Are the cases of Shanghai, Hubei and Hubei “Fuyang” infected again?
According to the analysis of infectious diseases experts, there are three possibilities for the cause, and the possibility of recurrence is greater than that of re-infection.
On August 12th and 13th, Jingzhou, Hubei and Shanghai each reported a case of "Fuyang" cases of new coronary pneumonia several months after the cure. Among them, one case in Jingzhou, Hubei was a woman who was diagnosed in February. A few months after healed, she tested positive again on August 9; the case in Shanghai was a male from Jilin who came to Shanghai for medical treatment. He was diagnosed in April and lifted from isolation in July. Tested positive again on the same day.
Since the outbreak of the new crown epidemic, the discussion on "Fuyang" has never stopped. Is this a "false negative" or re-infection after recovery? Is "Fuyang" a unique feature of the new coronavirus? In this regard, a reporter from the Beijing News sorted out the relevant cases and invited experts from the infectious disease department who had been fighting the epidemic on the front line to analyze and clarify doubts.
Follow-up 1
Why is there "Fuyang" after healing?
Infectious diseases experts analyzed that there are three possibilities for the recent reyang cases
In February and March of this year, patients discharged from the hospital had "fuyang", and some respiratory experts who treated patients in the "red area" of Wuhan confirmed to reporters that many patients had multiple nucleic acid test results with different results.
According to expert analysis, this type of "fuyang" is highly likely to be "false negative". Affected by complicated links such as kits, sampling time, and sampling techniques, the nucleic acid negative results obtained may not be 100% accurate.
Tong Zhaohui, a member of the expert group of the Central Guidance Group to Hubei, said earlier that there may be some patients who have used hormones for a long time and a relatively large amount. The virus will be cleared from the body. The test was negative at that time, and the test will be positive again. Song Tie, deputy director of the Guangdong Provincial Center for Disease Control and Prevention, believes that patients may have intermittent detoxification. In short, "True Negative" does not mean that the virus in the patient has been completely eliminated.
"Recent cases of Fuyang, based on the existing information analysis, there are also several possibilities. First, the virus in the patient's body has not completely disappeared; Second, the resistance developed after the first infection is not durable; Third, the virus has mutated, the previous Resistance is ineffective and re-infected.” said an infectious disease expert who had been in Wuhan for more than 60 days to fight the epidemic.
"If the virus in the patient's body is not'cleared', it is likely to be very low, so low that it cannot be detected. This should be analyzed in conjunction with the degree of absorption of inflammation in the lungs at the time of discharge. We call it relapse and reburn." The expert Said that if it is indeed completely cured, there is a possibility of re-infection. "Either the resistance is not lasting after the first infection, or the virus has mutated and a new subtype appears, and the previously generated immunity does not work. It is similar to that there will be a different influenza virus epidemic every year, and people who have had influenza before. May get flu again soon."
However, considering the source of infection and other factors, the above-mentioned experts believe that the possibility of recurrence is greater than that of re-infection.
Jiang Rongmeng, a member of the Expert Committee of the National Hospital Infection Control Quality Control Center, reminded that for "fuyang" cases, attention should be paid to the careful identification of CT numbers during nucleic acid amplification, and the possibility of "false positives" should be excluded.
Follow-up 2
Is "Fuyang" unique to COVID-19?
Experts believe that if the virus is indeed present in the body for a long time, it is not unique to the new coronary pneumonia
Although "Fuyang" has repeatedly triggered external discussions, it is no longer a case in clinical practice.
Jiang Rongmeng introduced that with the increase in the number of discharged patients, patients have "re-yang" in many areas, and the "re-yang" rate in some areas is around 15%. Some patients tested positive for nucleic acid again during isolation, while others were a few months later.
"I tend to think that the so-called'Fuyang' is'Changyang'. In the middle, it is because of the low amount of virus or sampling reasons that no positives were detected. If it is true that there is a virus in the body for a long time, it is not unique to COVID-19. It is said that some people carry the herpes virus for a long time after being infected, but it does not attack and is not contagious; some people will relapse when the immune system is weak, showing herpes zoster. It is worth studying now that the virus will be cleared after a general acute infection , Will not carry it for a long time. What is the situation of the new crown rejuvenating patients? No conclusion can be made." Jiang Rongmeng said that overall, the average hospital stay for new crown pneumonia is 15 to 18 days, and most people can be cured in a short time. Yin and "Fuyang" cases are rare, and there is no need to be overly nervous.
