The influenza virus and the causative agent of acute respiratory viral infection turned out to be “competitors”

Influenza is a severe viral infection that affects men, women and children of all ages and nationalities. Influenza is associated with a high mortality rate, especially in young children and the elderly. Influenza epidemics occur every year, usually during the cold season, and affect up to 15% of the world's population.

Influenza is an infectious disease that is characterized by various lesions of the respiratory tract and manifests itself in a variety of respiratory symptoms. Epidemics occur during the cold season and affect up to 15% of the world's population, often leading to death in patients at risk. However, despite this, the idea of ​​influenza infection as a mild illness is still common. The difficulty in refuting this myth is partly due to the fact that many use the term “flu” not only to refer to a laboratory-confirmed disease, but also to refer to a wide range of other viral diseases, from the common cold (ARI) to gastroenteritis (“stomach flu”). But in fact, this is a severe viral infection that affects the respiratory tract and requires timely treatment.

• Routes of transmission of the virus
• What complications may arise
• The first signs in an adult
• Treatments for influenza in adults
• Recovery after illness

Influenza (French grippe), influenza is an acute, highly contagious respiratory viral infection with an airborne transmission mechanism, caused by influenza viruses type A, B and C (family Orthomyxoviridae, genus Influenzavirus).

This infection has a tendency to spread epidemically and affects all age groups of the population in various geographical conditions. The disease is characterized by a short incubation period, a rapid cyclic course, the presence of intoxication and catarrhal syndromes with predominant damage to the epithelium of the mucous membrane of the upper respiratory tract. In the International Classification of Diseases, Injuries and Causes of Death, nosological forms of influenza are included in the group “Respiratory diseases”.

Today, the continuous circulation of disease viruses and the emergence of new strains of animal origin pose a constant danger to the health of the population of all countries. It is believed that 5-10% of adults and 20-30% of children get sick every year. At the same time, complications develop in 10-15% of patients, especially if they do not treat it. Severe influenza may be accompanied by damage to the lower respiratory tract with signs of respiratory failure, pulmonary edema, vascular collapse, cerebral edema, hemorrhagic syndrome and the addition of secondary bacterial complications. Among hospitalized patients, often in risk groups, this figure can reach 30%.

The annual mortality rate due to complications of influenza is 7.5-23 people per 100,000 population, with the majority of deaths occurring in people over 65 years of age. According to the World Health Organization (WHO), at least 600,000 patients die every year from influenza infection. This figure is the highest among risk groups. The global economy is suffering enormous damage from this disease. Approximately 50% of all cases of sick leave are due to acute respiratory viral infections, including influenza.

Features of influenza

This type of ARVI is different in that people of absolutely all ages are susceptible to it. The source of infection is considered to be a person with the virus in the body. This can be an obvious form of the disease or a hidden one, as well as carriage of the virus without clinical manifestations. A person becomes contagious within a couple of hours after the onset of the disease, when there are no symptoms.

Infection occurs by aerosol. Transmission of the virus is immediate and susceptibility is almost 100%. This is what makes influenza capable of frequent epidemics or pandemics. Serotype (a group of microorganisms of the same species) A ​​occurs in the form of an epidemic approximately every 2 or 3 years, serotype B is slightly less common - every 5 or 6 years, and serotype C usually occurs in outbreaks of influenza in children, the elderly, or people with weakened immune systems.

Influenza is characterized by autumn-winter seasonality. Peak activity is January or February. This is facilitated by a decrease in air humidity, namely mucus that protects the lining of the respiratory tract. In dry air, it is produced less, and the respiratory system loses its protection against the influenza virus.

The effect of the virus on the human body

When an influenza virus develops in the body, an external examination of the patient reveals:

1. Swelling of the oral cavity and nasopharynx, granularity caused by an increase in lymphatic follicles.
2. Pallor of the skin.
3. Minor hemorrhages in the soft palate (in severe forms of the disease).

In 90% of cases of viral disease, patients experience a dry cough accompanied by wheezing and hard breathing. During severe coughing or sneezing, the walls of the nasal vessels are often damaged, causing mild nosebleeds. The progression of the virus leads to toxic damage to the heart muscle, disruption of its rhythm, and pain in the chest (mainly in the first day of the development of the disease).

