Etiology of influenza A H 1N 1

H 1N 1 is a virus belonging to orthomyxoviridae series. Its hosts are birds and some mammals. All subtypes of H 1N 1 virus have been isolated from wild birds, but the disease is rare. Some serious diseases caused by H 1N 1 virus mostly occur in birds, but rarely in humans. However, through the spread and variation of birds and mammals, this may lead to the epidemic or large-scale spread of influenza.

The same series as H 1N 1 are H5N 1, H7N2, H 1N7, H7N9, H1N6, H3N8, H9N2, H5N2 and H5N9.

change

Variants sometimes vary depending on the host. There are mainly the following types:

* Avian influenza

* Human influenza

* Swine flu

* Equine influenza

* Dog flu

Sometimes named after its deadly birds, especially chickens:

Low pathogenic avian influenza (LPAI)

Highly pathogenic avian influenza, also known as fatal influenza or avian influenza death.

In H 1N 1, H number (type of hemagglutinin) and N number (type of neuraminidase) are marked. Each subtype of avian influenza virus has mutated into various strains with different pathogenic characteristics; Some diseases are caused by one species, but others are unacceptable to many species. The most famous species has gone extinct.

H 1N 1 virus is a single-stranded and segmented RNA virus in the negative sense. There are 16 different HA antigens (H 1 to H 16) and 9 different applicable antigens (N 1 to N9).

heritage

Its virus structure is spherical or filamentous. Clinical isolation has experienced limited laboratory tests and tissue culture, and filamentous particles are more than spherical particles, but mainly include spherical particles.

The genome of H 1N 1 virus contains eight proteins (ha, na, NP, m 1, m2, ns 1, nep, pa, pb 1, pb), which are encoded by single (unpaired) RNA chains. The total genome size is 13588. A segmented genome allows the whole gene to coexist in cells with different viral vectors. The eight RNA parts are:

* The infection encoding hemagglutinin is transmitted to the host organism HA. Influenza virus buds polarize epithelial cells (such as bronchial epithelial cells) from the apical surface to the cavity and lungs, so they are usually pneumophilic. The reason is that the trypsin-like enzyme Kla is limited to the lungs. However, the subtype H5 and H7 avian influenza viruses in 2004 made the virus grow faster in other organs than in the lungs.

*NA neuraminidase.

*NP nuclear protein.

*M matrix protein.

* two different nonstructural proteins of ns (NS 1 and NEP).

*PA RNA polymerase.

* RNA polymerase of Pb1and protein of PB 1-F2 generation.

* PB2 RNA polymerase.

RNA synthesis takes place in the nucleus, while protein synthesis takes place in the cytoplasm. The virus kernel leaves the nucleus and is transplanted to the cell membrane, the transmembrane protein of plaque virus (hemagglutinin, neuraminidase protein and M2) and a basal layer to supply M 1 protein. Through these supplements, the enveloped virus is released into extracellular fluid.

1998 A H3N2 subtype h 1n 1 strain was isolated from North Carolina, USA. The HA, NA and PB 1 genes are human influenza virus genes, the m, NP and NS genes are swine influenza virus genes, and the PB2 and PA genes are avian influenza virus genes [10]. 1H 1N2h 1n 1 which broke out in Japan in 1978 is a new subtype [1 1] produced by recombination of h 1n 1 and H3N2 genes. H9N2 influenza virus was isolated from Shandong pigs in China, and the analysis may be the result of recombination of chicken and duck influenza virus [10]. After H9N2 subtype influenza virus 1998, it was isolated from pigs for the first time. The results showed that the H9N2 subtype from pigs was highly homologous to the avian influenza virus isolated in China by partial sequence analysis. Cross-infection and transmission may also occur between SI and human influenza. 1978, H3N2 subtype h 1n 1 was isolated from a pig farm in Taiwan Province province. By sequencing, it was found that the gene fragments of human influenza virus and SI virus were recombined [12].

Due to the great immune pressure of h 1n 1, the amino acid changes of 8 gene fragments have accumulated continuously, and their antigens have obvious variation. In the isolated geographical environment, h 1n 1 can persist and maintain relative genetic stability [13- 14].

As a "mixer" of influenza virus, pigs play an important role in the process of influenza virus crossing the species barrier and infecting new hosts. Because there are sialic acid 2,6-galactoside and sialic acid 2,3-galactoside in pig epithelial cells, human influenza virus can bind to the former, and avian influenza virus can bind to the latter, so pig epithelial cells can be infected by human influenza virus and avian influenza virus and become a living vector for gene recombination between strains [15- 16].

