Chances are your Sunday New Year’s Eve dinner was skipped because of a respiratory infection, or someone almost irresponsibly took a hit. Colds, catarrh and other upper respiratory illnesses have increased exponentially in recent weeks and have reached a peak.
The week before Christmas, the last available data, shows The incidence rate per 100,000 residents exceeds 900, an increase of 100 cases from the previous 7 days. Hospitalizations have increased to 21 per 100,000 residents, and primary and hospital emergency care are being overwhelmed by the respiratory virus.
“We are facing a very complicated January,” he acknowledged. Pascual PiñeraSemes, Vice President of the Spanish Society of Emergency Medicine. “The pandemic seems to have made us forget that, but we had a very deadly pandemic in 2017 and we may do the same this year.”
Is it the flu or the new coronavirus?
Piñera estimates that 8 to 9 out of every 10 hospital emergency room visits are for influenza, primarily influenza A.There have been waves of Influenza A and Covid in primary school, with the former now predominating and “very few cases of Influenza B and some combinations of Influenza A-Covid or Influenza A-Influenza B”, comments Lorenzo Armanterosspokesperson for the Spanish Association of General Practitioners and Family Physicians.
The latest weekly report from the Carlos III Institute shows that among people who first experience symptoms of a respiratory infection, almost a quarter test positive for influenza: 24.8%, while 4% test positive for SARS-CoV-2 13.6%. In hospitals, the rates were similar: 26.8% for influenza and 10.8% for COVID-19.
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As Piñera and Armenteros point out, current influenza is almost always type A. In the primary school subtype sample, 72% correspond to subtype (H1)pdm09 The remaining 28% is H3N2.
Among the new coronaviruses, the XBB.1.5-like lineage with the F456L mutation dominates, originating from the XBB.1.5 variant selected for the update of the vaccine available in Spain this fall.
This lineage accounted for 48.51% of cases sequenced in the week before Christmas, while BA.2.86 accounted for 22.76% of cases, although it was the dominant variant in recent weeks (up to 74%). .29% of sequenced viruses correspond to this variant).
What are your symptoms?
Lorenzo Armenteros stressed that clinically, influenza and the new coronavirus are two “indistinguishable diseases, they have almost the same symptoms: “fatigue, muscle pain, cough, sore throat, high fever…”
However, it states that the main The difference noted in the consultation was that “when Fatigue dominates, often with COVID. “On the other hand, if a patient notices more severe muscle pain, it’s more likely to be the flu.
The family doctor explains that we must distinguish these two viruses from others that are also circulating at this time, “They cause the typical colds of a lifetime and keep us going to work even if we have a runny nose and fatigue. “
How serious is the matter?
The current main strain is H1N1. Specifically, it is a successor to the 2009 pandemic, which is why the suffix “pdm09” was added to the report, which contains sequences from avian, swine and human viruses.
This subtype is the predominant subtype and the first to appear during the season. Towards the end of the year, between February and March, more cases of influenza B virus began to appear, which was generally more benign, although it led to unexpected waves of virulence, such as the 2018 virus, which was first due to the fact that The vaccines recommended that year did not match the strains that eventually circulated.
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Pascual Piñera explained that it was mainly young people who came to the emergency room “with the usual symptoms” – headaches, fever, general malaise, myalgias and weakness – but there were also older people with symptoms of respiratory failure, “Some people also developed pneumonia.”
Do the math One in 10 seniors who go to the emergency room with a respiratory infection ends up in the hospital. Data from the Carlos III Health Institute show hospitalization rates have increased since mid-November, from 12.7 cases per 100,000 people to 21 in the penultimate week of the year.
Why do symptoms last longer this year?
Flu symptoms usually last about 7 days, and the first 4-5 days may be the hardest for the remaining symptoms (especially fever) to improve.
This winter, however, many people are complaining that their symptoms seem to be outside the normal range. None of the doctors consulted by La España confirmed this at a clinical level, but Lorenzo Armenteros pointed to a possible explanation: a loss of immunity over the three years of the pandemic.
“Every now and then you encounter people with compromised immunity; You can extend the period up to 10 days instead of the classic 7 daysbut that’s usually not common,” he commented.
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He noted that this duration, or the perception of duration produced by a more intense infection, may be because “we have lost some immunity to the flu over the years when the virus was circulating less, which may Make an impact on us.” The impression is that it is more radical now. “
The longest-lasting symptom is a cough, which is “dry, unproductive, irritating and occurs mainly at night and can last up to a month after the acute phase is over” and is caused by “a direct attack of the virus on the respiratory tract”. Upper respiratory tract: trachea, bronchi, and oropharynx”.
What treatments are effective?
If there are no other complications from the flu, treatment is to relieve symptoms. “Topical hydration and some anti-inflammatory effectsArmanteros said.
i.e. water (also works Grandma’s Remedy such as honey milk) to soothe the throat, as well as “proven antipyretics and analgesics such as paracetamol and ibuprofen with optimal safety profiles.”
GPs discourage recommending cough suppressants “unless the cough exceeds normal limits, in which case evaluation by a doctor is recommended. In any case, this is not suitable for everyone as they may develop complications.”
He notes that certain syrups can help soothe the throat “like candy or gargling with honey water.”
Semes Vice President Pascual Piñera explained that for older adults who come to the emergency room with respiratory problems, they may end up receiving non-invasive ventilation, “and we may end up admitting them.”
When to go to the emergency room?
Lorenzo Armenteros explains that sometimes people go to the doctor at an early stage “before the disease is even revealed.”that’s why It is recommended to wait 48 hours and take care of yourself with hydration and pain medication Watch their evolution and check “whether we have progressed enough to not have to go to the doctor and avoid overloading health centers”.
What is not advisable is to be accompanied by dyspnea (respiratory insufficiency), “a feeling of suffocation when short of breath or a discoloration of the mucus from white to green, which may indicate bacterial superinfection.”
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We also recommend going if we have a fever for more than four or five days, “or if the condition continues to worsen.”
Pascual Piñera remembers Many older people often suffer from advanced disease “because they often rely on other people to come”.
That’s why he recommends not waiting until you feel short of breath before taking action in this situation. “If they start in the clinic and find that the fever doesn’t go away, they should go to the emergency room to see what happens before they develop difficulty breathing.
How are the kids doing this season?
David AndinaWith the end of the respiratory syncytial virus (RSV) epidemic that peaked over the December long weekend, influenza is now as dominant as it is in adults, notes an emergency pediatrician at Madrid’s Niño Jesús Hospital. .
“The epidemic curve has not peaked yet” and it is expected that after the closure of nurseries and schools at Christmas, “this wave of epidemics will slow down, although we have not seen it yet.”
Since these images are viral images,”No antibiotic treatment required. The only thing we can offer is to give them a fever reducer (usually paracetamol) and hydration, and in younger children, a nasal rinse to relieve a bit of the upper airway obstruction. “
He noted that while it’s difficult to make general recommendations, if a fever persists “for more than 4-5 days, parents should consider going to the emergency room if there are signs of difficulty breathing (he’s clutching his stomach or having difficulty breathing) or soon) or “We saw that he was sleepy and more depressed than usual.”
In itself, Cristina CalvoThe president of the Spanish Society of Pediatric Infection pointed out that thanks to nirsevimab immunization, this year RSV “has caused many fewer serious cases in infants who received the vaccine, which is very different from previous years.”
In general, the flu “while causing a lot of fever, usually does not require or be hospitalized less frequently.” The coronavirus “is also milder, and generally small babies under one year old are admitted, although after a few days The condition is progressing well, but the situation is more concerning.”