A fatal outcome becomes possible if the patient’s body, in addition to the virus, has other serious diseases. The risk of death of a patient increases significantly with the development of a fulminant form of the disease, which can quickly cause heart or pulmonary failure and cerebral edema.

Mechanism of disease development

The first place the virus is encountered in the body is the upper respiratory tract. These include the nasopharynx, trachea and main bronchi. In their mucous membrane, a local irritation reaction occurs to the introduction of the pathogen into the body. This manifests itself with initial symptoms of coughing, runny nose and sneezing. This is where the influenza virus multiplies and then enters the blood. At this stage, general symptoms appear - weakness, muscle and head pain. At this stage, the body weakens, making it susceptible to other infections. That's why people often get pneumonia during the flu.

Pathogen

The causative agent of influenza is one of the most studied viruses today, as it is closely monitored by scientists around the world. However, this has still not brought humanity any closer to controlling influenza infection, due to its incredible variability. The influenza virus belongs to the Orthmyxoviridae family and is divided into 3 types:

• type A – found in humans and animals, most often causing massive outbreaks of the disease;
• type B is human, accounting for less than 20% of cases of the disease;
• type C is human, found in no more than 5% of cases.

Scheme of the structure of the influenza virus

The types differ in the type of outer membrane proteins - hemagglutinin (H) and neuraminidase (N). For example, the most common type A virus carries hemagglutinin type 1 and neuraminidase type 1, which is briefly referred to as H1N1. To date, viruses with antigens H1, H2, H3 and N1, N2 have been isolated from humans; other types of antigens are found in influenza pathogens in animals and birds.

The influenza virus has a fairly simple structure: it has a protein capsule surrounding an RNA molecule - its hereditary information. It encodes only 11 protein molecules, from which the entire virion is assembled. The pathogen was isolated from the material of a sick person back in 1931, and after the development of electron microscopy, it became possible to visually study its structure. The virion has a spherical shape and size up to 120 nm, its surface is dotted with “spikes” - neuraminidase molecules.

The pathogenicity of the influenza virus is ensured by its structural proteins:

• Hemagglutinin (HA) – serves to attach virions to body cells and is the main target for immune antibodies;
• Nucleoprotein (NP) – transports viral RNA from the nucleus to the cytoplasm during the assembly of viral particles;
• Neuraminidase (NA) is responsible for the release of new virions from the cell and prevents them from sticking together, which ensures high efficiency of infection of new targets;
• Internal membrane protein (M2) – forms a channel in the thickness of the cell membrane for virus penetration;
• Non-structural protein NS1 - suppresses the synthetic activity of the host cell, triggers the mechanism of its self-destruction (apoptosis).

Carriers of the influenza A virus are wild and domestic waterfowl: ducks, geese, plovers. Its final owners are humans, horses, and pigs. The hosts and sources of the remaining types (B, C) are only humans.

Alternate circulation of the virus in the body of humans and animals every few decades leads to significant changes in its genome. As a result, one or both surface antigens are replaced by others, as was the case with the bird flu pathogen in China in 2013. It acquired the H7N9 structure while retaining the ability to infect people.

Birds are a natural reservoir of infection in which all existing genetic modifications of the virus are preserved. Consequently, the Spanish flu genes responsible for the high contagiousness and lethality of the infection still circulate in nature, creating the danger of a repeat pandemic. WHO is closely monitoring the readiness of the virus for new devastating marches across the planet, assessing the current situation as halfway towards the virus acquiring highly pathogenic properties.

Classification

There are several ways to classify the flu. Some of the most common are:

• By severity : mild, moderate and severe. They are set depending on the severity of symptoms. The most common form is a mild form, which can be treated in a clinic at home. A severe form is always treated only in an inpatient infectious diseases hospital. It is characterized by severe symptoms, disability, and sometimes the presence of complications that require constant medical supervision.
• According to the nature of the course, typical, atypical and fulminant forms of the course in humans are noted: the typical form occurs in the overwhelming majority of cases. It is characterized by classic flu symptoms. The duration of the disease is about a week or two;
• the atypical form is observed more often outside the period of epidemics. It usually manifests itself with scanty symptoms, excluding fever;
• the fulminant, or fulminant, form is manifested by an abrupt onset of symptoms. Pulmonary and extrapulmonary complications develop very quickly and require urgent hospitalization. The duration of this form of flu is about 3-4 days. It is this type that is fatal.

