Recently, a screenshot claiming that the XBB.1.5 strain attacks the digestive system and recommends stocking up on medicines was widely circulated. norfloxacin and montmorillonite powder mentioned in the screenshot subsequently appeared on hot searches and triggered discussions. What exactly is this strain? Is it necessary to start stocking up on digestive tract drugs? What is the risk of reinfection? What should we do if we have digestive system symptoms?
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What is the XBB.1.5 strain?
According to reports from NBC and other US media, the US Centers for Disease Control and Prevention stated that the new variant XBB.1.5 of Omicron is spreading rapidly in the United States. Currently, 40% of new coronavirus confirmed cases are infected with this new variant, up from 20% the previous week. In the northeast region of , about 75% of confirmed cases are infected with XBB.1.5.
Barbara, director of the Respiratory Viruses Division at the U.S. Centers for Disease Control and Prevention, said there is no indication that XBB.1.5 causes more severe disease than other Omicron variants. While COVID-19 hospitalization rates are rising across the country overall, hospitalization rates are not rising in the Northeast.
Pecoutz, an expert in virology at Johns Hopkins University in the United States, said that XBB.1.5 has an additional mutation that allows it to better bind to cells. Columbia University scientists warned in a study that the increasing number of Omicron XBB subvariants could further compromise the efficacy of the new crown vaccine and lead to a surge in breakthrough infections and reinfections.
Li Tong, chief physician of the Department of Respiratory and Infectious Diseases at Beijing You'an Hospital, once told reporters, "XBB still belongs to a sub-branch of Omicron and is a recombinant mutant strain of the mutant strain below BA.2, with immune evasion ability. The epidemic has been strengthened in some foreign areas, resulting in an increase in the number of infections, but foreign data show that its pathogenicity is no different from previous strains. "
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How is the spread of the XBB strain in my country?
On December 31, 2022, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine , Translational Medicine National Major Infrastructure (Shanghai) Chen Saijuan team and Fan Xiaohong’s team from Shanghai Public Health Clinical Center jointly tackled key problems at Frontiers of Medicine published a research paper "Primary assessment of the diversity of Omicron sublineages and the epidemiologic features of autumn/winter 2022 COVID-19 wave in Chinese mainland".
The research team conducted genome sequencing on 378 randomly selected samples from patients admitted to the Shanghai Public Health Center during the autumn and winter of 2022, and obtained 369 high-quality new coronavirus full genome sequences. Molecular evolutionary tree analysis found that these viral genomes contained a total of 30 Omicron subtype strains recorded in the Global Initiative for Sharing All Influenza Data (GISAID) database, of which 355 (95.95%) genome sequences were concentrated in 5 Omicron subtypes. The main strains include BF.7 and BA.5.2 that have been reported to be prevalent in Beijing and Guangzhou, and BQ.1 and XBB that have recently appeared in Europe and the United States. Combining the travel history and infection contact history of infected people, it was proved that people with a history of contact with the Beijing or Guangzhou epidemic mainly carried BF.7 and BA.5.2 substrains respectively; infected people entering Shanghai from overseas mainly carried BQ.1 and XBB; and among local infected people in Shanghai, in addition to BA.5.2, there are also multiple Omicron substrains that account for a relatively high proportion. No new coronavirus variants have been found in these results.
▲Image source: Shanghai Jiao Tong University School of Medicine
On December 27, 2022, Pan Yang, a researcher at the Institute of Infectious and Endemic Disease Control of the Beijing Center for Disease Control and Prevention, was interviewed by The Beijing News and said that in the 50th week of 2022, the BF.7 variant infection in Beijing accounted for about 71%, and the BA.5.2 variant accounted for about 29%. Neither , delta nor the original strain was found to be popular in Beijing. Pan Yang said that recent social surveillance data in Beijing showed that no mutant strains such as XBB and BQ.1 were found to be prevalent in the community, nor were non-Omikron mutant strains such as the original strain and Delta found to be prevalent.Will the risk of reinfection with the new strain
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increase? Will
XBB.1.5 lead to large-scale secondary infection of with ? Wang Xinyu, deputy director of the Department of Infectious Diseases at Huashan Hospital Affiliated to Fudan University, said that the pathogenicity of XBB, BQ.1, and BQ.1.1 is similar to previous strains, but their immune evasion ability has increased. Therefore, the virus caused by may spread faster than before.
If you encounter these strains, the probability of reinfection mainly depends on two aspects:
On the one hand, how much overlap the strain you encounter again has with BA.5 and BF.7. If the virus keeps mutating and the cross-protection effect is reduced, infection may occur;
On the other hand, it depends on the level of the person's autoantibodies .
