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Since the beginning of winter, multiple factors have led to a high incidence of influenza in many places. Data show that the percentage of influenza-like illnesses diagnosed this winter is higher than the same period in the past three years.
Experts expect that this round of peak influenza activity will continue for some time, and the level of influenza activity is expected to peak in mid- to late-January, and gradually decline with the advent of the winter vacation for schools and child care institutions.
Recently, the reporter visited hospitals, clinics, pharmaceutical companies and other aspects of the discovery of a flu, exposed us in the sense of prevention, emergency response mechanism and the construction of a hierarchical diagnosis and treatment system and other aspects of the problem still need to be improved.
The prevention and treatment of influenza should be "scientific by system"
January 12, Hebei Children's Hospital, patients are queuing up to get medicine. Reporter Chen Jianyu photo
January 13, 9 a.m., the provincial children's hospital clinic is overcrowded, each clinic area is filled with a long line, crowded with children and parents. Children's coughs, cries and parents' anxious inquiries almost drowned out the call of the intelligent consultation system, and the security guards outside the respiratory clinic were sweating profusely to maintain the order of consultation from time to time.
Since the beginning of winter, influenza is high in many places, major hospitals are overcrowded, especially respiratory, pediatrics and other outpatient clinics, due to colds, fever, coughing patients to the clinic increased significantly.
Provincial Children's Hospital, the relevant person in charge of the hospital, from October 2017, the hospital daily outpatient volume soared, from 3,000 children a day to 5,000 or so, most of the children are diagnosed with upper respiratory tract infections, intestinal infections and other diseases.
The current round of influenza is a global event, our country is also one of the "hardest hit".
Jiao Yahui, deputy director of the Medical Affairs Bureau of the National Health and Family Planning Commission, told the media that the influenza pandemic is due to the superposition of multiple factors, viruses, temperatures, movement of people and other factors that led to this winter, China's overall level of influenza epidemic is significantly higher than in previous years, is the most serious flu epidemic in recent years.
From the monitoring situation, some areas have shown signs of slowing down the rising trend of epidemic levels. Experts expect that the peak of influenza activity will continue for some time, and the level of influenza activity is expected to peak in mid- to late January. With the advent of the winter vacation in schools and child care institutions, the level of influenza activity will gradually decline.
And the response to this round of influenza has revealed a series of problems in our response to pandemic diseases.
The first thing that has come to the fore is the lack of awareness of pandemic diseases like influenza.
From an individual's point of view, in Shijiazhuang, for example, Ms. Li's family, from the middle of last month, the whole family of six people all suffered from influenza, and as early as the beginning of last month, the child's school and Ms. Li's unit that is an increase in the number of patients with the phenomenon of influenza, but because of the annual fall and winter family members suffering from the flu is very normal, and did not cause Ms. Li to pay attention to enough.
Shijiazhuang citizen Ms. Wang introduced, after the daughter suffered from influenza, their own in the process of caring for the child to wear a mask, to avoid cross-infection. But she also found that "care of their own children throughout the mask" this thing, in the "circle of friends" actually sparked a lot of controversy.
"The prevention and treatment of influenza should be more scientific, rather than relying on experience and sensibility." Experts said that in the peak flu season, the elderly, children and other susceptible people to minimize the activities of the public **** place to reduce personnel contact. "In addition to public **** places, wearing a mask is a very good way to block the spread of influenza in the office, at home, especially in environments where people with influenza are already present."
And surveillance from the province's disease control department shows that the current round of influenza is a co-pandemic of multiple influenza viruses***. This also means that, in the treatment process, some families commonly used therapeutic drugs may not be symptomatic, "for example, some families are accustomed to using antimicrobials, but come up to use antimicrobials on the influenza virus is not effective." Experts pointed out.
In addition, schools and related departments also have deficiencies in influenza prevention and emergency measures.
"If the school's emergency response mechanism could be more flexible, the impact of this round of flu could be much smaller." Ms. Li said the family got the flu, which first began with her daughter, who is in second grade, "At that time, there were already multiple children in her class with fever and cough, and I think that cross-infection within the school is an important reason for the flu to be widespread among the children."
"In the course of this rotating sensation, no measures were taken to suspend classes." An elementary school in the provincial capital, a classroom teacher said, the current school centralized suspension measures to use more cautious, generally more weather factors, natural disasters and other special circumstances to decide, such as some extreme rain and snow when the school will be temporarily suspended.
The reporter found that the Ministry of Education, the Ministry of Health recently issued a work program on the suspension of classes or in 2009 when the influenza A (H1N1) epidemic appeared.
"What degree and standard of influenza can be taken to suspend classes, the health and education departments should have a more flexible and efficient emergency mechanism." Ms. Li believes that when influenza occurs, the departments concerned should share information in a timely manner and come up with contingency measures.
Pharmaceutical companies need a "message board"
January 13, 10 o'clock, the provincial children's hospital respiratory department Dr. Liu is using the diagnosis and treatment system for the children prescribed medication, but one second there is a stock of a proprietary Chinese medicine oral liquid, the next second shows that there is no medication, Dr. Liu can only choose to replace the drug.