According to the type of virus, influenza is:

• Type A. Because of this type, a moderate or severe form of the disease is more often observed. The symptoms of influenza A are pronounced and more difficult to treat. There have been cases of fulminant development of influenza. Occurs in humans and animals. Capable of sudden changes, which makes it resistant to drugs and vaccines every few years. That is why this species often provokes pandemics and influenza epidemics. This particular strain caused epidemics of bird flu, or chicken flu.
• Type B. This species usually does not cause serious pandemics, limiting itself to small areas of outbreaks. Sometimes intra-collective influenza epidemics occur. This species only affects humans.
• Type C. The least studied species, but rarely causes serious forms of the disease. Often limited to minimal symptoms.

Briefly about the development of the disease

Influenza became known to medicine as a separate disease at the beginning of the 15th century. In subsequent years, at least 20 pandemics of this disease were recorded in the world, leading to the spread of the viral infection to entire countries. Until the mid-20th century, doctors were unable to control the development of the disease. When the epidemic occurred, human casualties numbered in the millions. So in 1918-1919. The Spanish flu killed about 100 million people and infected 500 million.

Only after establishing the viral nature of the disease, developing effective drugs and preventive vaccines, doctors were able to significantly reduce mortality and reduce the risk of developing deadly complications.

Flu symptoms

Signs of influenza do not have specific features; without additional research it is impossible to establish an accurate diagnosis. The incubation period of influenza ranges from several hours to 7 days. On average it lasts 1-2 days. With mild severity of the disease, the following flu symptoms are distinguished:

• a sharp increase in temperature to 38-40 degrees;
• chills, pain in the head and muscles;
• fatigue, fatigue;
• dryness in the nasopharynx;
• dry cough, sometimes with chest pain;

However, the flu sometimes occurs in severe forms that require urgent hospitalization in an infectious diseases hospital. For example, flu symptoms such as:

• cerebral edema;
• vascular collapse;
• bleeding;
• layering of bacterial infection;

With the flu, symptoms from the gastrointestinal tract sometimes appear: nausea, stool disorders . But they should not be confused with the concept of “intestinal flu,” which is caused by rotaviruses and has nothing to do with influenza.

Therapeutic measures

A mild form of the viral disease allows treatment on an outpatient basis (at home). A more severe course of the disease requires the patient to be under constant medical supervision. In this case, the patient is hospitalized in the infectious diseases department.

Drug therapy for viral disease

If the patient is confirmed to have influenza, treatment is carried out with the following:

1. Antiviral drugs (Remantadine, Tamiflu, Zanamivir).
2. Inducers of interferonogenesis that enhance the synthesis of antibodies to influenza viruses (Kagocel, Ingavirin, Cycloferon).
3. Antipyretic medications (Paracetamol, Ibuprofen).
4. Anticongestants that eliminate nasal congestion characteristic of the disease (Xylometazoline, Pinosol).
5. Expectorant medications (Ambroxol, Acetylcysteine).
6. Saline solutions administered intravenously to relieve viral intoxication.
7. Hemostatic agents that relieve bleeding caused by a virus (Etamsylate, aminocaproic acid).

In the acute stage of the disease, it becomes mandatory to take increased doses of vitamin C, the need for which increases when the body is affected by a viral infection.

For patients with severe respiratory failure, respiratory support is indicated - the supply of oxygen-saturated air using an intranasal tube.

Nutrition for the flu

The body, which spends considerable reserves of energy to fight the virus, needs a varied and rich diet. The following will be useful:

• rich chicken broths;
• mashed potatoes;
• a variety of vegetables and fruits.

Rich chicken broth or soup prepared with it helps the body fight neutrophils, the number of which increases against the background of a viral disease. During illness, these white blood cells cause nasal congestion and a sore throat. You can get the maximum benefit from soup or broth by adding a small amount of spices to it that increase sweating, make breathing and swallowing easier (ginger, mustard, coriander, cinnamon).