Because h 1n 1 can directly infect people, resulting in human illness or death, its public health significance is increasingly significant. Strengthening the research on h 1n 1 is of far-reaching significance for reducing the world economic losses and improving human health.

[Edit this paragraph] Specific introduction of epidemic situation

H is called erythrocyte agglutinin and n is called neuraminidase. They are all glycoproteins, which are distributed on the surface of the virus. H has subtype 1- 15, and n has subtype 1-9 (take virus A as an example). Because of the different combinations of H and N, the toxicity and transmission speed of the virus are also different.

19 18 ~ 1920 first appeared in the eastern United States in 19 18, and it was popular in the French army in April of 19 18, and then spread rapidly. This epidemic is called the biggest plague in human history, and the total death toll is estimated to be about 20 million. As for the pathogen of this epidemic, according to serological tracing, it is believed that it is caused by swine influenza virus HSW1N1(H1N1).

On April 25th, 2009, there was a sudden outbreak of swine flu in Mexico.

US government officials said on the 28th that they are considering changing the name of the current rampant influenza epidemic, because "swine flu" will lead people to misunderstand that the epidemics in Mexico, the United States and other countries are related to eating pork.

The Associated Press reported that the virus was actually a mixture, which concentrated the characteristics of swine flu virus, human influenza virus and avian influenza virus. Because American officials believe that although the swine flu virus has played a certain role in it, it is not accurate to simply name the current flu as "swine flu", but it has seriously affected the export of pork and pork products in North America.

The US Centers for Disease Control and Prevention said that eating pork will not cause swine flu, and the virus may spread from person to person at present.

The US Centers for Disease Control and Prevention announced that swine flu was renamed as "Influenza A H 1N 1" because the virus was not transmitted by pigs.

Swine flu virus (SIV) is an orthomyxovirus, which can cause endemic influenza in pigs. At present, most viruses isolated in the laboratory are identified as a subspecies of influenza C virus or influenza A virus. There are many different types of influenza A virus swine flu under the electron microscope, including: influenza A virus H 1N 1, H 1N2, H3N 1, H3N2 and H2N3 subtypes can all cause swine flu infection.

The current outbreak of swine flu in Mexico is a respiratory infectious disease of pigs caused by influenza A virus. Preliminary research shows that the virus is influenza A virus, which carries H 1N 1 subtype swine influenza virus strains, including DNA gene fragments of avian influenza, swine influenza and human influenza virus, and has the characteristics of Asian swine influenza and African swine influenza virus.

Reuters quoted the research results of American scientists as saying that this new influenza virus is swine flu, because scientists have detected H 1N 1 subtype swine flu virus in patients, but this new influenza virus has the characteristics of virus hybridization.

According to the World Health Organization, the virus that caused swine flu this time is a new virus produced by the "shuffling effect" of avian influenza and human influenza. When different viruses meet, they exchange genes and mutate into new hybrid viruses, so humans lack immunity to them. It will be difficult to estimate the spread and subsequent impact of the swine flu epidemic. However, the aggressiveness of the virus, the individual differences of human immunity and the comprehensive resistance acquired by human beings against various influenza are the decisive factors that determine the epidemic situation.

According to American records, human infected with swine flu virus H 1N 1 appeared in 1976 and 1988, resulting in two deaths.

2. What are the symptoms of swine flu?

The cross-species nature of influenza virus can also infect humans with swine flu virus, and its symptoms are similar to those of ordinary influenza, but the severity is very different. The general symptoms are sudden fever, cough, headache, joint pain, stuffy nose, general fatigue and loss of appetite above 38 degrees. Some people infected with the virus will also have symptoms such as runny nose, sore throat, nausea, vomiting and diarrhea. In some previously discovered cases, swine flu can also lead to pneumonia, respiratory failure and chronic deterioration of health. And some patients have no discomfort, and some are enough to die. Professor Yuan from the Department of Microbiology of the University of Hong Kong pointed out that swine flu mainly threatens people with weak resistance. Therefore, as long as people keep healthy and keep exercising, people don't need to worry too much.

3. How does swine flu spread?

Mexicans wear masks on the subway.

