The cause of the rapid spread of the new crown, and found a new crown pneumonia infectious cause!

The Lancet sub-issue: a new crown of pneumonia is highly contagious! The Team of HKU found that the first week of the new crown pneumonia patients saliva virus load soared to the highest level of the "singki network" in recent days, the progress of the global epidemic simply let the singof saw the cold air: 4 days abroad to add 100,000 cases, the United States one-day new 10,000, several countries will soon to the eve of the outbreak, more and more imported cases ... It is estimated that everyone's mind, like a singbar cake, has a big question mark: how can the spread of the new crown pneumonia (COVID-19) so fast, many times faster than the spread of SARS 17 years ago? A new study published in The Lancet Infectious Diseases may give some answers: A team of researchers at the University of Hong Kong analyzed 23 patients and found that the viral load in their saliva peaked in the first week of symptoms of new coronary pneumonia, such as fever and cough. This characteristic of the new crown pneumonia is very different from SARS and MIDDLE East Respiratory Syndrome (MERS), more seasonal influenza, and also means that patients with new coronary pneumonia are highly contagious early in the course of their illness, when the symptoms are mild.
and analysis also showed that about 1/3 of patients, saliva detection of the new coronavirus (SARS-CoV-2) RNA time will last more than 20 days, even after clinical rehabilitation can still be detected, but these patients are not necessarily more serious, so nucleic acid testing continuous negative as the discharge standard, may also be debatable.
based on these two findings, the team called for stricter prevention and control measures for patients with new coronary pneumonia to avoid more human transmission, while the prevention and control work, can be used to take saliva testvirus, to reduce the discomfort of nasopharyngeal swab examination.
how strong the infection ability of patients with xinguan pneumonia and how long the infection period is have been one of the focus of attention in this outbreak.
not long ago, Guangzhou Eighth People's Hospital and the University of Hong Kong team released a pre-printed analysis showed that 44% of the new coronary pneumonia transmission, may occur before the patient develops symptoms. although
are coronavirus, but if the new crown pneumonia really has this characteristic, it is very different from the previous SARS and MERS, they are 7 days or even 10 days after the onset of the disease, the patient's ability to infect the highest.
and according to the odd dot cake understanding, the vast majority of European and American countries, still do not take the outbreak of China when the "receiving" strategy, but let a large number of patients with minor diseases at home isolation, such as the number of cases yesterday exceeded 2000 in Portugal, the official announcement of the treatment of patients only more than 200 people.
if the infection of patients with mild disease is strong, then the resulting second or even three infections, can be very adverse to the epidemic prevention and control.
to analyze this problem, we need to start with the changes in the respiratory tract of patients with new coronary pneumonia(Viral Load) and conduct a complete assessment in conjunction with the course of the patient's illness.
this is also the analysis of the Hong Kong university team used the strategy, and in order to increase the degree of patient cooperation, the research team did not use nasal swab pharynx sampling, but by the patient in the morning brushing teeth and eat breakfast, under the guidance of the nurse to cough up saliva.
this sampling method has proven to be effective.
from the patient characteristics, the analysis included 23 patients 10 are severe, 13 are mild, the overall age distribution, clinical symptoms and imaging and laboratory test characteristics, are similar to some previous analyses, the main antiviral therapy is Lopinavir / Litonevir.
3 of the 23 patients had no viral RNA in their saliva, and the median saliva viral load in the other 20 patients was 5.2 log10 copies/ml.
in the changing trend, the viral load peaks in the first week after the onset of symptoms and gradually decreases thereafter, but there is no such change in the trachea attractor scan testing in severely ill patients.
combined with patient characteristics, the virus load of elderly patients is relatively high, but in patients with severe and combined chronic diseases, there is no significant difference between viral load and patients with mild disease.
of the 21 recovered patients (2 died), 7 tested positive for saliva RNA for more than 20 days, and the longest patient reached 25 days, but this long detection of the virus had no significant correlation with the duration and severity of the patient's clinical symptoms.
in addition to viral load, antibodies in patients with new coronary pneumonia are another focus of this analysis.
tests on serum antibodies in 16 patients showed that anti-neo-coronavirus nuclear protein (NP) and surface echidna receptor binding domain (RBD) antibodies were only as high as they began to rise 10 days after the onstheicle pneumonia symptoms.
the changes of IgG and IgM, NP antibodies and RBD antibodies are different from the findings of this series, how to interpret them? The first is the problem of viral load, the research team pointed out in the paper, since the virus load of the new coronapneumonia changes similar to influenza, then early antiviral treatment may be critical to improve the prognosis, but the use of lopinavir/ Litonevir in this analysis has been limited in domestic trials.
and for the outbreak of the outbreak of new crown pneumonia prevention and control, the early virus load is high, infectious, it certainly means that prevention and control is more difficult, but the research team proposed saliva testing method, it is indeed more easily acceptable to the subject, after all, some time ago there are also international students returned home, refused to swallow swab testing things.
second, for a small number of patients saliva nucleic acid test continued to positive, the research team believes that the key is to determine whether these patients are still "detox", if the patient's clinical symptoms basically disappear, continued hospitalization will indeed crowd up medical resources, but from the perspective of infectious disease prevention and treatment, the detox patient discharged from hospital is obviously risky.
the answer to this question, more research is needed to confirm, the same follow-up research is also the problem of antibody levels, after all, from the data analyzed, the patient's antibody level changes and clinical symptoms are not significant, but since the SARS virus antibodies may lead to acute lung damage, the new coronavirus also has to be carefully viewed.