So, do the "fuyang" people show commonality?
"We have analyzed the characteristics of the patient's age, underlying disease, severity of illness, and level of immunity. At present, we have not found a clear correlation. Human understanding of the new crown needs to be further deepened." Jiang Rongmeng said.
Follow-up 3
Are "fuyang" people contagious?
Generally not considered contagious, and some experts believe that the possibility cannot be completely ruled out
Will "fuyang" people infect other people?
The reporter combed and found that for the aforementioned "Fuyang" cases, the official results of nucleic acid tests on the relevant contacts were all negative, and said that there is no evidence that the "Fuyang" cases are at risk of transmission.
"In general, people who do not think'Fuyang' are contagious, and some experts believe that the possibility cannot be completely ruled out." Jiang Rongmeng introduced.
The first point of view is based on the fact that no live virus has been isolated from the body of the "fuyang" person, but the virus corpse or fragments, and the "fuyang" person's condition has not worsened. In the United States, South Korea and other regions, patients are not subject to long-term isolation.
The second point of view is that in the short-term "rejuvenation", it can be said that the patient's body is just a fragment of the virus that has not yet been metabolized. In theory, as long as there is a live virus, it is infectious. However, the patient's infectivity is strongest one week before the onset of the disease, and very low even if there is a few months later.
"Don't worry too much about the issue of'Fuyang'. We are still relatively strict in the prevention and control of the new crown. Patients have an isolation period and regular follow-up after they are discharged.'Fuyang' is a small probability event. Even if the isolation is lifted, many patients are very cautious. , They will pay attention to preventive measures when they are in contact with others and even at home. What ordinary citizens can do is to increase their awareness, wear masks, gather less, and wash their hands frequently." Jiang Rongmeng said.
Announcement of "Fuyang" cases after several months of cure
On the 13th, the Shanghai Municipal People’s Government issued a notice
On August 10, Shanghai Zhongshan Hospital found a case of "Fuyang" new coronary pneumonia from Jilin who came to Shanghai for medical treatment
After investigation, the case was diagnosed as an imported confirmed case overseas in April this year, and was discharged after isolation treatment
The information released by Jilin is more specific. The patient is an imported case of new coronary pneumonia. After several months of recovery, the patient will be "rejuvenated."
On April 27, the patient entered the country from Russia via Xi’an. The nucleic acid test was positive and he was diagnosed as a confirmed case of new coronary pneumonia. He was hospitalized on the spot in Xi’an.
On June 16, after being cured and discharged from the hospital with a negative nucleic acid test, he was transported back to Hunchun City point-to-point, where separate isolation and control measures were taken.
On July 9, the isolation control was lifted after 4 negative nucleic acid tests
On August 2, he had to go to Shanghai for diagnosis and treatment because of other diseases. After a negative nucleic acid test in Hunchun City, he went to Shanghai
On the 12th, Jingzhou City, Hubei Province issued a notice
On August 9, a 68-year-old female retired employee from Lianhe Street, Development Zone, Jingzhou City, was hospitalized due to illness and tested positive for the new coronavirus nucleic acid.
This woman is a patient with new coronary pneumonia diagnosed on February 8 and "re-yang" a few months after healed. It is not a new case. Currently, the patient is treated in isolation again
All contacts have been tested negative for nucleic acid, their homes and activity areas have been thoroughly disinfected, and risks are fully controlled
"Fuyang" is not the first time after several months of healing
On May 30, the Emergency Headquarters for Epidemic Prevention and Control in the High-tech Zone of Hefei City, Anhui released a message
An employee of a company in this district, Wei Moumou (female, 24 years old), underwent a health follow-up review for the third month on May 26, and was found "Fuyang" by the hospital.
Wei's previous nucleic acid test results were negative.
Beijing News reporter Dai Xuan