Dr. Liu said that in the treatment of children with influenza, the doctor based on the condition of the judgment, tend to use some proprietary Chinese medicine punch, oral liquid and spray, to minimize the possible side effects of the drug. The surge in the number of children, resulting in a temporary shortage of such drugs in the hospital, the drug section can only quickly step up procurement and supplementation.
The reporter found that due to the flu epidemic, the demand for drugs to treat influenza continues to increase, some common cold and flu medicines appeared in short supply, such as some patients reflect some hospitals are difficult to prescribe Oseltamivir and other anti-flu viral drugs.
The National Health Planning Commission recently released the Influenza Diagnosis and Treatment Program (2018 Edition), announcing a batch of recommended anti-influenza virus medicines, and proprietary Chinese medicines, such as Lianhua Qingdian capsule, Qingkailing oral solution, and Golden Lotus oral solution, have been selected as recommended medicines. But then, the market supply of these pCms began to run out.
In response, the Medical Affairs Bureau of the National Health and Family Planning Commission asked medical institutions across the country to urgently take temporary procurement measures to ensure the supply of antiviral drugs.
As a pharmaceutical province, many pharmaceutical companies in our province quickly adjusted their production plans to increase the production of related drugs, a number of proprietary Chinese medicine manufacturers are urgently organized to increase production and supply.
Shijiazhuang four drugs Co., Ltd. responsible person said that with the continued high incidence of influenza outbreak, the enterprise's gold lotus oral liquid, clear heat and detoxification of oral liquid and Yinhuang capsule and many other traditional Chinese medicine products are in short supply, they are urgently preparing the raw materials, full production, and try to ensure that the required.
Ealing Pharmaceuticals is urgently expanding the production of the anti-influenza Chinese medicine Lianhua Qingdian, quickly mobilizing raw materials, and meticulously organizing the procurement, production, quality control, logistics and other departments to work overtime to ensure supply. Over the past few days, the daily production volume has increased five times.
Shenwei Pharmaceutical adjusted the production plan to increase production, Qingkailing injection average daily production and average daily shipments increased by more than 40% over the same period.
Interviews with pharmaceutical companies in our province, said the recent anti-influenza virus drug supply of temporary supply constraints, exposing the drug production market and epidemic prevention and control of epidemic prevention and control of asymmetric information between the problem.
"Even this urgent increase in production to ensure supply, we are based on market feedback." Shijiazhuang, a pharmaceutical company told reporters that, as a special commodity, the production and inventory of drugs have great limitations, can only be based on market information to develop production plans. At present, in response to epidemic diseases, pharmaceutical companies are in urgent need of a high level of information alert mechanism, so that enterprises can adjust production plans in a timely manner.
Interview with a tertiary hospital vice president told reporters that in the continuing process of health care reform, medical institutions in the diagnosis and treatment, medical insurance, drug prices and other aspects of a great deal of effort, but part of the drug supply and demand information asymmetry problem, not only in the anti-influenza drugs in this case, for example, some hospitals had previously been exposed to some of the shortage of anticancer drugs.
"At present, we have no problem with the production capacity of drugs to support the overall supply security, but it is not enough to rely solely on the market for the production and deployment of drugs." The vice president said, "Reforms in the area of pharmaceutical linkage should pay more attention to this point."
Primary medical institutions should improve their capacity
On Jan. 12, parents brought their sick children to Hebei Children's Hospital. Reporter Chen Jianyu photographed
On the morning of January 13, Mr. Yang, a citizen of Shijiazhuang, waited for three hours at the hospital with a child who had a fever before seeing a doctor. But Mr. Yang got the medicines and found that they were basically the same as those taken the day before at the community clinic.
"You've just seen the "Influenza Diagnosis and Treatment Program (2018 Edition)" that was just released, in fact, for the treatment of influenza, whether it's a tertiary hospital or a community hospital, basically follow the guidance of this diagnosis and treatment program." In the face of Mr. Yang's questions, the pediatrician who saw the child explained.
"It takes three minutes to see a doctor and eight hours to line up," said a parent during this round of flu.
On the one hand, a lot of patients in the hospital waiting in line for a long time. On the other hand, the doctors "even take a break in the heart", high-intensity and long overtime work.
A doctor told reporters: "From the patient's point of view, everyone's concept of medical care, medical habits also need to change."
From the general situation she encountered, this rotating sense, the child is sick parents bring their children to the big hospitals to see. In fact, at the grassroots hospitals, trained doctors with some clinical experience are treatable.
"Of course, to what level of hospitals, is the patient's right to encourage people to hierarchical treatment is not mandatory." Yin Yuru, interim head of a community hospital in Hengshui City, was once an internist at a well-known local hospital and was rehired to a community hospital after her retirement.
With the flu on the way, she found that many current primary care organizations have some shortcomings to make up for.
First, there is a serious shortage of talent. In this regard, Yin Yuru suggests that reference can be made to the Beijing experience, by the tertiary hospitals and community hospitals to jointly run the medical, to ensure that primary hospitals or community clinics have sufficient physician resources, especially general practitioners.
