1, 1918 “Spanish flu” and this year’s influenza A how similar?
Answer: According to the U.S. National Institute of Allergy and Infectious Diseases researchers said that all the current influenza A virus can infect humans are 1918 “Spanish flu” pandemic H1N1 influenza virus descendants. Historical records of the “Spanish flu” pandemic in the first wave is not very serious, the second wave of critical cases increased, there are some records of a third wave, it is not like the ordinary seasonal flu, only kill the elderly or immunocompromised people, but seems to be more “favored” It seems to be more “favored” by young adults. From the perspective of the current epidemic, there are many similarities between this influenza A and the 1918 pandemic in terms of spread and infection characteristics, especially the infection of young adults, which may be due to the following two reasons: First, the immunity of young adults is relatively strong, once infected, the virus may induce an immune “storm”, causing a strong abnormal Once infected, the virus may induce an immune “storm” and cause a strong abnormal immune response, which can easily transform from mild to severe disease. At present, the number of children and young adults is high, so the number of serious illnesses is also high.
2. Who is likely to become seriously ill with influenza A?
Answer.
1.Women during pregnancy;
2, with the following diseases or conditions: chronic respiratory disease, cardiovascular disease (except hypertension), kidney disease, liver disease, hematologic disease, neurological and neuromuscular diseases, metabolic and endocrine system diseases, immune suppression (including the application of immunosuppressants or HIV infection, etc. resulting in immune deficiency), long-term aspirin users under 19 years of age;
3, obese people (BMI ≥ 40 high risk, BMI in 30-39 may be a high risk factor);
4. Children <5 years of age (age <2 years are more likely to develop serious complications);
5. elderly people aged ≥65 years.
The above groups of people with influenza-like symptoms are more likely to develop into serious cases and should be given high priority and consulted as soon as possible.
3.What are the characteristics of severe and critical cases of influenza A?
Answer: (a) Serious cases are those who have one of the following conditions.
1. Persistent high fever >3 days;
2.Severe cough, coughing up pus or blood sputum, or chest pain;
3, rapid respiratory rate, dyspnea, cyanosis of lips and mouth;
4.Mental changes: unresponsiveness, drowsiness, agitation, convulsions, etc;
5.Severe vomiting, diarrhea, and dehydration;
6. Imaging with signs of pneumonia;
7. Rapid increase in the level of cardiac enzymes such as creatine kinase (CK) and creatine kinase isoenzyme (CK-MB);
8. Significant aggravation of the original underlying disease.
(b) Critical cases are those with one of the following conditions.
1, respiratory failure;
2.Infectious toxic shock;
3.Multi-organ insufficiency;
(4) Other serious clinical conditions that require supervised treatment.
4.What are the common complications of severe influenza A?
A: As with seasonal influenza, complications of influenza A include respiratory, circulatory, neurological and muscular diseases.
Respiratory complications Pneumonia and respiratory failure (acute respiratory failure syndrome, or ADS) are the most common. Secondary bacterial pneumonia occurs in about 10% of patients with influenza A, with pneumococcal pneumonia being the most common one. Studies have shown that there are three main types of severe influenza A pneumonia, the first being primary viral pneumonia. The disease starts with flu symptoms and worsens after 1-2 days with high fever, violent cough with bloody sputum, respiratory distress and mostly death due to respiratory and circulatory failure. The second is secondary bacterial pneumonia, which gradually improves 1-4 days after the onset of the disease, but then worsens again, with elevated body temperature, increased cough, thick sputum, shortness of breath, and cyanosis. Third, there is mixed viral bacterial pneumonia. In conclusion, pneumonia is both an indicator of severe influenza A and the most common comorbidity in critically ill patients, with rapid progression, and clinical staff should pay more attention to the prevention and treatment of influenza A combined with pneumonia.
Circulatory complications are a common complication of influenza A and one of the main causes of death, including myocarditis and pericarditis. Some patients who recover from influenza with myocarditis may die of heart failure.
Neurological complications include encephalitis and seizures. Neurological complications occur one to four days after the onset of respiratory symptoms and can be characterized by unexplained convulsions, mental status changes, and even cerebral edema and intracranial hypertension.
Complications in muscle disease include myopathy and rhabdomyolysis. Patients exhibit generalized muscle pain and dark urine, and some patients may experience renal failure.
5.What should I do if I find severe influenza A?