Another important product when you have the flu is mashed potatoes. By consuming this dish warm and not too thick, you can reduce swelling of the throat and nasopharynx and support the body in the fight against the virus and inflammatory processes.

Among the vegetables, the most useful is garlic, which contains allicin (a substance that kills not only influenza viruses, but also bacteria and fungi). The patient's diet should also include citrus fruits, walnuts and hazelnuts, yellow and red onions, tomatoes, green peppers, cherries, grapes, and lingonberries.

To successfully cure influenza viruses, it is recommended to consume foods containing flavonoids, zinc, and important vitamins. The list of foods that help defeat a viral disease includes peanut and corn oils, eggs, seafood, meat, and fish oil.

The benefits of folk remedies

Folk remedies for influenza should be taken as an addition to the main therapeutic regimen. Treating a viral infection with alternative medicine alone is unsafe, because... The disease has a fairly active course and a tendency to quickly develop complications.

To speed up recovery and strengthen various systems of the patient’s body, during illness it is recommended:

1. Take orally decoctions and infusions of rose hips, rowan, black currant leaves, tincture of echinacea or propolis.
2. Inhale the fumes of fresh onions.
3. Place garlic drops into your nose.
4. Perform inhalations with essential oils - eucalyptus, menthol, mint (2-3 drops per 0.5 liters of hot water).
5. Drink tea from currant branches, ginger and honey.

In case of a viral disease, baths become effective. The procedure is performed for 10 minutes, lowering your arms to the elbows in a container of water (at a temperature of 38-40 degrees). After completing the session, you should put on warm mittens and sleep in them until the morning.

Before using folk remedies for the flu, you must discuss this possibility with your doctor. Parents of children prone to allergic reactions should be especially careful.

Features of the course of influenza in people of different ages

Due to the developing immunity in children, the flu is more severe. Severe forms of the disease are more common. The disease is especially dangerous in children under 2-3 years of age. Symptoms always have a more pronounced clinical picture and last more than a week, unlike symptoms in adults.

In older people, the flu is also not easy. A slow metabolism delays the immune response. The temperature in this category of people lasts a very long time, and the symptoms of the flu are much more difficult to get rid of. Due to a decrease in the efficiency of the cardiovascular system, complications are more often observed.

Characteristic features of a viral disease, differences from ARVI

Experts are well aware of the tendency of influenza viruses to mutate. Thus, in type A pathogens, changes in the external structure periodically occur, leading to the inability of the immune system to resist them, and mass infections. New types of influenza viruses are discovered periodically, with 10-30 year intervals.

Due to the high variability of viruses, the same patient can become infected with influenza repeatedly over a short period of time.

In some patients, the disease may be confused with ARVI (acute respiratory viral infection). The course of both pathologies has some differences that are clearly visible to an experienced specialist:

Influenza, together with acute respiratory viral infections and other pathologies, is included in the group of acute respiratory diseases (ARI). Unlike other pathologies, this viral disease occurs with the most striking symptoms and leads to the most dangerous complications.

Complications of influenza

This type of ARVI is rarely complicated, but it can pose a threat to the health and sometimes the life of the patient. Children under 3 years of age or older people are most susceptible to this. The most common complications of influenza:

• from the lungs: pneumonia, lung abscesses, pleural empyema, as well as acute respiratory distress syndrome;
• extrapulmonary complications: rhinitis, otitis, sinusitis, encephalitis or meningitis, neuritis, myocarditis.

Dangerous ties

So, the first step has been taken: the virus has contacted cellular receptors. At the site of binding, a depression in the plasma membrane is formed, the edges of which then close, and the virus ends up in the cavity of the so-called endocytic vesicle

. In general, endocytosis is a process common to cells of higher organisms, which use this mechanism to absorb large molecules. The virus, thus, exploits the cell’s transport system, and does so “legally”: the “ticket” is the very fact of binding to cell receptors.