The second step is to promote equipment and resource ****sharing between grassroots hospitals and large hospitals, and to establish efficient referral channels.
But what Yin Yuru most wants to say is that primary care organizations should give more prominence to popularizing science and improving their own recognition, "To put it bluntly, we need to package and publicize ourselves, and what we can do and how well we can do it, all in order to let the residents in the area fully understand and enhance their trust."
Yin Yuru believes that most primary care organizations are now upgrading their hardware and software, and that community hospitals are fully capable of treating non-critical illnesses like influenza. "But people don't know, or don't trust you enough, before they flock to the big hospitals."
In fact, during the current round of influenza prevention and treatment, in order for primary health care organizations to improve their ability to admit and treat patients, the National Health Commission is focusing on training medical staff of primary health care organizations to master diagnostic and treatment knowledge and workflow, and to improve their awareness and ability to identify influenza cases at an early stage, and to provide early antiviral treatment, so as to reduce the incidence of serious illnesses.
At the same time, local health departments are also promoting family doctors and other grassroots health "gatekeepers" to increase health promotion, health education, popularization of influenza prevention and treatment of core information, so that the people from their own start, good prevention and control.
Related
Should you get the flu vaccine?
In the course of the current round of influenza pandemic, the flu vaccine has once again entered the public eye. So, is the flu vaccine useful? Is there a need for vaccination?
"China's influenza vaccination rate is not high, less than 2%. Probably 26 million doses of vaccine supplied to the market each year, but only 20 million doses, the number of vaccinations is still too small." Feng Zijian, deputy director of the Chinese Center for Disease Control and Prevention (CDC), said at a Jan. 9 conference on the 2018 influenza prevention and control work.
What's more embarrassing is that a dominant virus that caused the current round of influenza pandemic is not covered by the vaccine.
The reporter learned that the main influenza virus detected is a type B virus, which has not been the dominant strain for many years. Because China mainly uses a trivalent vaccine, and no quadrivalent vaccine is officially on the market, the vaccine covers only two strains of influenza A and one strain of influenza B, making it unable to cover the other common strain of influenza B that is part of the pandemic.
Because the flu vaccine has not been upgraded, and most people have not gotten into the habit of getting the flu vaccine, the use of the flu vaccine has not been satisfactory, which has inadvertently led to an increase in the scope of the flu epidemic.
Industry experts said that in the case of limited use of antiviral drugs, safe and effective vaccine is the most effective means of preventing influenza, has an irreplaceable role, which has been the global general **** knowledge.
Experts reminded that even though the flu vaccine is still self-funded in most areas, the public must recognize the need for influenza vaccination, especially the elderly, children, pregnant women, and patients with chronic diseases should be given priority for vaccination.
Additionally, because the influenza epidemic strains are constantly evolving and changing, the strains in the influenza vaccine need to be evaluated and updated on a regular basis. This may result in a mismatch between the later-emerging influenza viruses and the first-emerging "cure" influenza vaccine, reducing the protective effect of the influenza vaccine.
But even if some strains may not be predicted correctly at the current time, the vaccine will still protect against other strains that are predicted accurately at the current time, or against strains that are prevalent at other times. (Reporter Yuan Weihua)
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Prevention of influenza Chinese medicine tips
According to the Xinhua News Agency, China has entered the high season of influenza and other respiratory infectious diseases in many places. Recently, a number of experts at the Beijing Hospital of Traditional Chinese Medicine concluded that the Chinese medicine evidence of this flu is mainly outside the cold and internal heat evidence, and launched a number of Chinese medicine programs for adults and children.
Experts based on 376 influenza-like cases recently collected by the Beijing Hospital of Traditional Chinese Medicine in nine hospitals found that the precursor symptoms of this influenza are mainly fever, malignant cold and sore throat, and the symptoms of medical consultation are fever, dry throat, malignant cold, cough is obvious, as well as digestive symptoms, etc., of which the proportion of constipation has increased significantly compared to the same period in 2015 and 2016.
To this end, the Beijing Hospital of Traditional Chinese Medicine organized a number of experts in emergency medicine, respiratory medicine, pediatrics and infection, emergency consultation and research "Beijing Hospital of Traditional Chinese Medicine 2017 winter influenza Chinese medicine characteristics and TCM prevention and treatment of expert guidance", the development of adult influenza antipyretic formula, influenza cough formula, respectively, for children's heat and evil blazing evidence and heat and evil hostage to wet evidence of anti-sensory formula, as well as children's influenza prevention formula, and so on.
Reporters in the adult influenza formula see, the main ingredients are thorns spike, gardenia, raw ephedra, artemisia, burdock, almonds, xuan shen, and so on. Children's influenza prevention formula "moist lung clear heart drink" mainly contains rehmannia glutinosa, leucaena leucocephala, chrysanthemum, chenpi, maitake, hawthorn, malt, umeboshi.
Experts also suggest that the Chinese medicine pay attention to the smell and identify the evidence of treatment, if the patient suspected of influenza symptoms, it is recommended not to blindly grab their own medicine, should be timely to the hospital, under the guidance of the doctor to identify the evidence of the use of medication.