Outbreaks in mid-to-late February or peak, be alert to cross-infection of multiple pathogens

As of 24 hours on February 17, according to 31 provinces (autonomous regions, municipalities directly under the central government) and Xinjiang Production and Construction Corps, there are 58016 confirmed cases (of which 11741 cases of severe illness), a cumulative cure of 12552 cases (7 more in Beijing nuclear), a cumulative number of deaths of 1868 cases, A total of 72436 confirmed cases have been reported (2 more than the number of nuclear cases in Xinjiang Production and Construction Corps), and 6242 suspected cases are available.

The existing suspected cases in the country 8 consecutive drop, the number of new cases outside Hubei has appeared 14 consecutive drops, which means that China’s epidemic prevention and control effect is initially apparent. Of course, the battle against the new crown is far from over.

A commentary published online by The Lancet on February 13th suggested that monitoring community transmission over the next two to three weeks (by the end of February) was crucial and that strategies to curb disease should continue. Four days later, Zhong Nanshan, a member of the Chinese Academy of Engineering, said during a video consultation that the digital model predicted that the number of cases nationwide would peak in mid-to-late February, but the peak did not mean an “inflection point” and that the outbreak could return with workers to a new peak.

The fight against the epidemic remains the most critical issue, and at the same time, there are other issues that cannot be ignored.

On February 7, researchers at Wuhan University’s Zhongnan Hospital published a study in JAMA that alerted 40 health care workers to the fact that they were infected: they must be alert to cross-infection in the hospital. Ten days later, a report by the Cdc covering 70,000 people was another wake-up call: as of February 11, 3,019 medical personnel in China had been infected with the new coronavirus, which may have been caused by non-occupational exposure.

On February 13th researchers at Wuhan University People’s Hospital issued a report on the pre-printed medRxiv (without peer review) warning on the other side: be alert to cross-infection of pathogens while preventing and controlling the outbreak.

Outbreaks in mid-to-late February or peak, be alert to cross-infection of multiple pathogens

doi: https://doi.org/10.1101/2020.02.12.20022327

In the report, the researchers analyzed a total of 8,274 close contacts with neo-coronavirus from 20 January to 9 February 2020, of whom 2,745 (33.2 per cent) were positive for neo-coronavirus and 5,277 (63.8 per cent) were negative. Another 252 (3.0%) close contacts had unclear diagnoses (only one of the two targets nCoV-NP and nCov ORF1ab tested), and the median age of the three groups was 56 years (42-67), 40 years (30-57 years) and 52 years (35-64 years).

Of the 252 subjects whose diagnosis was unclear, 16 retested a few days later, 14 of whom were eventually positive for the new coronavirus and 2 were negative. Overall, the male infection rate (35.5 per cent) was higher than that of women (29.6 per cent).

Outbreaks in mid-to-late February or peak, be alert to cross-infection of multiple pathogens

Number of people diagnosed with new coronary pneumonia at all ages

The researchers conducted multiple tests of 13 respiratory pathogens, including influenza A virus, rhinovirus, H3N2 virus, respiratory syncytial virus, influenza B virus, coronavirus, scuba virus, H1N1, adenovirus, mycosist pneumonia, Paravirus, chlamydia, Boca virus. Of these, 316 also tested positive for the new coronavirus, 212 tested negative and 104 tested positive.

Outbreaks in mid-to-late February or peak, be alert to cross-infection of multiple pathogens

A: Results of 13 respiratory pathogens tests on 613 febrile subjects

B: Results of 13 respiratory pathogens tests in 202 undiagnosed patients

C: Results of 13 respiratory pathogens tests in 104 confirmed patients

Of the 212 subjects who tested negative, 39 (18.4%) had other pathogen infections, with positive rates of the pathogen nucleic acid being: influenza A virus 5.66% (11/202), A H3N2 virus 5.66% (11/202), rhinovirus 4.7 2% (10/202), respiratory syncytial virus 3.30% (7/202), influenza B 2.83% (6/202), lung virus 1.89% (4/202), coronavirus 0.94% (2/202).

Of the 104 subjects diagnosed with new coronary pneumonia, 6 (5.8%) were infected with other pathogens, with the results being 2.88% (3/104), influenza A virus 1.94% (2/104), rhinovirus 1.94% (2/104) and H3N2 0.96% (1/104).

In other words, the new coronavirus can be combined with other viruses, in the treatment of new coronary pneumonia, should also pay attention to the detection and treatment of other respiratory diseases. However, at present, medical institutions usually use traditional smear and culture methods to detect bacterial pathogen infection, but the low rate of sputum smear positive, the process of processing time is an indisputable fact, researchers called for the clinical development of a broad-spectrum, fast and accurate bacterial screening testing platform, so as to identify pathogens, Help to judge the patient’s condition and avoid blind medication.

The new coronavirus has a secondary bacterial and fungal infection, common secondary infections including Bowman’s bacteria, the pylori of pneumococcal, the aflatoxin, the smooth candida, and the white candida. Among them, some resistant strains , such as Baumann, infections will make treatment more difficult, and patients may even experience infectious shock. The study showed that the majority of people infected with new coronary pneumonia were middle-aged and elderly, and their resistance was generally low, in which case preventive antibiotics could reduce their mortality and co-disease rates.

The researchers recommend that patients with neo-coronavirus pneumonia be treated in isolation from other pathogen patients during hospitalization and treatment to prevent cross-infection of pathogens.