The first sorting node of the endocytic transport stream is the endosome

- a membrane vesicle with outgrowths and small bubbles inside. Despite its apparent simplicity, the endosome performs complex logistical functions in the cell: it “recognizes” and sorts the macromolecules that enter it, directing them along one or another metabolic pathway. However, the virus does not need this at all - it itself “knows” what to do next. Taking advantage of the acidic environment inside the endosome, the viral envelope is tightly “pressed” against the endosome membrane and merges with it. As a result, the viral RNA enters the cytoplasm - just half an hour after the virus has contacted the cell surface. By the way, drugs from the rimantadine group act specifically at the “undressing” stage of the influenza virus, blocking the fusion of the viral envelope with the endosomal membrane.

Let us add that at the stage of penetration into the cell, the influenza virus also uses different endocytosis pathways, which increases the impact of the infection and makes it more likely to avoid an attack by the immune system.

Diagnostics

When diagnosing influenza, you need to pay most attention to the clinic. With influenza, unlike other acute respiratory viral infections, the temperature rises very sharply and pronouncedly. There are fluctuations during the day. You should also pay attention to the appearance of specific pain in the eyes, muscles, and head.

The doctor's first order will be a general blood and urine test . There will be an increase in the number of leukocytes in the blood, with changes in the leukocyte formula to the left. It is also necessary to pay attention to increasing ESR.

A general urine test will not show any changes if there are no complications in the genitourinary system. In a biochemical blood test, an increase in the content of fibrinogen and C-reactive protein is sometimes noted. If meningitis or encephalitis is suspected, spinal fluid is collected.

If pulmonary complications are suspected, an X-ray of the lungs , on which inflammation or purulent foci can be seen. For the same purpose, an x-ray of the sinuses can be prescribed. In older people, a mandatory research method is ECG . Helps to identify complications of the cardiovascular system in advance.

The specific diagnosis for influenza virus is culture . To do this, you need to take material from the walls of the pharynx or simply ask the patient to cough into a Petri dish. Only by culture can an accurate diagnosis of influenza be made.

Prevention

It is impossible to completely protect yourself from the flu. But you can take precautions to reduce the likelihood of infection. Vaccination will provide short-term immunity.

You should also strengthen your body, which will help resist the disease. Recommended:

• lead a healthy lifestyle;
• maintain a daily routine;
• eat well;
• exercise;
• take daily walks in the fresh air.

If it was not possible to avoid infection, then you should not delay visiting a therapist. He will advise you on what the flu is and how to fight it. The main goal of treatment is to make the flu easier, shorten its duration and prevent possible complications in the future.

Flu treatment

You can treat influenza using only conservative methods, namely medications, or add physical therapy and folk remedies. In addition, it is recommended to maintain bed rest, drink more warm liquids, and give up bad habits.

Under no circumstances should influenza be treated with antibiotics. They are prescribed for a bacterial infection, and influenza is a viral disease. Their appointment is possible only for bacterial complications.

Drug treatment

The following groups of drugs are used for this treatment of influenza:

• Antiviral. This therapy is aimed directly at eliminating the influenza virus, rather than at the symptoms. Oseltamivir, Zanamivir . They are considered the most effective drugs in the fight against the influenza virus, because they can treat influenza both in the initial phase of the disease and in the active one. This is the most common flu medicine in Europe and North America.
• Tamiflu . It is also an effective remedy in the fight against the influenza virus. Facilitates the course of the disease, shortens its duration and fights complications. But there is evidence of the development of virus resistance to this drug, so it is recommended to choose newer analogues. And also should not be confused with the drug Theraflu, which only relieves symptoms and does not fight the virus.
• Remantadine and Amantadine . They show their activity only against influenza type A. In most cases, the advisability of using this medicine for influenza is only in the initial phases of the disease, with almost no clinical manifestations.
• Immunoglobulins . Either donor serum or gamma globulin has an effect. It is best to prescribe in the earliest phases of the disease.
• Interferon . This drug has a place in the treatment of influenza, but its use sometimes causes many side effects. Therefore, it is prescribed only in severe forms, in which the benefits of interferons prevail over its toxicity. Since treating flu with interferon is still effective, it is used in physical therapy.

Influenza virus strains

The influenza virus was first discovered in 1933. It is an RNA virus of the orthomyxovirus family. They have three antigenically independent serotypes - A, B, C.

