What Does an Infectious Disease Doctor Do?

Infectious diseases refer to diseases that are easily transmitted among people, such as atypical pneumonia (SARS).

infectious disease

Infectious diseases refer to diseases that are easily transmitted among people, such as atypical pneumonia (SARS).

Chinese name

Atypical pneumonia

Foreign name

SARS

Treatment

Symptoms of respiratory infections should be checked with a doctor as soon as possible

Popular in China in 2003

Atypical pneumonia is relative to typical pneumonia, which is usually caused by common bacteria such as pneumococcus. Symptoms are typical, such as fever, chest pain, cough, sputum, etc. Laboratory tests show increased white blood cells and antibiotic treatment is effective. Atypical pneumonia itself is not a newly discovered disease. It is mostly caused by viruses, mycoplasma, chlamydia, rickettsia, and other pathogens. Symptoms, lung signs, and blood test results are not as obvious as typical pneumonia infections. Some viral pneumonia antibiotics are not effective.

Atypical pneumonia refers to a group of diseases caused by the above-mentioned atypical pathogens, rather than a definite diagnosis. Its clinical features are occult onset, mostly dry cough, occasional hemoptysis, and fewer auscultation signs in the lungs. X-ray chest radiographs mainly show interstitial infiltration. The disease process is usually mild and patients rarely And death.

The name of atypical pneumonia originated in late 1930 and corresponds to typical pneumonia, which is mainly lobar pneumonia or bronchial pneumonia caused by bacteria. In the 1960s, Mycoplasma pneumoniae found at that time was used as the main pathogen of atypical pneumonia, but other pathogens were found, especially Chlamydia pneumoniae. At present, it is believed that the pathogens of atypical pneumonia mainly include Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Legionella and Rickettsia (causing Q fever pneumonia), which are more common in the past and account for almost every year of adult community acquired pneumonia One third of the inpatients. Most of these pathogens are intracellular parasites and have no cell wall. Therefore, broad-spectrum antibiotics (mainly macrolides and tetracyclines) that can penetrate into cells are effective for their treatment, while -lactam antibiotics are not effective. For atypical pneumonia caused by a virus, antibiotics are not effective.

On November 16, 2002, Foshan First People's Hospital received a case of special pneumonia. Two to three cases were found in Foshan. Since then, similar cases have appeared in Heyuan, Zhongshan, Jiangmen, Guangzhou, and Shenzhen.

On December 15, 2002, Huang Kechu and Guo Ducheng of Zijin County were admitted to the People's Hospital of Heyuan City. The 5 medical staff who had consulted them had the same symptoms as the patients. People in panic lined up in front of the major drug stores in Heyuan. At that time, people rushed to the pharmacy, but it was not clear what medicine to buy, just to follow suit and snap up some antiviral drugs. Someone suddenly bought more than 10 boxes. Soon, the city's pharmacies sold out of such drugs, and people who could not buy them became more panic. Until 9 pm, many pharmacies closed and there were people waiting in line. More parents rushed to school to pick up their children to avoid the "disaster."

On January 2, 2003, Zhongshan City treated similar patients. Due to a lack of understanding of the disease, medical staff did not protect it in a timely manner, and seven or eight staff members of a hospital in Zhongshan City were infected. Beginning on January 16, rumors of a "pneumonia epidemic" spread in Zhongshan. Citizens have come to pharmacies to buy medicine for precaution. Some people buy dozens of boxes. The reporter learned that a box of ordinary roxithromycin is more than 10 yuan a box, a better one is 28 yuan a box, most citizens buy hundreds of yuan. The person in charge of Relay Big Pharmacy, the largest drug chain store in Zhongshan City, said that starting on the 16th, the number of citizens who came to the pharmacy to buy roxithromycin began to increase, reaching a peak on the 17th, and half of its 8 chain stores appeared. Erythromycin out of stock situation.

On February 6, 2003, the incidence of atypical pneumonia in Guangdong reached its peak. The number of cases found in the province reached 218, an increase of 45 cases at a time, which greatly exceeded the previous single-day new cases. These cases are mainly concentrated in Guangzhou, and a considerable part of them are still medical staff. "First, we sent reminder text messages to relatives and friends from the staff inside the hospital, and then passed them on to more social groups. From the eighth to the tenth day of the first month, it has spread widely. In Guangdong, quite a few citizens have two mobile phones. According to statistics from Guangdong Mobile's SMS traffic statistics, its users sent a total of 126 million short messages over the past three days, which is almost in line with the new year's SMS traffic during the 30th to the first day of the New Year. The extremely flood of information has brought catastrophic social panic. From February 10th to 11th, the streets of Guangzhou showed a slump landscape, with hotels, restaurants and various entertainment venues unattended. On the 12th, even pharmacies in Beijing adopted restrictions on the purchase of Banlangen (two boxes from Tongrentang and five boxes from other brands).

Air droplets are transmitted at close range, and family members and medical staff may be infected by contact with patients' secretions.