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in addition, we also prepared a small number of paper handouts, after the purchase of the course plus editor-in-chief WeChat can claim free, first-come, first-served! Reference: 1. To K-W, Tsang O T-Y, Leung W-S, et al. Temporal profiles of the viral load in posterior oropharyngeal spits serum and antibody responses infection by SARS-CoV-2: an observational cohort shofs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Lancet E. Diseases, 2020.2. K K W, Tsang O T Y, Yip C C Y, et al. Consistent detection of 2019 novel coronavirus in saliva . Clinical Enmes, 2020.4.Cao B, Wang Y, Wen D, et al. A Trial of Lopinavir - Ritonavir in Adults Seifod with Severe Covid-19 . New England Journal of Medicine, 2020.5. Liu L, Wei Q, Lin Q, et al. Anti-spike IgG causes acute acute lung oedy by skewing macrophage responses yr acute acute SARS-CoV infection . JCI Insight, 2019, 4 (4). The writer of this article is not yet a time to breathe a sigh of relief. Why did
the new crown outbreak spread rapidly in Italy? Global Observer MATT: The outbreak of coronary disease in Italy has worsened rapidly, with more than 59,000 confirmed cases and more than 5,000 deaths in Italy as of March 23, making it the world's most deadly country. Why did the outbreak of
disease spread rapidly in Italy? Population ageing, according to population data from the United Nations Department of Economic and Social Affairs, has 23 per cent of the population aged 65 and over in Italy as of 2019, with the median age of 45.4 years, the highest in Europe.
the highest mortality from viral infections is among older people over 80 years of age, with a mortality rate of 15 per cent.
Italy's outbreak data on March 20th showed that Italy had an 8.6 per cent mortality rate, with an average age of 78.5 years, and nearly 99 per cent of those had at least one disease.
, according to a study in the journal Population Science, young Italians often live with their parents and grandparents than in other countries, and because of their extensive work and living contact with the outside world, the virus is brought home and transmitted to older people with weak immunity.
2. Of course, the lack of medical resources is not the only factor affecting the outbreak.
Japan's median age is higher than Italy's, but the number of deaths in more than 30 is far lower than In Italy's.
Italy has universal health care, but funding has been in short supply.
national health budget accounts for only 6.8% of GDP, less than any other EU country.
sudden outbreak of coronary disease has led to a surge in cases, only a few patients can stay in negative pressure wards or have access to facilities such as ventilation and respirators.
when hospitals lack equipment such as ventilators and beds, doctors often have to make life-threatening trade-offs, giving priority to patients who are more likely to survive, resulting in higher-risk patients dying.
in addition, Italy's public health care has long faced serious shortageof medical and care workers, health care workers have also been infected.
Italy's health-care system could collapse if patients continue to multiply.
once the health care system reaches saturation point, the disease spreads more quickly.
3. The epidemic epidemic is not strict, missed the golden time of the epidemic at the end of January when the outbreak in China was already quite serious, Italy only three people were confirmed, two of them Chinese tourists.
Italy imposed a travel ban on China in the first place.
the Italian government thought it would be okay to cut ties with China, but ignored the possibility that more people might fly to Italy via third countries.
many travelers were blocked for fear of entry and did not take the initiative to inform their travel history, making it difficult to determine at first where the source of the infection came from. in addition, the Italian government has ignored the possibility of community infection,
.
many experts analysis, northern Italy should be as early as January, when there are fever patients, but at that time are treated as a general flu.
Lombardy and Veneto in northern Italy are among the worst affected areas in Italy, where the government has imposed "city-sealing" on 11 of them and has ordered schools to close for a week.
. It's a common habit for Italians to enjoy the outdoors, to enjoy life with all their heart and soul, and it's become normal to have a drink with a colleague or friend after work and then go home for dinner.
The Italian government has increased restrictions on individual and public activities, with the number of new diagnoses rising rapidly every day since March 10.
early March, when quarantine zones began in northern Italy, many young people under the age of 30 continued to go out as usual, including sunbathing on the beach on weekends and eating seafood.
two Italian women even broadcast pictures of themselves partying outside the bar, boasting that they had found a way to break the ban.
the city-wide quarantine has now been implemented across Italy, there are growing reports that people are violating segregation and are more inclined to interpret the law as a way to hear and listen to advice.
5. The outbreak has become a political game, although Italy's opposition, although in the seal of the city on issues such as epidemic prevention, but behind the existence of serious partisan interests involved.
Italy's opposition in February 23-25, the original put down the quarrel sparring and stereotypes, temporarily supportitalian Prime Minister Conte to block the affected areas of Lombardy and Veneto region 11 affected towns, but for economic reasons, the blockade, curfew imposed only two days, was opposed by the local political forces in Milan, was forced to cancel.
during this period, Italian politicians have even been keen to travel to the affected areas to participate in the parade, the opposition groups have also called for a large-scale entertainment activities. The president of the Italian Democratic Party, who was diagnosed with the disease on March 7th,
, and Mr Zingaretti, the president of the Italian Democratic Party, also led a delegation to Milan on February 27th to celebrate the lifting of the curfew.
and the Italian government in the early stages of the spread of the disease, insisted that the disease is "big flu", resulting in Italy's epidemic prevention and isolation has been greatly affected.
Source: Singowonder.com.