Immune Debt in Children and Virus Infections: Pediatric Findings and Concerns

2023-12-20 15:46:18
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This year, doctors have observed that young children are infected with many types of viruses, including influenza, adenovirus, enterovirus, parainfluenza, norovirus, respiratory fusion virus, etc. It is speculated that this is because following these children were born, almost all of them were infected during the epidemic. They are all associated with masks. They have not been infected with many viruses and have no antibodies in their bodies, leading to immune debt. According to a health survey in the post-epidemic era, it was found that among the families who have paid for vaccinations at their own expense, in addition to conventional vaccines, new crown vaccines and influenza vaccines, only 8.38% of parents allow their children to receive other types of vaccines, and the vaccine hesitancy rate is slightly higher.

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Pediatrician Lin Yingran: “Come on, try harder, you are very brave.”

Family member Ms. Zhang vs. doctor Lin Yingran: “The asthma is not cured yet.”

The cute little girl followed her grandma to and from the doctor. She had been diagnosed with asthma before, and the adults were very nervous.

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Family member Ms. Zhang: “I was playing in the park that day, and then suddenly I coughed very badly. I felt like vomiting and then kept coughing. It was very uncomfortable. Then I felt very panicked. The last time I coughed was because of mycoplasma. , we have been watching like this for nearly 3 months. After going home and seeing the (doctor) once more and once more, she kept coughing over and over once more. (very worried) I was very worried that she kept coughing, and then she got better and got infected once more at school. right away.”

Pediatrician Lin Yingran: “I was thinking regarding January and February when the weather was very cold, and I was thinking that the immune debt would be more obvious and serious. The virus likes to break out suddenly when it is very cold, whether it is influenza, COVID-19, or… The RSV (respiratory fusion virus) you are talking regarding now, parainfluenza viruses such as adenovirus, and respiratory fusion virus all have this characteristic, so our real peak immunity period, that is, the peak period of infection has not yet arrived.”

After three years of epidemic, normal life will resume in 2023. Some doctors have observed that Taiwan has experienced a wave of RSV respiratory fusion virus infection peaks for two consecutive years, and the infection targets are no longer limited to children under two years old, but have extended to three and four years old. Young children, because these children were almost always accompanied by masks during the epidemic following they were born. Many viruses have not been infected and the body does not have antibodies, so it is almost difficult to resist following the lockdown is lifted. This is the so-called immune debt, and there are many types of viruses that young children will be infected with in 2023. , including influenza, adenovirus, enterovirus, parainfluenza, norovirus, respiratory fusion virus, etc.

Huang Yucheng, professor-level attending physician at the Department of Pediatric Infectious Diseases at Linkou Chang Gung Memorial Hospital: “We discovered during this period that from the test data of the (hospital) virus room, or we now have a respiratory kit, we analyze it from the inpatients , then since June and July, there have been regarding 6 or 7 kinds of viruses that have been circulating in the community. If we look at another positive situation of rapid influenza screening, then in our hospital, From January this year to now, the positivity rate every month has remained between 10% and 15%.”

The flu has been around for almost a whole year, and in the past few months many children have sought medical treatment or even been hospitalized.

Huang Yucheng, a professor-level attending physician at the Department of Pediatric Infectious Diseases at Linkou Chang Gung Memorial Hospital: “In the past, the number of cases, fever, respiratory tract infections, and infections were relatively low in primary school students from the first to the fourth grade, but recently you have seen a lot of people from the first to fourth grade of primary school. Doctors tell us that it is true that in the past three years, some respiratory viruses have not been spreading, but some infectious diseases have begun to appear recently, and some respiratory diseases that should have been acquired in elementary schools and before entering school , to… it is still happening one following another, so to put it simply, it is a bit like, the phenomenon of immune debt is really manifested. “

Huang Siwei, deputy director of the Department of Pediatrics at Wanfang Hospital: “This year, especially following August or September, more and more sick children with upper respiratory tract infections are being hospitalized and seeing more and more doctors. In fact, this is quite common. This is a medical history. The child said that the mother said that the child had been suffering from a cold for the whole week and the whole month. He had a fever for three days, and following two days it seemed to be better, the fever stayed like this for another five days. He has been like this for the whole month, right? Then this has something to do with immunity debt.”

According to a health survey in the post-epidemic era, it was found that among families who have paid for vaccinations at their own expense, in addition to conventional vaccines, COVID-19 vaccines and influenza vaccines, only 8.38% of parents let their children receive other types of vaccines. The vaccine hesitancy rate is slightly higher. Hesitation was listed by the WHO as one of the top 10 global health threats in 2019, further analyzing parents’ attitudes towards vaccination, including confusion regarding the types of vaccinations, vaccination schedules and methods, concerns regarding side effects, and other reasons.

Huang Siwei, deputy director of the Department of Pediatrics at Wanfang Hospital: “Taiwan provides a full range of vaccines at public expense. Yes, the more important ones are influenza. Our five-in-one has some Haemophilus, and then there is Streptococcus pneumoniae. These vaccines are all They are covered by public funds, so the protection is actually quite good. Some additional vaccines, such as the recently introduced enterovirus and meningococcal vaccines, actually require additional self-funded vaccinations. In fact, The self-pay part will indeed cause parents to hesitate, that is, whether it is necessary to spend this money.”

Doctors believe that the vaccination rate in Taiwan is quite high, and many hospital monitoring systems have also warned that viruses such as influenza, RSV, and parainfluenza are increasingly seasonal and unpredictable, and we must be more vigilant.

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Further reading:

The number of confirmed cases of the new coronavirus variant JN.1 has increased significantly. The WHO announced the inclusion of “variant strains that need attention”

Autumn and winter are difficult!Viruses and bacteria may double attack doctors: “Immunity debt” is not over yet

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