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China - Pediatric hospitals full with seasonal flu + mycoplasma pneumonia patients, Guangzhou, Guangdong province - November 27, 2023

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  • China - Pediatric hospitals full with seasonal flu + mycoplasma pneumonia patients, Guangzhou, Guangdong province - November 27, 2023

    Pediatrics are full, is the flu peak coming? Reporters visited many hospitals in Guangzhou
    2023-11-27 08:34 Source: South+

    Artificial intelligence reading:
    This winter, various respiratory infectious diseases are coming together. Pediatric outpatient clinics and children's hospitals in many places across the country are "full".

    According to the latest "Influenza Surveillance Weekly Report" released by the National Influenza Center on November 23, from November 13 to 19, the positive rate of influenza virus testing in my country's southern and northern provinces continued to increase. Among them, the proportion of influenza-like cases reported by sentinel hospitals in southern provinces was 6.4%, which was slightly higher than that of northern provinces, and also higher than the level of the previous week (5.5%) and the level of the same period from 2020 to 2022 (3.7%, 3.4% and 3.0%). %).

    On November 24, when reporters visited various hospitals in Guangzhou, they found that there had been an increase in influenza patients recently, but Mycoplasma pneumoniae infection was still the "mainstream". Although the number of medical visits in many hospitals has increased significantly, they have all made full preparations to deal with the peak epidemic of respiratory diseases. The medical treatment sites are orderly and the situation is generally stable.

    Women's and Children's Hospital:

    Mycoplasma pneumoniae still accounts for the majority of children

    At 11:40 a.m. on November 24, Fangru (pseudonym) hurriedly took her son, who had a high fever of 38.4 degrees Celsius, to the fever clinic of the Zhujiang New City Campus of Guangzhou Women and Children’s Medical Center to report. The staff at the outpatient nurse station gave her a number paper with "321" written on it.

    At this time, the screen above the nurse station was calling "No. 180", and Fangru still had more than 100 numbers to wait. "It'll be great if I can get registered." She didn't mind the trouble and breathed a sigh of relief.

    At 1:17 noon on the same day, Tang Yuanping, chief pediatrician of Tianhe Branch of Guangdong Maternal and Child Health Hospital, was seeing the 44th patient that morning. The consultation time that originally ended at 12 o'clock has been extended by more than an hour due to the extra sign.

    Outside the clinic, there were about three or four parents waiting with their children. Mr. Liu said with a sad face that his child had been diagnosed with mycoplasma pneumonia, but he no longer had a fever. He wanted to ask the doctor whether he still needed hospitalization.

    "The children recently admitted are still mainly infected with Mycoplasma pneumoniae." Li Zengqing, chief physician of the Department of Pediatric Respiratory Medicine at the Panyu Campus of the Provincial Maternal and Child Health Hospital, pointed out that since November, the number of patients in his clinic has increased by 40% month-on-month. In the past two weeks, the detection rate of influenza among hospitalized children has increased slightly, but it has not exceeded Mycoplasma pneumoniae.

    According to the reception situation, Lu Gen, director of the Respiratory Department of Guangzhou Women and Children's Medical Center, also said that although the number of influenza cases has been on the rise, it is still sporadic, and Mycoplasma pneumoniae infection is still the "mainstream".

    "Judging from the characteristics of disease epidemics in the past, it is rare for two pathogens to be prevalent at the same time. Usually one pathogen will dominate." Lugen said that if influenza becomes more frequent in the future, Mycoplasma pneumoniae infections "may decline." .

    In order to better cope with the peak number of children visiting the hospital, the fever clinic and pediatric internal medicine clinic of Guangzhou Women and Children's Medical Center have added daytime and nighttime call sources and visiting doctors. In the respiratory department where Lu Gen is located, specialist doctors have also added 20 calls per person per day. sources to divert pediatric patients.

    The reporter also noticed at the scene that although there were many patients in the outpatient hall, the order was good. The respiratory clinic of the hospital also has a number of independent nebulization rooms, where children can watch cartoons while undergoing treatment.