Epidemiological rules: There is no difference in incidence between men and women, and young people account for 70% to 80% in terms of age. Most of them are different from the old and young patients who are weak in previous respiratory infectious diseases; due to insufficient protective measures at the time of onset, medical staff It is a high-risk group of atypical pneumonia, but after taking measures, the infection rate of medical staff has dropped from about 33% to about 24%; there are clustered infections in homes and hospitals.

The current incubation period is 1-14 days, with a median of 4 days.

Most people with atypical pneumonia develop symptoms 4 days after infection, with fever as the first symptom, and their body temperature lasts above 39 ° C for several days. Some people may be accompanied by headache, chills, fatigue, joint pain, general soreness, and diarrhea. Respiratory symptoms are obvious, dry cough, sputum sputum, and occasionally bloody sputum. In 5 days, dyspnea symptoms such as accelerated breathing and belching occur. Very few patients have respiratory failure. Delays in diagnosis and treatment can cause death.

The above symptoms are like upper respiratory tract infections. Therefore, 4 conditions must be met for highly suspected atypical pneumonia, that is, a recent history of the disease endemic area or close contact with the patient; a blood test of less than 10,000 leukocytes, or even a progressive decrease; chest radiography There are varying degrees of shading; no significant effect of antimicrobial treatment.

Common atypical patients have had close contact with similar patients 2 weeks before the onset, or have clear evidence of being infected by others, or live in an endemic area, or have visited an area where atypical pneumonia is prevalent 2 weeks before the onset, the main clinical symptoms Fever (> 38 ° C) and cough, rapid breathing, shortness of breath, or respiratory distress syndrome, lung rales or signs of pulmonary consolidation. Laboratory tests showed that the blood WBC count did not increase or decrease in the early stage, while lung imaging examination revealed varying degrees of patchy, patchy infiltrating shadows or reticular changes in the lungs, and no significant effect was seen with antibacterial treatment. . The patient was accompanied by headache, joint aches, general soreness, fatigue, chest pain, and diarrhea. Medical institutions at all levels should pay attention to the exclusion of primary bacterial or fungal pneumonia, tuberculosis, lung tumors, non-infectious pulmonary interstitial disease, pulmonary edema, atelectasis, pulmonary embolism, and pulmonary eosinophils. Infiltrative disease, pulmonary vasculitis and other clinical manifestations of similar pulmonary diseases.

The Beijing Municipal Government opened a 120 emergency telephone hotline. If citizens find that they, their family members, or friends have any of the following symptoms, please dial 120 emergency number quickly, and 120 ambulances will be sent to the hospital for treatment.

1. Fever (above 38 ° C); accompanied by headache, joint aches, general aches and weakness. ??

2. Dry cough with little sputum, occasional bloodshot sputum, rapid breathing, shortness of breath, and respiratory distress.

3. No obvious effect on antibacterial treatment.

Avoid visiting crowded places.

Good ventilation: Keep indoor air circulation, and often open windows for ventilation. Open windows and ventilate on buses or TAXI.

Pay attention to personal hygiene: wash your hands frequently, keep your hands clean, and wash your hands with the correct method. Wash your hands with soap and running water for more than 30 seconds. Wash hands when hands are soiled by respiratory secretions (such as after sneezing). Avoid touching eyes, nose, and mouth. If you need to touch, wash your hands first.

Pay attention to a balanced diet, exercise regularly, have enough rest, reduce stress, and avoid smoking to enhance your body's resistance.

Items frequently used or touched in public places are regularly soaked with disinfectant, wiped and disinfected.

16 crowd gauze masks can be worn in crowded places in public places. However, it is not necessary to wear a mask when moving in an open area or walking on the street.

Avoid visiting patients.

Cover your nose when sneezing or coughing.

GOPLA Tip: Good mood and good mindset are more important than strict preventive measures. Whether you can stay away from the disease lies in your own immunity. Proper infection with some viruses is not completely necessary. The contagion of SARS is not as terrible as people think.

What measures should be taken in contact with SARS patients?

If a family member or friend is diagnosed with atypical pneumonia, the following measures should be taken to ensure the health of the patient's family members, contacts, and others:

Under the guidance of the local disease prevention and control agencies, disinfect the patients' homes or the places where the patients have recently stayed, including items such as air, furniture, and clothing.

In order to control the epidemic situation, close contacts of patients should cooperate with the disease control agency for medical observation or relative isolation. The period is generally 2 weeks. Try to rest at home as far as possible without participating in group activities or traveling far. If you feel unwell, please seek medical treatment as soon as possible, and take the initiative to inform "have closely contacted similar patients."

Avoid visiting patients. When you need to visit, you must wear a mask. Pay attention to your physical condition, pay attention to personal hygiene, and wash your hands frequently.

If you have symptoms of respiratory infections, you should consult a doctor as soon as possible. The sooner you treat, the higher the chance of recovery. The disease can be cured by timely treatment.

Before the cause is unknown, GOPLA recommends that it is best to take traditional Chinese medicine treatments to correct the evil. Or through treatment methods that stimulate and mobilize the patient's immune function.