"The immune evasion ability of the current XBB strain has been enhanced, which is different from the BA.5 popular in my country. After a period of time after infection with BA.5, the level of protection decreases. When encountering strains with strong immune evasion ability, the risk of reinfection will increase. However, reinfection mainly occurs in some people with low immunity. Immune function People with normal immune function have a relatively small risk of reinfection in a short period of time, and the symptoms after infection are usually milder than the first time." Li Tong once said.
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The Is it Floxacin?
Mao Yimin, chief physician of the Gastroenterology Department of Shanghai Renji Hospital, said that Norfloxacin is an antibiotic and is only effective against bacterial infections. It is not suitable for diarrhea caused by the new coronavirus. Abuse of antibiotics can damage the liver and even aggravate diarrhea. Mao Yimin said that under normal circumstances, diarrhea can excrete viruses and toxins from the body. It is not recommended to take antidiarrheal drugs such as montmorillonite powder as soon as diarrhea occurs. If diarrhea occurs multiple times in a row, you need to seek medical treatment as soon as possible.
Is it necessary to stock up on montmorillonite powder? Li Tong once told reporters: Montmorillonite powder is a drug for treating diarrhea. Some people infected with the new coronavirus do have symptoms of vomiting and diarrhea, which usually resolve on their own in 1 to 3 days. XBB1.5 has not been found to be more likely to invade the cardiovascular and cerebrovascular systems and digestive systems. Drugs for treating respiratory tract infections and digestive tract infections can be prepared appropriately, but there is no need to hoard them in large quantities.
Zhang Boli, an academician of the Chinese Academy of Engineering, emphasized that after being infected with the new coronavirus, you must be rational, rational and patient when taking medication. It takes a certain amount of time for the medication to take effect. Remember there is no miracle cure, no magic cure. It is also forbidden to take medicines indiscriminately when you are sick, or to combine medicines without purpose, as they may cause drug harm. The "main force" in the fight against the new coronavirus is one's own immunity. Therefore, stocking up on medicine is not as good as stocking up on “good health”. Adjusting your physical condition, paying attention to rest, drinking more water, eating more fresh fruits and vegetables, ensuring nutritional intake, maintaining a good mood, and improving the body's immunity are the most important factors in successfully passing the infection process.
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What kind of intervention measures should be taken for digestive tract symptoms
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Zheng Qing, deputy leader of the Inflammatory Bowel Disease Group of the Gastroenterology Branch of the Chinese Medical Association and chief physician of the Gastroenterology Department of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, gave the following three suggestions:
First, strengthen dietary nutrition. Patients infected with the new coronavirus must maintain adequate nutritional intake and enhance the body's resistance. It is recommended that the three meals should be balanced and balanced according to your body's tolerance. They should be easy to digest and less greasy, and ensure sufficient water, energy, high-quality protein, and vitamins .
The second is mainly symptomatic treatment. For the more common gastrointestinal symptoms, if they are not particularly severe, they generally do not require special treatment and will get better on their own as the overall condition improves. Those with more obvious symptoms can be given symptomatic and supportive treatment.
For more severe diarrhea, attention should be paid to replenishing water and electrolytes, and appropriate use of montmorillonite powder, berberine, probiotics and other symptomatic treatments.What does Montmorillonite Powder mainly treat? Montmorillonite Powder has a strong adsorption effect. When adsorbing pathogens , it may also absorb other drugs, so it must be taken separately from other drugs. It is generally not recommended to use drugs that inhibit intestinal peristalsis to stop diarrhea . Berberine can be taken to relieve diarrhea. It is generally recommended that the daily dosage for adults is 600-900mg (100mg/tablet), taken in three divided doses. Probiotics can be used to improve intestinal flora and maintain intestinal microecological balance. When using probiotics, be careful to avoid using live bacteria with antibiotics. In cases where co-infection is identified, antibiotics may be used appropriately.
Other symptoms such as vomiting can be treated with antiemetics. For abdominal distension and anorexia, you can take some prokinetic drugs (such as mosapride, itopride) and compound digestive enzymes to relieve symptoms. Patients with liver damage and can be given hepatoprotective treatment to help recover.
The third is to find and eliminate the incentives. Patients should pay attention to avoid taking multiple drugs with similar ingredients in order to avoid overdose; use drugs rationally to minimize adverse drug reactions; avoid long-term use of large doses of antibiotics; the use of traditional Chinese medicine should be selected according to individual cold syndrome, heat syndrome, etc., or syndrome differentiation and treatment under the guidance of an experienced Chinese medicine practitioner.