Hemagglutinin promotes the formation of virus-neutralizing antibodies by the human body. This protein consists of hundreds of amino acids and is highly variable. It is because of this that new strains of the influenza virus appear every year, and scientists have to constantly change strains for the vaccine.

Neuraminidase, which facilitates the penetration of the virion into host cells, also has antigenic properties.

Every 20 to 30 years, a new serotype of influenza virus is formed. A change in serotype causes a pandemic of the disease.

Influenza A virus is responsible for the most severe forms of the disease. It is isolated from pigs, horses and birds. Viruses of serotypes B and C are dangerous only to humans.

Influenza B viruses are less variable. The disease is local in nature and is more common in large groups.

Influenza C viruses cause only sudden (sporadic) cases of illness, often in children in the first year of life. Its antigenic structure is constant and, as a rule, all children from 10 years of age have antibodies to this virus.

Flu prevention

Vaccination is the best protection against influenza viruses.
No matter how much we talk about flu prevention, it will never be enough. A specific prevention method is vaccination against the influenza virus. The vaccine is selected for the three most common and dangerous strains of the virus.

However, there are outbreaks of a certain new strain, in which case the flu shot may not be effective. It creates moderate protection against the effects of the virus, however, if immunity is reduced and other methods of prevention are ignored, it can be extremely unreliable. This prevention of influenza in children is especially important.

The following methods are used as nonspecific prevention of influenza:

• thorough wet cleaning, it is advisable to use disinfectants to wipe dust on all horizontal surfaces;
• it is necessary to disinfect indoor air using ultraviolet irradiation or special aerosol disinfectors for apartments;
• using masks not only to avoid infecting others, but also to avoid becoming infected yourself from those who have the flu;
• avoid crowds during periods of epidemics, reduce the time spent on public transport to the maximum;
• when you are ill, you should not attend work/school;
• reduce contact with people with influenza as much as possible;
• take vitamins and immunostimulating or antiviral drugs during epidemic periods to prevent influenza;
• avoid bad habits because they lower the immune system;
• Get flu vaccinations on time;

Recovery from influenza in adults

After an influenza infection, most patients experience increased weakness, lethargy, and sleep disturbances for a long time. All these are manifestations of asthenic syndrome. As a rule, asthenia is expressed in increased exhaustion of mental and physical strength. The main symptoms in this case will be increased fatigue, tiredness and weakness.

After the disease, the patient often feels emotional instability, which is expressed in frequent mood swings and irritability. A feeling of anxiety, restlessness, and internal tension appears. The ability for prolonged mental and physical stress is lost. Autonomic disorders may also appear. Frequent headaches are a concern, sweating increases, appetite worsens, there is a feeling of interruptions in the functioning of the heart, memory deteriorates, and sleep is disturbed. Daytime sleepiness may occur.

With asthenic syndrome, it is necessary to take care of an organized work and rest schedule and minimize stress. It is necessary to adhere to a daily routine, do not forget about moderate physical activity, and try to spend more time in the fresh air. The diet must be balanced, contain the required amount of proteins, fats, carbohydrates, vitamins and microelements with the obligatory inclusion of fresh vegetables and fruits in the menu. On the recommendation of a doctor, you can take vitamin and mineral complexes.

Reference and information material

Author of the article

Gerasimenko Igor Olegovich

General doctor

1. R.Z.Gatich, L.V. Kolobukhina, E.I. Isaeva, E.I. Burtseva, T.G. Orlova, F.V. Voronina, V.V. Malinovskaya “Efficacy of Viferon for influenza in adult patients”, Russian Medical Journal No. 14, 2004.

Sources:

https://cyberleninka.ru/ [ii]https://umedp.ru/ [iii] https://www.influenza.spb.ru/ [iv] https://ru.wikipedia.org/ [v] https://eduherald.ru/ [vi] https://rospotrebnadzor.ru/

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How to treat the flu?

The basis of therapy for respiratory viral infections is to support the immune system. If there are no bacterial components of the disease, only basic pharmacological agents are required to relieve the clinical manifestations of the pathology. For mild and moderate forms of the disease, outpatient treatment of influenza is recommended - clinical recommendations:

• bed rest;
• quarantine;
• plenty of warm drinks;
• gentle fortified diet;
• regular ventilation and wet antiseptic cleaning of premises;
• daily shower.