    In the hut, 3-year-old Huahua obediently held up the machine for atomized inhalation treatment. The treatment lasted for more than ten minutes, but Huahua neither cried nor fussed, and was completely attracted by the cartoon "Peppa Pig". "This is really unexpected!" Huahua's father sighed with emotion.

    "Although busy, it is not chaotic." According to Deng Wen, chief physician of the emergency department of the Provincial Maternal and Child Health Hospital, after three years of epidemic, the hospital's reception capacity and emphasis on handling infectious diseases have increased. Recently, the average daily number of emergency department visits in the Panyu hospital district where he is located has reached more than 800, which has exceeded the peak of spring influenza in Guangzhou in March this year, but the department has been relatively calm in dealing with it.

    He introduced that before the peak of this wave came, the hospital had formulated relevant emergency plans, and adopted measures such as adding more doctors on duty and adding new Internet hospital video consultation services to improve the efficiency of medical treatment and disperse some outpatient and emergency visits. There are many children with the disease at night, and the longest waiting time for parents is three hours. "We can basically see most of the patients before 12 o'clock in the morning."

    general Hospital:

    The detection rate of B-fluidemia among “old children” increases

    At 10:30 a.m. on November 24, the waiting area of the emergency department of Guangdong Second People's Hospital was still relatively loose. Unlike the Women's and Children's Hospital, there are not many people in the pediatric infusion area here, and one-third of the 24 seats are still available. There are about 30 seats in the adult area, but they are basically full.

    "The number of adult patients with pneumonia has increased." Yan Zhenzhen, the nurse in charge of the hospital's emergency department, said that many adult patients receiving infusions have recently had "pneumonia" written on their diagnosis sheets. However, because the symptoms are mild, infusion treatment can be done in the outpatient clinic, and not Requires hospitalization.

    In the pediatric infusion room, Mr. Xue is accompanying his daughter to get an injection. Two days ago, his daughter developed symptoms of fever and cough, and he immediately called the pediatrician at the No. 2 Provincial Hospital for her. “After I came here this morning, it only took a long time to see the doctor, draw blood, get the results, and get the injection. It took less than an hour and was smooth.”

    "The number of people seeking treatment during the day is actually not that large, and the peak is at night." Huang Shuai, an emergency physician at the hospital, said that in the past two weeks, the number of emergency visits at night has been about three times that of the day. At the most, the number of patients is nearly 30, and the waiting time is about one and a half Hours to three hours. Among them, 80% of the patients developed symptoms of respiratory tract infections, and about 10% of them tested positive for influenza. “Although there has been an increase, it has not yet shown an obvious high-incidence trend.”

    Currently, the emergency department of the Second Provincial Hospital has strengthened the scheduling of on-duty personnel. The nurses at the triage desk will also appropriately divert personnel to the fever clinic based on the patient's symptoms to ensure orderly diagnosis and treatment.

    In the clinic of Wu Zhu, head of the pediatric outpatient and emergency department of Zhujiang Hospital of Southern Medical University, the number of patients is also running at a high level. According to his recent observations, the number of children infected with Mycoplasma pneumoniae has declined, while influenza is on the rise, with influenza B being the dominant category.

    "Currently, about 50% of children with fever have been detected with influenza virus, but it has not yet reached its peak." Wu Zhu said that in terms of symptoms, these children behave very typically - high fevers reaching 39 or even 41 degrees Celsius, and some people Accompanied by sore throat, listlessness, severe vomiting, etc.

    Wu Zhu said that in addition to the increase in B-flu, another major feature of this wave of influenza is the increase in "older children". Among the approximately 90 patients he sees every day, most are students in third grade to junior high school. Its department is actively responding to the increase in influenza and developing symptomatic and antiviral treatments.

    He also reminded that the most serious complications of influenza A and B are acute respiratory distress syndrome and acute necrotizing encephalopathy. If your child has a high fever, difficulty breathing, listlessness, or even cramps and frequent vomiting, he should go to the hospital as soon as possible.

    Data from Guangdong Provincial People's Hospital shows that the number of pediatric emergency rooms has indeed increased two or three times compared with before. However, the relevant person in charge said that there are enough general pediatric outpatient doctors, and the hospital has also prepared inpatient doctors as a "reserve army" who can support emergency emergencies at any time, so parents can rest assured.

    community Hospital:

    The number of medical visits has dropped and the referral mechanism has been smooth.