If your symptoms fail to improve after taking the medicine for several days, and may even worsen, please seek medical attention in time. In special times, you can first choose an Internet hospital for consultation, or you can go to the nearest community hospital for treatment, and be careful to rule out symptoms caused by other digestive tract diseases.
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Opinion: The new coronavirus XBB variant strain is here
Stay concerned but don’t need to be afraid
As XBB and its sub-branches XBB.1 and XBB.1.5 appear around the world and in my country, some news says that these mutant strains mainly attack the cardiovascular, cerebrovascular and digestive systems, and can easily cause diarrhea. Therefore, there is now a rush for medicines in some places, with Changyanning tablets , montmorillonite powder, norfloxacin capsules, lactobacilli tablets, etc. being out of stock.
There is nothing wrong with buying medicine. However, other situations also need to be considered. First, there is no definite clinical evidence as to whether XBB and its sub-branches can cause cardiovascular, cerebrovascular and gastrointestinal symptoms; second, even if you need to take medication, you need to take it under the guidance of a doctor, and you should not take it by yourself.
The key question is that it needs to be clarified how much XBB and its sub-branches will affect the current epidemic trend and harm people.
Judging from the current situation, XBB only has enhanced immune evasion, but the symptoms it causes are not serious and the fatality rate is not high. Therefore, there is no need to worry too much about XBB and its sub-branches.
According to the sequencing results of domestic virus strains extracted from infected persons, domestic infections are still dominated by the BA.5.2 and BF.7 subtypes of Omicron. As for whether the source of infection will be dominated by XBB and sub-clades in the future, it still needs to be observed. But even so, XBB and its sub-branches are unlikely to cause a bigger disturbance than BA.5.2 and BF.7.
According to the current clinical situation in other countries, such as the United States, the pathogenicity of XBB and its sub-branches has not been significantly enhanced. The symptoms that people experience after infection are similar to those caused by other subtypes of Omicron, or even milder, and the fatality rate has not increased. If virus mutation is regarded as a normal state, XBB is just a normal mutant strain of Omicron.
▲On December 27, citizens purchased medicine at a pharmacy in Tianjin. Picture/Xinhua News Agency
It should still be noted that XBB has a special mutation. Relevant studies have shown that XBB.1.5 is different from strains of the same family. It has an additional key mutation F486P, which has a stronger affinity with the human angiotensin-converting enzyme 2 (ACE2) receptor, and ACE2 is the portal for the virus to enter human cells. This makes it easier for the XBB.1.5 mutant strain to invade human cells.
A subsequent result is that XBB.1.5 has a higher immune evasion capability.In other words, even if you are vaccinated with vaccine , whether it is inactivated vaccine or mRNA vaccine, the immune protection against this variant strain may decrease, which means that XBB.1.5 is more likely to cause infection than other strains.
At the same time, natural infection with the virus is equivalent to being vaccinated once, which will produce neutralizing antibodies in the body. However, due to the enhanced immune evasion ability of XBB.1.5, the immunity acquired after natural infection may also decrease, making it difficult to block XBB.1.5 infection. However, small molecule antiviral drugs are also effective against XBB.1.5.
These situations can also be explained by the mutation of the virus. Everything is different from its original origin, even XBB and its sub-branches are just derived from the mutant strain of Omicron.
So far, The World Health Organization has announced only 5 variants of concern, namely Alpha, Beta, Gamma, Delta and Omicron variants. The World Health Organization only upgraded the Omicron variant to a currently circulating variant of concern on November 26, 2021.
Currently, Omicron mutant strains are still mutating. World Health Organization observations show that at least hundreds of sub-branches of Omicron are mutating. XBB is only a small branch of Omicron. The evidence currently observed is that its pathogenicity and lethality are not strong, but its immune evasion ability is enhanced.
In this case, what needs to be prevented is secondary infection, especially XBB.1.5, which may cause secondary infection. However, most existing secondary infections (not necessarily caused by XBB.1.5) show milder symptoms than the first time.
The best way to avoid secondary infection and infection caused by XBB.1.5 is to get a booster vaccine. Of course, you do not need to be vaccinated if you have just been infected. You can wait 4-6 months before getting the second booster shot. In addition, pay attention to self-protection before and after the Spring Festival, wear a mask when going out, and wash hands frequently.
In addition, we need to remind you that if you have persistent fever, difficulty breathing, severe nausea, vomiting, diarrhea and other digestive system symptoms, poor mental status, aggravation of existing underlying diseases, etc., you need to seek medical treatment in time.
We have experienced strong winds and waves. On the basis of good protection and preparation, there is no need to worry too much.
(Source: Beijing News, Overseas Network, People's Daily, etc.)
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