How to treat influenza in adults?

In addition to the measures listed above, therapy for ARVI includes taking medications. Treatment of influenza at home involves the use of etiotropic drugs that affect the cause of the disease, and symptomatic drugs that alleviate the human condition. It is advisable to take antiviral tablets or drops in the first 1-3 days after infection. Late etiotropic treatment of influenza is ineffective, because pathogenic cells have already spread throughout the body.

Symptomatic remedies are selected depending on the emerging clinical phenomena. These include the following medications:

• antihistamines;
• anti-inflammatory;
• painkillers;
• antipyretics;
• vasoconstrictor solutions (for the nose);
• antitussives;
• mucolytics;
• expectorants.

Treatment of influenza in children

All methods of ARVI therapy for adults are also applicable when a child is infected. Before treating the flu at home, it is advisable to consult a pediatrician and confirm the diagnosis. The early symptoms of the pathology in question are very similar to other viral infections that often occur in childhood - chickenpox, measles, rubella.

The main danger of influenza for a child is dehydration due to vomiting, diarrhea, fever and increased bowel movements. Parents should monitor the baby's drinking regime, because a lack of water in the body can cause serious complications. Babies should be latched to the breast or given a bottle more often. Older children are recommended to drink 0.5-1 glass of warm compote, herbal tea or still water every few hours.

How to treat flu during pregnancy?

During pregnancy, women should not take almost all pharmacological agents. Treatment of influenza in pregnant women is limited to basic clinical guidelines. For symptomatic therapy, only safe medications (Paracetamol and its synonyms), natural preparations based on herbs and foods, and inhalations are used. The correct treatment for influenza in expectant mothers should be developed by a therapist. It is strictly forbidden to use strong antibacterial agents; this is dangerous for the fetus.

Treatment

Flu is a dangerous disease and requires treatment under the supervision of a physician. It should be borne in mind that the latent phase precedes the appearance of the first symptoms of influenza in adults. The length of the incubation period depends on the type of virus, it is usually 3-5 days. The most dangerous period in terms of contagiousness for others is considered to be from 5 to 7 days from the moment the first symptoms appear.

The disease can be typical or atypical. In the first case, all the symptoms of the flu will appear in an adult with a fever. While in the atypical form the disease proceeds completely without fever or intoxication and differs in duration. This is a fulminant form of the flu. Cases of atypical influenza are usually isolated, while typical influenza rages during epidemics.

How to treat influenza in an adult should be decided only by the attending physician. Delay or incorrect therapy can cause a deterioration in the patient’s condition or a serious complication. Only the use of an integrated approach will help cope with the disease.

Treatment for influenza in adults can theoretically be divided into 2 types:

1. Non-drug therapy . The patient should be provided with rest and bed rest. He must drink a lot of fluids, this will help quickly eliminate waste and toxins. The virus causes symptoms such as nausea, headache and loss of energy. The patient also loses fluid due to excessive sweating. To avoid dehydration, you need to drink a lot. It is recommended to drink the drink warm, giving preference to herbal tea, berry juice or mineral water with lemon. You should avoid drinking very hot drinks to avoid injuring your sore throat. There is also no need to cover the patient with a very warm blanket. This may cause disruption of the thermoregulation process. For any symptoms of influenza, treatment in adults should only be carried out under the supervision of a physician, since the disease is dangerous due to its complications. It is recommended to call a doctor at home rather than go to the clinic yourself.
2. Drug therapy . When treating influenza in adults, antiviral drugs and symptomatic drugs are used. Arbidol helps fight the pathogen. The drug is produced in Russia, has passed all clinical trials, during which its effectiveness in treating influenza, reducing the manifestation of unpleasant symptoms of the disease and reducing the likelihood of developing serious complications was confirmed. The main task of symptomatic drugs is to reduce temperature and relieve pain. Typically, the therapist prescribes one of the non-steroidal anti-inflammatory medications, which include ibuprofen and paracetamol. To treat a runny nose, vasoconstrictor drops are used, which are recommended to be used for no more than one week due to the risk of drug-induced rhinitis. Depending on the type of cough, the doctor will prescribe the necessary medicine. For a wet cough, the therapist will prescribe a medicine that helps thin the sputum and cleanse the lungs. If the cough is dry, then it is necessary to take medications that suppress such attacks.

