Shocking news! Eating hot pot and drinking cold drinks can actually kill people? Wait, the truth may be different from what you think...

Recently, the news that a 26-year-old girl had a sore throat after eating hot pot and later died of an acute and severe illness became a hot topic, attracting the attention of netizens:

Picture taken from Weibo

In addition, the topic of "Be careful of acute epiglottitis when eating hot pot and drinking cold drinks" has also attracted the attention of many people. Many people believe that the girl developed acute epiglottitis because she drank cold drinks after eating hot pot.

Picture taken from Weibo

The sudden death of a young life is regrettable, but is eating hot pot and drinking cold drinks really that dangerous? How can a common symptom like sore throat lead to death within just ten hours? Is there any way to prevent this situation, or to detect and save oneself in time after the onset of the disease? After reading this article, these questions will be clear.

01

Dangerous inflammation

Throat pain, fatality, and extremely short course of illness, these characteristics combined make it easy for medical professionals to tell at a glance that it is most likely acute epiglottitis.

The epiglottis is located behind the tongue root and is composed of soft tissue wrapped around the epiglottis cartilage. The openings of the trachea and esophagus are both connected to the oral cavity, and the epiglottis is like a lid for the trachea , which is usually slightly open to allow air to pass freely through the trachea; when swallowing, the epiglottis will cover the trachea to prevent food from entering the trachea by mistake.

When swallowing food, the epiglottis blocks the trachea and prevents food from flowing into the trachea.

It can be seen that the epiglottis is located in the "traffic fortress" of the respiratory tract, so when it becomes inflamed and swollen, the "lid" that should be open expands into a "boulder", and the respiratory tract becomes narrow, and in severe cases it is even completely blocked, leading to respiratory and cardiac arrest or suffocation and death. This is the direct cause of the dangerous and rapid death of acute epiglottitis.

02

Cold drinks are not the cause

The main cause of acute epiglottitis is infection with Haemophilus influenzae type B. A retrospective study in Denmark found that after the introduction of the Haemophilus influenzae type B vaccine, the incidence of acute epiglottitis in children decreased by 84% within a few years. With the popularization of the vaccine, the incidence rate has dropped by 99.6% compared with before the introduction of the vaccine, with only two cases per 10 million children per year [1]. The fact that the vaccine can cause such a significant decrease in the incidence rate shows the important role of Haemophilus influenzae type B in acute epiglottitis.

In addition to Haemophilus influenzae type B, some streptococci and influenza viruses can also be infectious factors for acute epiglottitis[2-4]. In addition, non-infectious factors such as direct trauma to the epiglottis, high temperature burns, and stimulation by corrosive substances are also occasional causes of acute epiglottitis[5,6].

From this we can see that the girl in the news was more likely infected with Haemophilus influenzae type b or other pathogens, but the symptoms just happened to appear after eating hot pot.

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In fact, even if the girl suffered from acute epiglottitis due to severe burns from hot food while eating hot pot, the key factor was the hot food, not the cold drinks while eating hot pot . If a burn really occurred, drinking cold drinks would cool down in time and reduce the damage, rather than aggravate the damage. This is the same as the need to quickly leave the heat source after a burn and rinse with cold water to cool down.

Therefore, eating hot pot and drinking cold drinks is safe in itself, and there is no need to feel psychologically burdened .

03

How to prevent it?

Given the importance of Haemophilus influenzae type B in acute epiglottitis, the most recommended treatment is of course to get the corresponding Haemophilus influenzae type B vaccine (Hib vaccine). Among the second-class vaccines in China, the pathogens prevented by the pentavalent vaccine include Haemophilus influenzae type B. If you have also received the pneumococcal vaccine and the influenza vaccine, the chances of encountering acute epiglottitis are very low.

Of course, we also need to avoid overheating food in our daily lives, not only to protect the epiglottis from being burned, but also to reduce the risk of esophageal cancer[7].

04

When should we be alert?

The most frightening thing about this case is that it took only 10 hours for the girl to die from a simple sore throat. But who hasn't had a sore throat? Do we have to be on high alert every time we have a sore throat, as if our lives are in danger?

In fact, there is no need to be so nervous. Even before the widespread use of vaccines, the incidence of acute epiglottitis was very low , with an annual incidence of 4.9 cases per 100,000 children and 1.9 cases per 100,000 adults [1], indicating that it is not that common. With the protection of vaccines, the incidence rate has dropped sharply, and the risk of infection is even lower.

However, since the consequences of acute epiglottitis can be extremely serious, even if the absolute risk of encountering it is not high, everyone still needs to be on guard. If severe throat pain is accompanied by difficulty swallowing, drooling, and wheezing, especially when there are signs of breathing difficulties such as anxiety and shortness of breath, you must go to the hospital in time for treatment.

I wish the deceased rest in peace, and I hope this article can help more people avoid illness and death.

References:

[1] Guldfred LA, Lyhne D, Becker BC. Acute epiglottitis: epidemiology, clinical presentation, management and outcome. J Laryngol Otol. 2008;122(8):818-823. doi:10.1017/S0022215107000473

[2] Briem B, Thorvardsson O, Petersen H. Acute epiglottitis in Iceland 1983-2005. Auris Nasus Larynx. 2009;36(1):46-52. doi:10.1016/j.anl.2008.03.012

[3] OʼBryant SC, Lewis JD, Cruz AT, Mothner BA. Influenza A-Associated Epiglottitis and Compensatory Pursed Lip Breathing in an Infant. Pediatr Emerg Care. 2019;35(11):e213-e216. doi:10.1097/PEC.0000000000001589

[4] Grattan-Smith T, Forer M, Kilham H, Gillis J. Viral supraglottitis. J Pediatr. 1987;110(3):434-435. doi:10.1016/s0022-3476(87)80512-7

[5] Harjacek M, Kornberg AE, Yates EW, Montgomery P. Thermal epiglottitis after swallowing hot tea. Pediatr Emerg Care. 1992;8(6):342-344. doi:10.1097/00006565-199212000-00009

[6] Inaguma Y, Matsui S, Kusumoto M, Kurosawa H, Tanaka R. Thermal epiglottitis: Acute airway obstruction caused by ingestion of hot food. Pediatr Int. 2019;61(9):927-929. doi:10.1111/ped.13948

[7] Wu M, Liu AM, Kampman E, et al. Green tea drinking, high tea temperature and esophageal cancer in high- and low-risk areas of Jiangsu Province, China: a population-based case-control study. Int J Cancer. 2009;124(8):1907-1913. doi:10.1002/ijc.24142

Author: Doctor Flying Knife Cutting Rain

Reviewer: Pang Yufeng, Chief Physician of Otolaryngology Department, The Fifth People's Hospital Affiliated to Fudan University

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