This winter, as respiratory diseases such as mycoplasma pneumonia, influenza, and respiratory syncytial virus superimpose, “children have fevers one after another” has made some parents feel anxious, and symptoms such as colds and fevers seem to be more frequent in adults.
How severe are the various respiratory diseases prevalent this year? Do we need to worry about the sequelae?
Why is mycoplasma pneumonia so severe this year?
Many children have been infected with mycoplasma and have symptoms of fever and cough, and even adults have been affected. What exactly is this “mycoplasma”?
Zeng Mei, deputy director of the Department of Infectious Diseases and doctoral supervisor at the Children’s Hospital of Fudan University, said in an interview with China News Service: It is a pathogenic microorganism that differs from normal bacteria in that it does not have a cell wall, so it is called a pathogenic microorganism. Typical bacteria. Pneumonia caused by infection with Mycoplasma pneumoniae is called mycoplasma pneumonia. Mycoplasma pneumoniae was discovered by humans in 1944 and was later found to cause lower respiratory tract infections in humans.
Why is this year’s mycoplasma pneumonia infection particularly “violent”?
Zeng Mei said that various pathogenic microorganisms in the respiratory system, including mycoplasma infections, coexist with us on the earth, and seasonal epidemics are inevitable. The reason why mycoplasma pneumonia and other epidemic respiratory infectious diseases are increasing this year is related to the fact that three years of epidemic prevention and control have temporarily blocked the spread of some epidemic respiratory infections, leading to the accumulation of more susceptible people. When normal life is fully restored this year, people will face various pathogenic microorganisms in nature and will appear more “vulnerable” than before the new coronavirus epidemic.
Experts also pointed out that exposure to these popular pathogenic factors is not entirely a bad thing, because it will enhance people’s immunity to these pathogenic factors; excessive reduction of exposure opportunities is not necessarily a good thing, as it will reduce the chance of immunity enhancement. Facing the presence of viruses and bacteria is normal.
Has the southern “peak” passed? What about the north?
Fever and cough have an impact on our normal lives, especially when children fall ill, which makes parents even more anxious. When will this epidemic wave pass?
Zeng Mei said that in Shanghai, respiratory epidemic diseases such as mycoplasma pneumonia have begun to spread this summer, and the epidemic wave has gradually increased in autumn. The epidemic continues to rise after schools reopen, reaching a peak around October. Judging from the current outpatient visits, the number of visits for children with mycoplasma pneumonia has been gradually decreasing. In some areas, the epidemic wave of mycoplasma is later than in the south, and the time point for the epidemic to decline will be delayed accordingly.
What are the transmission patterns of influenza and other epidemic respiratory diseases, including mycoplasma pneumonia?
Zeng Mei said that the spread of these epidemic diseases is closely related to crowd gathering. Mycoplasma pneumoniae exists all year round, and infections are more common in summer and autumn. After the start of school in the fall, the number of children with mycoplasma infection in outpatient clinics increased significantly, mainly related to students living in gatherings. Usually in January, especially after students go on vacation, the incidence of respiratory infections among children across the country will show a significant downward trend.
Is it more severe? Are there any sequelae?
Is the risk high after mycoplasma pneumonia infection? Will there be any sequelae? The expert’s answer is “very few.”
Zeng Mei said that even patients with severe mycoplasma pneumonia will recover well after active treatment. In a very small number of cases, necrotizing pneumonia may have an impact on lung function. Mycoplasma pneumonia should be promptly diagnosed and treated professionally under the guidance of a doctor to avoid long-term complications.
It is very important to seek medical treatment in time, but crowded areas with patients will increase the chance of infection. How to determine the time to seek medical treatment is crucial. Zeng Mei said that after school-age children are infected with mycoplasma pneumonia, they will develop high fever and severe cough. The high fever will not subside for more than 3 days and the cough will progressively worsen. They should seek medical treatment in time.
Choosing a suitable medical institution for treatment is also a matter of course. The higher the level and the greater the reputation, the better.