The inter-group transmission of swine flu is mainly mediated by coughing and sneezing of infected people, and it is more susceptible to infection in densely populated environments. More and more evidence shows that micro-viruses can remain on desktops, telephones or other planes, and then spread through finger contact with eyes, nose and mouth. So try not to touch, including shaking hands, kissing, eating, etc. If you touch something with swine flu virus and then touch your nose and mouth, you will also be infected. Infected people may infect others before symptoms appear, usually one week or more after infection. Children will be more infectious.

Recently, a new swine flu virus broke out in Mexico, the United States and other places. There are more than 4,000 suspected cases in Mexico, and 152 people may have died of swine flu. The United States has confirmed that 50 people have been infected. Netease exploration takes you to know swine flu.

4. How to prevent swine flu?

Mexico City requires citizens to be at least 1.8 meters away from each other in public.

One of the characteristics of this swine flu virus is that it is aggressive to young people. Most of the dead confirmed in Mexico are between the ages of 25 and 45. Health experts warn that it is difficult to stop the spread of influenza after the outbreak, but common sense can help individuals protect themselves. They pointed out that hand washing is the first thing, and alcohol-based hand washing milk or foam disinfectant can also kill bacteria or viruses well. Richard Besser, acting director of the Centers for Disease Control (CDC), said: "Cover up when coughing or sneezing, and wash your hands often."

Can eating pork spread swine flu? Generally speaking, the current H 1N 1 can be killed if it is heated to 7 1℃ as long as there is no variation, so citizens need not worry blindly.

Because the antigen of H 1N 1 subtype swine influenza virus is very different from that of human H 1N 1 virus, seasonal influenza vaccine can not provide protection for human beings. In order to prevent infection, the following measures should be taken:

Keep your hands clean and wash them in the right way. If there is no obvious dirt, it can be disinfected with alcohol wipe.

Avoid hand contact with eyes, nose and mouth.

Cover your nose and mouth when sneezing or coughing.

Don't spit everywhere. If you want to vomit, wrap the secretion and throw it in the covered trash can.

When symptoms of respiratory infection or fever appear, you should wear a mask and seek medical attention as soon as possible.

Don't go to work or school if you have flu symptoms.

If you have fever or flu-like symptoms during or after traveling abroad, you should seek medical attention immediately and inform your doctor of your travel records.

5. Is there a vaccine to prevent swine flu? Can swine flu be cured?

At present, no vaccine against swine flu virus has been developed. Because H 1N 1 swine influenza virus is different from H 1N 1 human influenza virus, existing influenza vaccines cannot prevent H 1N 1 swine influenza virus. But four drugs for seasonal influenza can prevent swine flu: amantadine, rimantadine, oseltamivir and zanamivir. Although they are all effective drugs to treat influenza, according to the virus characteristics recently detected in swine flu patients, they have developed resistance to amantadine and rimantadine. Therefore, oseltamivir and zanamivir will be more effective in treatment and prevention.

6. Will it spread on a large scale?

Since1H5N 1 avian influenza was rampant in Hong Kong in 1997, the World Health Organization (hereinafter referred to as WHO) raised the influenza warning level from level 3 to level 4 for the first time. This means that the world must take urgent measures to deal with the challenge brought by swine flu.

The World Health Organization has raised the influenza warning from level 3 to level 4, which means that the assessment of influenza risk has changed qualitatively. Because according to its classification, the first to third levels of early warning only require member States to make preparatory measures, including strengthening capacity building and making emergency preparedness measures; However, if it reaches level 4 to level 6, countries are required to enter an emergency response state and take necessary prevention and control measures.

In nature, influenza virus has spread among animals, including birds and pigs. Although theoretically, all these influenza viruses are in danger of infecting human beings, as long as they do not pose real danger to human beings, the early warning level is set at 1 level.

In the second warning stage, domestic or wild animals have caused human infection, posing a potential epidemic threat.

By the third warning stage, the influenza virus from animals or the virus after the recombination of animal and human influenza has caused sporadic or small-scale (family level) infection in people; But its whole interpersonal skills are unsustainable. At the beginning of this year, H5N 1 highly pathogenic avian influenza with sporadic cases in many places in China was at this stage.

Pregnant women fell ill and died after contact with sick pigs. During 1976, a military base in New Jersey, USA was infected with swine flu. One soldier died of the disease and four others were hospitalized with pneumonia. At first, experts worried that the virus was a variant of the Spanish flu that killed millions of people, but fortunately, the virus did not spread outside the base.

