Respiratory infections have entered the high incidence season, should children with fever seek medical attention immediately?

Respiratory infections have entered the high incidence season, should children with fever seek medical attention immediately? A reporter from the main station visited Beijing Children's Hospital

Beijing has entered the season of high incidence of respiratory infectious diseases, and a variety of pathogens such as influenza, adenovirus, and syncytial virus are prevalent. Beijing Children's Hospital, Capital Institute of Pediatrics and major hospitals have been running at a high level of pediatric outpatient volume for more than a month.

On November 11, the weather temperature in Beijing plummeted. At around eight o'clock, many parents hurried to the hospital with their children in their arms and their hands in their hands. At this time, the internal medicine clinics on the second and third floors of Beijing Children's Hospital were all accepting patients, and in order to increase the capacity, most of the surgical clinics on the fourth floor were also freed up for treating children with fever.

Due to the epidemic of multiple diseases, Beijing Children's Hospital is mobilizing the strength of the whole hospital to cope with the peak of visits, adjusting the staff to internal medicine and fever and cough clinics, and the number of doctors on call is dynamically adjusted according to the number of patients. Inspection, imaging, pharmacy and charging windows are linked, increasing the number of staff, extending working hours, and ensuring clinical needs.

Guo Lingyun, Deputy Chief Physician of the Department of Infectious Diseases, Beijing Children's Hospital: Because of the large number of patients in our hospital, in order to improve work efficiency, some senior residents have clearly written the cases and medical history in the system in advance, so that the efficiency can be improved a lot. Now there are doctors in each department working overtime every night, and everyone sees the Internet (outpatient) for at least 30 nights.

The waiting time for treatment is anxious for many children and their families. Younger children, with a small fever-reducing patch on their heads, wilted on their parents' shoulders. Older children, who are in better spirits, are playing and waiting in the toy area.

Beijing Children's Hospital appealed through multiple channels that due to the current large number of patients, if the child has just developed symptoms, it is not recommended to go to Beijing Children's Hospital, Pediatric Research Institute and other pediatric hospitals immediately.

Guo Jing, attending physician of the Department of Gastroenterology, Beijing Children's Hospital: Adenovirus or influenza A, these two are more common recently.

After visiting the outpatient clinic, many children have to enter infusion therapy, which is a big challenge for parents and nurses. After waiting in the outpatient clinic, when they arrived at the infusion room, the parents were more or less anxious, and the nurses had to withstand great pressure, under the watchful eyes of one or even several parents, to achieve the success of each needle puncture as much as possible, reduce the pain of the children with superb technology, and also make the parents' mood a little lighter.

Does my child have a fever and need to go to the hospital right away?

Does my child need to go to the hospital right away if he has a fever or fever with cough?

Parents should first distinguish between ages. For younger infants, especially those under three months of age, it is recommended that parents take their children to the doctor in time if they have a significant fever, regardless of whether they have respiratory symptoms. In older children, when high fever with mild respiratory symptoms but no other systemic manifestations is present, parents are advised to observe at home and use symptomatic medications. If the child has a high fever for 3~5 days, or is accompanied by obvious aggravation of respiratory symptoms, or even other symptoms, it is recommended that parents take the child to the doctor in time.

Qin Qiang, Chief Physician of the Department of Respiratory Medicine, Beijing Children's Hospital: Remind our fellow doctors that the current means of detecting various pathogens have their limitations, and they are limited by the detection methods and methods and their principles. Therefore, if it is simple to diagnose or even use drugs based on a positive or negative test, it will bring certain deviations and even errors. It is recommended that everything is still clinical, according to the signs of the child's onset process, as well as some routine, the simplest blood routine or a chest X-ray, which may play a good role in auxiliary diagnosis of many respiratory infections.

According to the monitoring in the past two weeks, compared with the previous stage of Mycoplasma pneumoniae-dominant, the pathogen spectrum has changed greatly, and respiratory viruses such as influenza have become the primary cause. The natural course of viral infection is generally 3~5 days, and it is normal that there is no recovery on the next day, and parents do not need to go to the hospital for several days to register.

