non-sustained-release tablets, which can make the blood concentration reach the peak as soon as possible after entering the body, and have a rapid fever reduction effect. "The effects of ibuprofen and acetaminophen in ordinary preparations are similar, and the extended-release dosage form has a slightly slower antipyretic rate. ”
Wang Xiaojuan finally reminded that the methods of preventing influenza and preventing the new crown are basically the same, such as avoiding crowded and closed places, ventilating the home environment frequently, wearing masks when going out, and washing hands frequently. ▲