[Edit this paragraph] Epidemic prevention and control

1, inactivated swine flu vaccine (SlV inactivated vaccine)

Among the developed swine influenza vaccines, H 1NI and H3N2 subtype monovalent or bivalent inactivated swine influenza viruses are the most mature for production. Its form is mostly oil adjuvant vaccine, and the inactivator is generally formaldehyde or BEI. According to reports, the inactivated swine flu vaccine can effectively protect weaned piglets and breeding pigs from SI, with the morbidity reduced by 30% ~ 70% and the mortality reduced by 60% ~ 87%. At present, this kind of vaccine has been commercialized in many countries in Europe and America, such as Inteway's End-End-FLUence (including Imugen) and End Fluence (including Microsol Diluvac Forte), Pfizer's FluSure, Schering-Plough Animal Health Company's MaxiVac-FIu and MaxiVac Excell 3, etc. Domestic South China Agricultural University, Harbin Veterinary Research Institute and other units have also done a lot of work in the development of inactivated swine flu oil emulsion vaccine. The results showed that H 1 subtype was prepared by culturing domestic strains. 9 1H3 subtype univalent and bivalent swine influenza oil emulsion inactivated vaccine, the Hl antibody titer can reach more than 1: 160 three weeks after primary immunization, and the HI antibody level exceeds 1: 400 four weeks after immunization, and the 12NHI antibody titer can still be maintained at/kloc after immunization. If the second immunization is carried out, the level of HI antibody will be higher, and the effective protection period can reach more than 6 months, which can completely meet the epidemic prevention needs of pigs of all ages. At present, these vaccines have passed clinical trials and are applying for new veterinary drug certificates. It is believed that commercialized domestic vaccines will be put on the market in the near future.

Although the inactivated swine flu virus vaccine has the advantages of safety, high efficiency, low production cost and long duration of effective antibodies, it also has the disadvantages of slow antibody production, weak ability to induce cellular immunity and strong stress response. In particular, most vaccine strains come from epidemic strains. Once the virus is leaked in the process of vaccine preparation, it will easily cause environmental pollution and induce a new epidemic. To this end, scientists are still exploring and developing new swine flu vaccines.

2.SlV subunit vaccine.

Subunit vaccine is a vaccine made by obtaining the main immunogen protein of pathogen through physical and chemical methods or genetic engineering means. It can effectively avoid the biosafety risks caused by the use of whole pathogens to produce vaccines, and is conducive to improving the concentration and purity of effective components in vaccines, as well as developing multivalent and multivariate vaccines. At present, subunit vaccines have been successfully developed, including foot-and-mouth disease virus VPI subunit vaccine, mycobacterium tuberculosis ribosome subunit vaccine, various bacterial exotoxin subunit vaccines, hepatitis B virus surface antigen subunit vaccine and so on. So far, the development of human influenza vaccine has gone through three periods. 1 generation vaccine is whole virus inactivated vaccine, second generation semi-split vaccine and third generation fully split virus subunit vaccine. Compared with the previous two generations of vaccines, the third generation vaccine further removes protein and pyrogen, which have little to do with immune function and have stress on the body, but concentrates the main immune antigens of influenza virus, namely hemagglutinin (HA) and neuraminidase (NA). Therefore, this vaccine has less stress on the body, rapid antibody rise after inoculation, long maintenance time, good immune effect and higher biological safety. At present, the third generation fully split influenza virus subunit vaccine has been widely used in many countries. However, for swine flu, the production cost of this subunit vaccine is too expensive, and it is unlikely that it will become the mainstream immune product in the short term. On the contrary, people pay more attention to the fourth generation genetic engineering subunit vaccine.

There are many methods to construct subunit genetic engineering vaccine of swine flu virus, among which the most reported ones are:

1) express the HA gene and NA gene of swine influenza virus epidemic strain in vitro with prokaryotic expression system (Escherichia coli system) or eukaryotic expression system (yeast system), then harvest the target protein, concentrate and purify it, and then further immunize the vaccine. The method has the advantages of simple preparation process, high yield of target protein and quantitative configuration of main components. However, because the protein expressed in vitro is difficult to maintain or restore the spatial structure of natural protein, the purification process of protein is complicated, the cost is high, and the overall immune effect is not as good as that of traditional whole virus inactivated vaccine, so the technology of this kind of vaccine needs to be further improved.

