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Experts: wearing masks and hand washing are limited to prevent pneumococcal disease

发布时间:2020-04-20

Experts suggest that children and the elderly should be vaccinated with influenza vaccine and pneumococcal vaccine


Guangzhou Daily News (all media reporter Wu ren) the flu season is coming. At the "seminar on prevention and control strategies for influenza and pneumonia in the new situation" held recently, disease control experts and clinical experts appealed that influenza is highly infectious and fast spreading, which can cause serious complications and death. It is suggested to vaccinate influenza before the epidemic season.


In addition to the prevention of influenza, we should also be alert to another major category of diseases, that is, Streptococcus pneumoniae disease. Because it is the most common pathogen of influenza combined with infection, when they work together, they can produce "1 + 1 > 2" destructive power to human health. However, due to the characteristics of not coming on immediately after infection and patients scattered in many departments, the harm of pneumococcus has been underestimated by the public in China.


High mortality and disability rate of pneumococcal diseases


Pneumococcus is an important cause of death in children with pneumonia in China. According to the detection of lung tissue in 202 children died of pneumonia in Beijing Children Hospital, 57% of them have pneumococcal infection.


But do not take it for granted that pneumococcus is causing pneumonia. "Clinically, pneumococcal disease is a major disease, which can be divided into invasive and non-invasive. Non invasive pneumococcal diseases include common pneumonia, otitis media, sinusitis, etc. when pneumococci invade the sterile parts and tissues, it may lead to meningitis, bacteremia, bacteremia pneumonia, and 95 rare pneumococcal infections, such as osteomyelitis, pericarditis, etc. " Introduction of Professor Chen ruchong, Department of respiratory medicine, the First Affiliated Hospital of Guangzhou Medical University.


The World Health Organization estimates that 32% of all vaccine preventable deaths in children under 5 years of age worldwide are caused by pneumococcal disease, with the majority of pneumococcal deaths occurring in Asia and Africa.


Limited protection for pneumococcal disease by wearing masks and washing hands


"At present, however, parents do not pay enough attention to pneumococcus." Professor Zeng Guang, chief epidemiologist of China Center for Disease Control and prevention, pointed out that the main reason is that the nature of pneumococcal disease is respiratory infectious disease, which is mainly transmitted by respiratory droplets, but the child may not get the disease immediately after infection, but may be planted in the nasopharynx, so the transmission way is relatively hidden; once the child immunity is low, pneumococcus may be“ The incidence of "waiting for the opportunity" is rare in kindergartens, and the seasonal peak is not obvious. However, in hospitals, because pneumococcus is a major disease, the cases may also be scattered in the emergency department, pediatrics, otolaryngology and other departments, and the clinical manifestations alone can not judge the infection of pneumococcus.


He reminded parents that pneumococcal diseases are highly sporadic and occur in all seasons of the year. However, antibiotic treatment has led to the increasing drug resistance of pneumococci. "Because pneumococci can be planted in the nasopharynx, the effect of protective measures such as wearing masks and washing hands is limited for children who have been infected. Breastfeeding can slightly reduce the incidence of infant disease, and vaccination is the only feasible specific preventive measure.


Recommended combination of influenza vaccine and pneumococcal vaccine


Although pneumococcal diseases can occur throughout the year, vaccination is particularly important before the flu season. Zeng Guang explained that pneumococcus and influenza virus have a strong synergistic effect, "1 + 1" is far more destructive than 2. "When people are infected with pneumococci, they can only be planted in the nasopharynx of people, and will not cause disease, and the infected influenza virus will open the" channel "for pneumococci to enter the human body." Zeng Guang said. Influenza virus will damage the upper surface of the lower respiratory tract, making pneumococcus easier to colonize. Other pathological changes caused by influenza virus, such as destruction of surfactant, increase of mucus secretion, infiltration of inflammatory cells, etc., are also conducive to the treatment of pneumococcus, and enhance the pathogenicity of influenza virus, while influenza virus further promotes the secondary infection of pneumococcus.


Data from the Centers for Disease Control and prevention in the past three years show that the number of deaths caused by pneumonia is higher than that caused by influenza in both normal flu seasons and during influenza outbreaks. In addition, it has been reported that about 50% of the deaths in the influenza season in the United States were caused by pneumonia, most of which were caused by pneumococcal infection. Pneumococcal co infection is the main cause of death in the influenza season.


Therefore, he strongly recommends that, in addition to the flu vaccine before the flu season, children of appropriate age should also be vaccinated against pneumococcal vaccine. The interval between the two vaccines is two weeks.


The elderly also recommend pneumococcal vaccination


For the elderly, the prevention of pneumococcal disease is also important, especially for the elderly with basic respiratory diseases. "In patients with chronic obstructive pulmonary disease, asthma, bronchiectasis and other airway diseases, if they have an acute attack, their lung function may not return to the original level, which has a great impact on the disease process and quality of life." "So I recommend to my patients that they have to be vaccinated against influenza every year, and to those over 60 years old, I also recommend them to be vaccinated against pneumococci, which can reduce the number of acute attacks and benefit," Chen said