Expert analysis shows that not seeking medical attention in time, not seeking medical attention correctly, and even delaying the best time for treatment are important reasons for the increase of severe influenza A. To prevent and treat influenza A, it is very important to seek medical attention scientifically and grasp the right time to seek medical attention. Once a pregnant woman has flu symptoms, she should go to a designated hospital as soon as possible and be treated with the antiviral drug oseltamivir (Tamiflu) as soon as possible; people with high blood pressure, diabetes, asthma and other diseases and children with weak constitution should go to a regular hospital as soon as flu-like symptoms appear; healthy people with a sudden high fever and a temperature above 39 degrees Celsius, or a fever that is not high but lasts for more than three days If you do not see any improvement, you should go to a regular hospital immediately.
In the event of an influenza A pandemic in the community, empirical neuraminidase inhibitor (Tamiflu, etc.) therapy should be started as soon as possible for any patient with suspected influenza manifestations or confirmed influenza, except for suspected coexisting bacterial infections suitable for initiating antibiotic therapy.
6.Is the influenza A vaccine developed in China safe and effective? What are the precautions for vaccination?
A: The clinical trial results show that the domestic vaccine is safe and effective. There are some adverse reactions, mainly local pain, redness and swelling, mild fever and headache, which can be relieved within 1-2 days. Blue Ruiming, the WHO representative in China, pointed out that no one has died because of vaccination. The safety of the vaccine is good, the incidence of adverse reactions does not exceed that of seasonal influenza vaccine, and no serious adverse reactions have occurred.
Who should not be vaccinated temporarily.
(1) Those who are allergic to eggs or any other components of the vaccine (including excipients, formaldehyde, lysate, etc.), especially ovalbumin;
(2) Persons suffering from acute diseases, serious chronic diseases, acute onset of chronic diseases, colds and fevers;
(3) uncontrolled epilepsy and other progressive neurological diseases;
(4) Persons with severe allergies;
(5) Persons younger than 3 years of age and other persons whose doctors consider them unsuitable for vaccination;
(6) Pregnant women and nursing mothers.
Vaccinators should also pay attention to the following matters.
(1) The patient should be kept under observation for 30 minutes after vaccination;
(2) In case of minor reactions, no special treatment is usually required, and if necessary, the patient can go to the hospital;
(4) so far, any vaccine protection effect can not reach 100%, still need to pay attention to personal protection.
7, in the face of China’s new situation of influenza A (H1N1) prevention and control strategy how to adjust?
China’s influenza A (H1N1) prevention and control strategy has been adjusted to “strengthen preventive measures, highlighting key aspects, strengthen critical care, reduce the risk of epidemic”.
8, how to prevent severe influenza A?
Answer: the second wave of influenza A characterized by severe influenza A has spread, the prevention of severe influenza A has become a key link in the control of the second wave of influenza A, can be attached to the following aspects:.
1, vaccination against influenza A: vaccination is to do a good job of influenza A H1N1 prevention and control of the most direct, the most specific, one of the most effective means to reduce the occurrence of outbreaks in specific groups of people, reduce the incidence of morbidity, morbidity and mortality, reduce the risk of influenza pandemic, so as to effectively prevent and control the second wave of the epidemic.
2, grasp the time to seek medical care: not timely medical care, incorrect medical care, and even delay the best treatment time, is an important reason for the increase in serious cases of influenza A.
3, pay attention to the underlying disease: most of the patients with severe influenza A found so far also have underlying diseases, such as heart disease, organ transplantation, autoimmune diseases, respiratory diseases, obesity, etc.
4, early use of neuraminidase inhibitors (Tamiflu): any patient with suspected influenza manifestations and confirmed influenza should start empirical neuraminidase inhibitor therapy as soon as possible, except for suspected coexisting bacterial infections suitable for initiating antibiotic therapy.
5. Traditional Chinese medicine: There are so many Chinese herbal formulas or ready-to-use medicines for the treatment of influenza in China that have played an important role in the prevention and treatment of influenza. One of the advantages of traditional medicine is that it has been clinically proven to be effective and safe. Therefore, it is desirable to use Chinese herbal medicine for patients with mild illnesses (e.g. Lianhua Qingfei capsule, Sensitive Cough Shuangqing capsule).
The epidemic in our province has entered the community epidemic stage, and although the influenza A epidemic is very serious, it can still be prevented, controlled and treated. According to the current epidemic development, influenza A (H1N1) disease is generally mild, the onset of symptoms and treatment methods and ordinary influenza is not very different, mild patients can be isolated at home for treatment, and will not leave after-effects after cure. However, as people are generally susceptible to influenza A (H1N1), the public should pay attention, do a good job of personal protection, reduce the chances of developing the disease, identify serious cases of influenza A, early detection, early treatment, and effectively reduce serious and fatal cases.