2) The immunogens (HA and NA) of swine influenza virus were cloned into eukaryotic expression plasmid alone or in series with the coding genes of cytokines (interleukin -6, interferon Y, etc.). ), then the recombinant DNA plasmid is introduced into the cells of the body and presented to the immune system through endogenous expression of the body, which induces the host to produce specific immune response and plays a protective role. This is the so-called DNA vaccine. The results show that the effect of DNA vaccine immunized with HA gene of swine flu virus is not ideal (the level of specific antibody is low and the protection against the virus is poor). If * * expresses some cytokines with immunomodulatory effect, or after using DNA vaccine, the immune protection level can be obviously improved. But in general, the immune effect of this kind of DNA vaccine is not reliable and the repeatability is poor. Compared with the traditional whole virus inactivated vaccine, there is still a certain gap, and it takes a long time from the laboratory stage to the development of molded products.

3) live vector genetic engineering subunit vaccine. At present, it is a vaccine with high hopes and may be commercialized. The vectors used include human adenovirus type 5 (HAd5), porcine adenovirus type 3 (PAV3), porcine pseudorabies virus (PRV), baculovirus and so on. Among them, the subunit genetic engineering vaccine of swine influenza with adenovirus as carrier is relatively mature. For example, some products developed by South China Agricultural University and other units have entered the stage of transgenic safety evaluation and clinical experiment, and the development prospect is expected to be good. Adenovirus vector has many advantages: ① adenovirus particles are relatively stable, the frequency of viral genome rearrangement is low, and it can be effectively replicated in packaging cells; ② Good safety, no integration of adenovirus and host gene was found; ③ Adenovirus has a large genome (about 36kb) and a large capacity for foreign genes (it has been confirmed that the insertion capacity of foreign DNA can reach 7.5 KB); ④ Adenovirus can not only propagate in intestine and respiratory tract, but also infect many somatic cells, such as liver cells, vascular endothelial cells, vascular smooth muscle cells and glial cells. Moreover, adenovirus infection has no strict requirements on whether the recipient cells are in mitosis. ⑤ Adenovirus vector can conveniently transfer foreign genes directly into target cells, so that they can be effectively expressed. Studies have confirmed that after 2 weeks of immunization with recombinant adenovirus vaccine (2× 109TCID) carrying H 1N 1 subtype swine influenza virus, the Hl antibody level of 40-day-old experimental pigs exceeded 1: 160, which can effectively resist the same subtype swine influenza virus. While developing a new type of live vector genetic engineering vaccine, people are also trying to solve the problems such as antigen concentration, secondary immunity being interfered by primary immune antibody, and some pigs being allergic to cell vaccine. It is hoped that this vaccine will be widely used as a supplement to the traditional inactivated whole virus vaccine in the near future.

3 Chinese medicine treatment of swine flu

Swine flu, as a kind of influenza, can be treated by TCM theory and methods. From the point of view of Chinese medicine, flu is a feeling of exogenous pathogens. When the guest is in the lung meridian and closes the channel, the lung qi can't fall, but people will inevitably shed tears, have fever, aversion to wind, aversion to cold, headache and body pain. San Xuan is easy to occur, such as Guizhi Decoction, Mahuang Decoction and Pueraria Decoction. If it is not treated in time, it will turn into internal injury, leading to kidney yang failure, endogenous yin cold, kidney collaterals leading to lung, deficiency of heart and lung yang, uncontrollable body fluid, but clear nose. The patient must have no symptoms of exogenous diseases, lethargy and listlessness, or sneezing constantly, or cold hands and feet. It is advisable to use Sini Decoction, Bai Tong Decoction, Bee Mei Dan Decoction, Mahuang Fuzi Asarum Decoction and Gui Jiang Decoction to help yang.

Traditional Chinese medicine emphasizes syndrome differentiation and treatment, and treats influenza according to its types. There is a trick: whenever you see sneezing, runny nose and stuffy nose without other symptoms, it belongs to internal cold. Regardless of the severity, taking Sini Decoction and Mahuang Fuzi Asarum Decoction will be effective. If the disease is gone, stop taking the medicine and leave no sequelae. If you take other cold medicines, it will not only be ineffective, but also deepen the pathogenic factors and evolve into serious diseases such as lung and kidney.

Therefore, taking medicine to treat influenza but treating exogenous diseases will definitely not have a good effect. But also accumulate yin and evil in the body, which will definitely attack at some time. At present, the treatment methods of traditional Chinese medicine and western medicine have the function of converging yin and evil again, which will eventually lead to respiratory diseases such as asthma, rhinitis, pharyngitis and tracheitis.

Chinese medicine is completely different from western medicine in treating influenza. It does not need to consider the pathogenic virus, but only treats the patients according to their specific symptoms. So Chinese medicine can treat swine flu or any other flu in the same way, and the premise of treatment is syndrome differentiation.