    Contrary to the busy pediatric outpatient and emergency departments of women's and children's hospitals and general hospitals, some community hospitals in Guangzhou have seen a decline in patient visits.

    Gao Jianhong, deputy director of the Huazhou Street Community Health Service Center in Haizhu District, said that in the first week of November, the center's daily average number of respiratory disease consultations reached more than 40 people, which has dropped to an average of more than 30 people per day in the past two weeks. The detection rate of viral infections is also declining.

    "We have not encountered a single severe case this year." Gao Jianhong said that because residents are close to each other, they usually come to see a doctor within a day or two when they develop symptoms such as fever and cough. After symptomatic treatment, they quickly improve. .

    According to Fan Xialing, deputy director of the Huazhou Street Community Health Service Center, the recent decline in the number of medical visits may be related to the "effectiveness" of the influenza vaccine.

    Since August, the social health center has started influenza vaccination publicity work. Through free clinics, campus lectures and collaboration with family doctors, it calls on residents to get the flu vaccine before the peak influenza season.

    According to the public science of the Guangdong Provincial Center for Disease Control and Prevention, the period of high influenza incidence in Guangdong is from November to March of the following year. Getting the influenza vaccine 2 to 4 weeks before the peak season will help to produce effective antibody protection in the body and prevent influenza infection and Severe illness occurs.

    "After the flu vaccine arrived in October, our vaccination volume increased three to four times, and now we are even a little short of vaccines." Fan Xialing said.

    She suggested that when residents have symptoms such as fever and cough but don’t know how to deal with it, they can feel free to come to community hospitals for medical treatment. This year, the Social Health Center has paid attention to the increase in Mycoplasma pneumoniae infections and has added Mycoplasma serum antibody testing services in July. The center is also equipped with azithromycin and other therapeutic drugs. If the condition is really serious, the hospital will directly transfer the patient to a higher-level hospital through the medical alliance to improve the efficiency of diagnosis and treatment.

    At a press conference held by the National Health Commission on November 24, Hu Qiangqiang, deputy director of the Publicity Department of the National Health Commission, also emphasized that the National Health Commission has recently guided various localities to implement a hierarchical diagnosis and treatment system, give full play to the role of the medical alliance, and improve primary care. With the health's ability to diagnose and treat general infections and the referral ability to identify severe cases, it is recommended that children with mild symptoms first go to primary medical health institutions or pediatricians in general hospitals.

    "Parents don't need to worry too much. There are very few patients who are seriously ill simply due to influenza and Mycoplasma pneumoniae infection." Yang Jiasheng, deputy chief physician of the Department of Respiratory and Critical Care Medicine of the Second People's Hospital of Guangdong Province, said that although the respiratory ward of his hospital is currently All are fully occupied, but less than 5% of the patients have severe pneumonia. Most of them are elderly people with underlying diseases. They become severe because they are combined with infections such as COPD, COVID-19, Streptococcus pneumoniae or fungi.

    Lugan also said that among children, the proportion of severe cases caused by Mycoplasma pneumoniae infection is very low. Some patients are relatively prone to mixed infections and severe illness because of underlying diseases such as congenital heart disease.

    Experts suggest that after a child develops symptoms, priority can be given to symptomatic treatment at home or treatment at a social health center. Only if the child has a high fever for more than three days and the drug is not effective will it be necessary to seek further diagnosis and treatment. It takes time for diseases to improve. For example, for Mycoplasma pneumoniae infection, it will take a week or two for patients with mild symptoms to recover. Parents should accept this and treat the disease rationally. Frequent trips to the hospital increase the chance of cross-infection and are not necessarily conducive to physical improvement.

    In addition, Lugen reminded that after being infected with Mycoplasma pneumoniae, the antibodies produced by the human body are not very protective. To avoid repeated infections in children, parents should take non-pharmaceutical intervention (NPI) measures in their daily lives. For example, wear a mask in crowded places; maintain hand hygiene; cover your mouth and nose when coughing to avoid the spread of droplets; pay attention to ventilation in classrooms and homes, and conduct regular air disinfection.​

    source: z

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