Respiratory syncytial virus: susceptibility in children There is no specific drug

"Respiratory syncytial virus" has recently sparked heated discussions. Syncytial virus is the most important viral pathogen causing acute lower respiratory tract infections in children under 5 years of age worldwide. In fact, it is not a new virus, this year in southern China has experienced a wave of epidemic peak, after a short retreat, as the temperature drops, the incidence has begun to rise recently. In children, syncytial virus and influenza are easily co-infected and may be more severe than infection with one pathogen alone.

RSV spreads through droplets and close contact and can occur all year round. However, it is more common in winter and spring. After respiratory syncytial virus infection, the incubation period is usually 2~8 days, and key populations such as infants under 6 months of age are at higher risk of infection. The clinical manifestations are mainly respiratory tract infection symptoms, and the typical symptoms of syncytial virus infection in children are fever, cough, nasal congestion, and runny nose; Typical symptoms of an adult infected person are very similar to those of the common cold, such as low-grade fever, cough, nasal congestion, and runny nose. Most of the symptoms will disappear within 1~2 weeks, a small number can develop bronchiolitis or pneumonia, more common in infants and young children under 2 years old, clinical symptoms include cough and wheezing, very severe may develop respiratory failure.

Cao Ling, Director of the Department of Respiratory Medicine, Children's Hospital Affiliated to the Capital Institute of Pediatrics: It mainly causes wheezing in young children, wheezing sometimes has a certain damage to lung function, and some sensitive children, his lung function damage may last for a long time, so we try to minimize the child's future wheezing opportunities to ensure that his lung function is within the normal range.

In previous years, RSV mostly occurred in children younger than 2 years old, but this year's clinical observation has found that infections in older children have also increased. There is no specific drug for respiratory syncytial virus infection, and symptomatic treatment is mainly for respiratory syncytial virus infection. Since there is no respiratory syncytial virus vaccine for infants and young children, infants and young children should still do a good job of daily protection, develop good hygiene habits, wash hands frequently, ventilate frequently, wear masks in crowded places, and pay attention to cough etiquette. In addition, young infants and young children should avoid crowded places. Personal protection should be done in medical institutions to prevent cross-infection in the hospital.

News link: How the major epidemic pathogens differ after infection

This year, there are more pathogens in which respiratory diseases are more prevalent. At present, the epidemic intensity of Mycoplasma pneumoniae in Beijing has dropped to the fourth place among respiratory infectious diseases in children, and the top three are influenza, adenovirus and respiratory syncytial virus. How can you tell them apart? What are the differences between the same symptoms such as cough and fever?

Influenza is a more familiar respiratory disease, it can occur at all ages, influenza is mainly transmitted through respiratory droplets, the incubation period is generally 1 to 4 days, the average is 2 days, the clinical manifestations are generally sudden high fever, cough, sore throat, can be accompanied by chills, older children will feel headache or muscle and joint pain, infants may appear listless, not good to feed or even less active.

Typical symptoms of adenovirus respiratory infections are cough, nasal congestion, and pharyngitis, while some types of adenovirus can cause gastroenteritis in infants and preschoolers, causing abdominal pain and diarrhea. Adenovirus infection is generally a self-limiting disease, and people with normal immunity can recover spontaneously in about 7 days.

Respiratory syncytial virus (RSV) is the most important viral pathogen causing acute lower respiratory tract infection in children under 5 years of age worldwide. Contagious, mainly through cough and droplets and close contact transmission, most healthy children infected with respiratory syncytial virus, mild symptoms and early symptoms of infection similar to the common cold, as the disease progresses, severe cases will have dyspnea or shortness of breath, wheezing, irritability, loss of appetite, etc., and even concurrent respiratory failure, heart failure, etc.

Including respiratory pathogens such as rhinovirus and parainfluenza virus, the clinical manifestations generally have symptoms such as fever and cough, but they are also different. For example, influenza and adenovirus infections often have a high fever of more than 39 °C, among which the systemic symptoms of influenza are obvious, such as headache, body aches, fatigue, etc.; Adenovirus infection is prone to coughing and wheezing, shortness of breath, mental fatigue, and a fever that lasts for a week or two; The fever of respiratory syncytial virus infection is generally about 38°C, and the main manifestation is cough and wheezing. Different pathogens are infected with different treatments. (CCTV News Client)