The onset time and area of influenza or plague has its fixed rules to follow. Because influenza and plague are both "warm" and "dry", they usually occur in spring and autumn or at the turn of the season. Therefore, most outbreaks in spring start from the south and gradually develop northward with the increase of temperature; The autumn epidemic started in the north and gradually developed to the south with the decrease of temperature. This is also the reason why influenza virus (or epidemic virus) will mutate with the change of climate temperature and human hotbed.

At the same time, the areas where influenza and plague occur are often closely related to local living habits (life erosion) and medical fashion (abuse of tonics, cold medicines or antibiotics). For example, the plague of livestock and poultry is mainly caused by castration, enclosure, hormone feeding, stimulating a large number of spawning and other factors, which greatly weakens the resistance of livestock and poultry [1] and is difficult to resist the plague. Humans are infected with plague because of lack of exercise, improper diet and excessive sexual intercourse, which leads to lack of vitality and low immunity.

In short, with the rapid development of biotechnology, the research and development of swine influenza vaccine will continue to advance, and the new vaccine will be safer and more effective. However, it must be emphasized that the prevention and control of swine flu can not only rely on vaccine immunization, but also strengthen daily feeding management, do a good job in biosafety protection and comprehensive epidemic prevention measures.

[Edit this paragraph] Items to be prepared to prevent influenza

Recently, the Shanghai Pharmaceutical and Commercial Industry Association has issued a commodity reference for the prevention and treatment of influenza A (H 1N 1):

Lotion: hand sanitizer, soap, etc.

Disinfectants: "84", formaldehyde, glutaraldehyde, potassium permanganate, ethylene oxide, peracetic acid, various air disinfectants, etc.

Protective equipment: masks, thermometers.

Antiviral drugs: amantadine, rimantadine, ribavirin, etc.

Treatment (1) symptomatic support.

Suspected and confirmed patients should be treated in isolation, emphasizing early treatment.

At present, people infected with swine flu mainly take comprehensive symptomatic support treatment. Pay attention to rest, drink plenty of water, pay attention to nutrition, and closely observe the changes of the disease; 48 hours after onset is the best treatment period. For those with high fever and obvious clinical symptoms, chest X-ray should be taken to check blood gas.

(2) medication.

1。 Antiviral treatment: antiviral drugs should be used as soon as possible, and oseltamivir (Tamiflu) can be tried. Tamiflu is a neuraminidase inhibitor, which may inhibit swine flu virus. The dosage is 75mg/d, and the course of treatment is 5 days. Use with caution for children. Viruses isolated from people who have recently been infected with swine flu virus in the United States are sensitive to oseltamivir and zanamivir, but resistant to amantadine and rimantadine.

2。 Antibiotics: Antibiotics can be used in the case of bacterial infection.

(3) TCM treatment based on syndrome differentiation.

1。 Poison damages lung health.

Symptoms: fever, aversion to cold, sore throat, headache, muscle aches and cough.

Treatment: clearing away heat and toxic materials, dispersing lung qi and eliminating pathogenic factors.

Reference prescription: roasted ephedra, almond, gypsum, Bupleurum, Scutellaria baicalensis, burdock, notopterygium root and raw licorice.

Commonly used Chinese patent medicines: Lianhua Qingwen capsule, Yinhuang preparation and Shuanghuanglian oral preparation.

2。 Drug addicts have lungs and stomachs.

Symptoms: fever, or aversion to cold, nausea, vomiting, abdominal pain and diarrhea, head and body pain and muscle pain.

Treatment: clearing away heat and toxic materials, eliminating dampness and harmonizing middle energizer.

Reference prescription: Radix Puerariae, Scutellariae Radix, Rhizoma Coptidis, Rhizoma Atractylodis, Herba Agastaches, Jiang Banxia, Folium Perillae, and Cortex Magnolia Officinalis.

Commonly used Chinese patent medicines: Gegen Qinlian micro pills, Huoxiang Zhengqi preparation, etc.

3。 Poison gas camp

Symptoms: high fever, cough, chest tightness, shortness of breath, irritability and even delirium.

Treatment: Qingqi Cool Camp.

Reference prescription: roasted ephedra, almond, Trichosanthes kirilowii, raw rhubarb, gypsum, red peony root and buffalo horn.

When necessary, Angong Niuhuang Pill, Tanreqing, Xuebijing, Qingkailing and Xingnaojing injection can be selected.