Zhi Xiuyi, a national health science popularization expert and chief expert of the Department of Thoracic Surgery at Xuanwu Hospital of Capital Medical University, said in an interview with China News Service: The level of diagnosis and treatment of influenza and respiratory infectious diseases in primary health care institutions in various places has increased significantly in the past three years. As long as you have symptoms such as fever and cough, or if you are suspected of being infected with respiratory diseases such as the new coronavirus, you should go to the hospital’s fever clinic in a timely manner. In the absence of severe clinical symptoms or other respiratory complications, it is not necessary to go to a large hospital for treatment. If you choose a nearby primary medical institution with a fever clinic, there will be fewer people and fewer opportunities for cross-infection.
Can self-test results and online prescriptions be trusted?
Nowadays, many respiratory diseases with similar symptoms are intertwined. Are the results of mycoplasma pneumonia self-test kits purchased in pharmacies trustworthy?
Zeng Mei said that at present, the diagnosis of mycoplasma pneumonia mainly involves collecting the patient’s nasopharyngeal secretions or sputum for mycoplasma nucleic acid testing, which is fast, sensitive and specific. Mycoplasma culture takes five to seven days and cannot provide early and timely clinical diagnosis. Antibody testing through serum can be used as an important reference for diagnosis, but the significance of a positive antibody test is not absolute. In clinical diagnosis, the significance of antibody positivity should be judged based on dynamic detection changes. A single serum IgM antibody changes from negative to positive, and double serum IgG antibody levels increase twice as much, which has diagnostic value. Mycoplasma infections can cause upper respiratory tract infections or asymptomatic infections that do not require antimicrobial treatment.
Therefore, from a doctor’s perspective, there is no need to adopt an overly aggressive treatment plan early. Including upper respiratory tract infections caused by mycoplasma, some do not require antibiotic treatment, but in the case of pneumonia, antibiotic treatment is required.
As mycoplasma pneumonia attracts more and more attention, some drugs such as azithromycin have almost become “common sense” among netizens to deal with such diseases, and some prescriptions titled “from a top-level tertiary hospital” have appeared on the Internet. Is this information trustworthy?
A senior person engaged in pharmaceutical sales said in an interview with China News Service Guoshi Express that in order to hype their products, some drug dealers or manufacturers often create gimmicks to achieve promotional purposes. Faced with “directly giving specific brands” Prescriptions” should be treated with caution. Medical experts generally only talk about the type of drug and will not give specific brands.
Zeng Mei said that measures to treat mycoplasma pneumonia include anti-infective treatment, anti-inflammatory treatment, cough and fever reduction and other symptomatic treatments. If the airway secretions are blocked by mucus plugs, symptoms and signs of airway obstruction appear, films show atelectasis, emphysema due to airway obstruction, or unilateral or bilateral lung consolidation, fiberoptic bronchoscopy can be performed. Airway irrigation, also known as “lung washing”, not only restores airway patency, but also removes inflammatory substances from the airways and reduces inflammatory damage to the airways.
There are a series of professional considerations behind why experts do not recommend patients to take medications without authorization, especially anti-inflammatory drugs.
Zeng Mei said that the Mycoplasma pneumoniae epidemic in my country had a relatively high resistance rate to macrolide drugs more than ten years ago, and the current resistance rate is already at a very high level. In this case, if you use macrolide drugs such as azithromycin, erythromycin, or clarithromycin, the efficacy may not meet expectations, or the treatment may even fail. Doctors will consider switching to new tetracyclines such as doxycycline and minocycline, or fluoroquinolones such as ciprofloxacin, levofloxacin, and moxifloxacin to achieve better and faster treatment effects. For severe patients with persistent high fever that does not subside for five to seven days and other conditions, combined with short-course glucocorticoid anti-inflammatory treatment, good therapeutic effects can be achieved and the condition will improve faster.
As for how to prevent mycoplasma pneumonia, Zeng Mei said that there is currently no relevant vaccine and the same preventive measures can be taken as for other respiratory infections.