Introduction
Protecting children is protecting our future.
Source: YimaitongAuthor: Han HanThis article is edited and written by Yimaitong, please do not reprint without authorization.
Recently, some netizens reported that a two-year-old girl in Zhenning County, Anshun City, Guizhou Province was suffering from a two-year-old girl. Condyloma acuminatum, the doctor said that there is a possibility of sexual transmission, it is recommended to seek medical attention as soon as possible, if there is a situation of sexual assault, you need to call the police.
Young girl, 2 years old, condyloma acuminatum, sexual assault… These key points cause fever in an instant discussion. According to the photos, it can be seen that the girl’s perianal lesions are very serious.
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Soon, the official ruled out everyone’s suspicion.
Yesterday (July 26), the Zhenning Autonomous County Health Bureau issued a notice saying that after a joint investigation, < strong>Sexual assault has been ruled out. Pathological traceability needs to be determined after further analysis by experts. According to the girl’s parents, since March this year, they have taken the girl out to work, so it is not ruled out that she may have access to unclean bedding.
Screenshot from Weibo p>
Whether it is based on notification or inspection results, sexual assault is unlikely. Why do you say that?
The organs of a 2-year-old child are not yet fully developed. When sexually assaulted, there will definitely be heavy bleeding, lacerations, and a high probability of serious injury or death.
However, the existence of obscenity remains controversial after the notification was published. Some netizens believe that “Condyloma acuminatum is a sexually transmitted disease, and it is nonsense to get sick from contact with unclean bedding.”
Source: Weibo Screenshot
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How do you get condyloma acuminatum? Does it have to be a sexual act?
Condyloma acuminatum is mostly caused by HPV infection. HPV virus is also called human papillomavirus. As a DNA virus, it has stability and specificity and can only infect humans as a host.
The HPV virus must be familiar to everyone. It is recommended that women be vaccinated in time with “nine-valent” and “four-valent” , “bivalent” vaccine, it is to prevent HPV infection. There are many subspecies of this virus. So far, more than 100 genotypes have been identified, which can be classified according to the target organ of infection and whether it will induce malignant tumor.
Condyloma acuminatum may recur even if cured, so it is a rather troublesome disease.
In general, HPV is mainly transmitted through sexual transmission, contact transmission, and mother-to-child transmission. Because young children’s own resistance is low, exposure to the virus is lessAdults are more susceptible to infection.
Although sexual transmission is the main mode of transmission, HPV infection in young children causes mucosal lesions , The occurrence of condyloma acuminatum is not necessarily all caused by “sexual transmission”.
A study of 51 women under the age of 12 with acute Statistics on patients with condyloma acuminatum found that the infection source of condyloma acuminatum in girls may be mainly from the environment, and the perianal area is most likely to be involved.
According to statistics, 2 of the 51 patients had a clear history of HPV infection, and 12 ( 23.6%) usually wear open-crotch pants, 24 cases (47.0%) usually bathe in service places, and 1 case has a clear history of being sexually assaulted.
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In addition, from October 2013 to September 2017, 48 children with condyloma acuminatum were treated in the outpatient department of Dermatology and Venereal Diseases of Guangdong Maternal and Child Health Hospital. As the research object, the conclusion is: Children’s condyloma acuminatum is more likely to occur in girls, the prevalent site is perianal, and it is mainly transmitted through non-sexual contact.
Among them, there were 37 females (77.08%) and 11 males (22.92%); There were 10 cases (20.8%) of children less than 2 years old. 1 case had a history of sexual assault, accounting for 2.08%; 5 cases had a history of common warts themselves, accounting for 10.42%; 7 cases had parents or caregivers with common wart disease, accounting for 14.58%; 9 cases were supported by parents or caregivers People have a history of condyloma acuminatum, accounting for 18.75%.
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Autologous vaccination and allogeneic vaccination are all possible ways to cause infection in young children.
Auto-vaccination means that the child’s own skin and mucous membranes are infected with HPV virus, which is then transmitted to Anogenital, causing lesions.
In contrast to allogeneic vaccination, refers to the non-sexual contact between the caregiver and the child transmission of HPV. In addition to the possibility of HPV infection by mouth, hand and genital contact, some people have suggested that HPV infection may be caused by contact with contaminated towels, underwear, etc., which is the so-called “unclean bedding” in this incident. However, this possibility is generally small, and only a very small number of cases of condyloma acuminatum in children may be caused by exposure to pollutants.
The 2021 edition of the “Guidelines for the Diagnosis and Treatment of Condyloma Acuminatum” also clearly supports “indirect transmission through close contact” .
Guidelines for Diagnosis and Treatment of Condyloma Acuminatum >
Mother-to-child transmission is also a common mode of transmission.
Some patients did not develop warts after infection with HPV or the warts were not obvious, and they were not detected or treated in time . However, as a subclinical infection and a latent infection population, these patients are also contagious, which greatly increases the possibility of mother-to-child transmission.
In the perinatal period, neonates may be infected with HPV through the mother’s reproductive tract during vaginal delivery, or they may HPV infection occurs prenatally due to ascending vaginal to uterine infection.
In vertical transmission from mother to child, respiratory infection was the first to be confirmed. However, if the virus does not come into contact with the oral mucosa during the production process, the possibility of no infection in the oral cavity exists. Moreover, the vertical transmission of mother-to-child infection is not only in the larynx, but the mucosal parts that come into contact with the virus may become infected.
In general, 2-year-old children infected with HPV also have the possibility of vertical transmission from mother to child.
It is not uncommon for minors to be sexually assaulted!
Due to the variable incubation period of HPV, the incubation period for condyloma acuminatum is between 3 weeks and 8 months , an average of 3 months, thus significantly increasing the difficulty of identifying the infection route of condyloma acuminatum virus in children.
However, no matter what the reason is, the child’s condition has developed to such a serious level before seeking medical advice. Parents are undoubtedly gross negligence.
This incident has come to an end for the time being. After all, the source of pathology still needs to be analyzed and determined by experts. But what can you do as a doctor? after all, the sexual assault of minors is far more than we think.
The book “Research on the Construction of Child Protection Institutions: Goals, Strategies and Paths” mentioned: More than 10% of minors are sexually assaulted in this form, of which about 1% are penetrative sexual assault.
This means that approximately 1 in 10 minors experience sex violated.
Easier access to clinicians due to occupational specificity For children who have been sexually assaulted, for example, in March this year, the news that a 13-year-old girl in Rugao was pregnant was discovered by doctors during the diagnosis and treatment process.
In response, in May 2020, the “Regulations on Establishing a Mandatory Reporting System for Violation Against Minors” Opinions (for Trial Implementation)”, it is stipulated that when a doctor discovers that a minor has suffered or is suspected of being illegally violated during his work, he should immediately report the case or report to the public security organ.
Although the law does not give doctors the right to examine and interrogate, they may face harm Infants and children, doctors are more powerless and helpless. But protecting our children is protecting our future.
Small Survey: During clinical In a similar situation, what would you do? Welcome to leave a message in the comment area.
References:
[1] Huang Dan , Ju Mei, Chang Baozhu, et al. Clinical analysis of 51 cases of condyloma acuminatum in girls [J]. Chinese Journal of Dermatology, 2018, 51(05): 363-365.
[J]. 2] Zhou Zhen, Diao Youtao, Shi Jing, etc. Clinical analysis of 48 cases of condyloma acuminatum in children [J]. China Clinical Research, 2019, 32(06): 823-825. DOI: 10.13429/j.cnki.cjcr.2019.06.026 .
Editor in charge｜Han Han
Cover image source｜Visual China
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