Only a therapist can answer the question of how to treat influenza in adults. A patient who refuses to consult a doctor and takes medications without a medical prescription may choose the wrong drug and thereby worsen his condition, causing congestion in the lungs. This therapy is fraught with pneumonia. And if the flu can be cured in a week, then the complication can be treated for months.

When the first symptoms of influenza appear in adults, treatment can be carried out at home, if the course of the disease is not complicated by other pathologies and does not occur in a complex form. The appearance of a virus in the body leads to a decrease in immunity, therefore, with the flu, chronic diseases often worsen and bacterial complications appear:

• runny nose;
• sinusitis;
• pneumonia;
• kidney diseases.

Manifestations of herpes and thrush also often accompany the disease. Regression of all these pathologies occurs 6-7 days from the onset of infection. But this happens subject to the use of correct and timely therapeutic measures. It is necessary to know exactly how the flu manifests itself in adults in order to take immediate action and not confuse it with a common cold.

Home recipes can be used during illness, but only as aids. Herbal teas and infusions in large quantities are recommended. But treatment and observation should only be carried out by the attending physician. You won’t be able to alleviate your health condition with herbs alone.

It must be remembered that a variety of diseases can be hidden under the mask of the flu:

• measles;
• hepatitis;
• HIV infection.

Therefore, self-medication in such cases is fraught with serious health consequences. It is better to consult a doctor about how the flu progresses in adults. He will examine the patient, make a diagnosis, prescribe tests if necessary, and determine what medications are needed in this case.

Patients with severe influenza require mandatory hospitalization to reduce the chance of developing cerebral or pulmonary edema, which can cause death.

How is it transmitted?

A person is susceptible to diseases such as influenza A and B. This means that there is a high probability of getting sick for the second and third time, especially with a new subtype. The disease is transmitted as follows:

• during communication with a sick person, through drops of saliva, mucus, sputum;
• together with food that has not been thermally processed;
• when directly touching the patient with your hands;
• through the air, through dust.

The patient is enveloped like a ball by a zone consisting of infected particles, its dimensions are from two to three meters. You can catch influenza A through any objects that were in his hands (for example, a telephone, a chair armrest, a door handle).

Everyone should know that this is a contagious disease - a person poses a danger to others even during the incubation period, even before he feels unwell. True, on the sixth day from the onset of the disease, it practically does not pose a threat to the health of others.

Flu

ETIOLOGY AND PATHOGENESIS

Seasonal influenza is an annual epidemic caused by typical influenza viruses that circulate among people. In the northern hemisphere, flu season falls from October to April, and in the southern hemisphere from May to September. Pandemic influenza is a disease that occurs every few years or decades in the form of a global epidemic (pandemic), caused by new, previously unknown in humans, subtypes or variants of the virus, for example. the so-called “Spanish flu” (in the 20s of the XX century). The infection spreads very quickly - during a pandemic, the number of diseases is several times higher than during the annual seasonal flu epidemics. WHO decides to declare a pandemic based on the geographic scope of infections with a new type of virus, and not on the severity of the disease. up

1. Etiological factor: the causative agent is the influenza virus. Epidemic diseases in humans are caused by types A and B. Type A is divided into subtypes based on the antigenic specificity of two surface proteins - hemagglutinin (H) and neuraminidase (N). The most common causes of seasonal influenza are viruses of the H1N1 and H3N2 subtypes (H2N2 in some seasons), and to a lesser extent influenza B viruses. Influenza A viruses are characterized by great antigenic variability, which creates a risk of annual disease and the need for annual updating of the vaccine composition. In recent years, sporadic diseases caused by avian influenza viruses (potential pandemic types) have been reported among humans, with a high risk of complications and high mortality (mainly in Asia and Egypt [H5N1], more recently in China [H7N9]). In June 2009, WHO declared a pandemic caused by a new variant of influenza, H1N1pdm09 (formerly A/H1N1v, the so-called “swine” flu), which dominated the 2009/2010 season, almost completely displacing previously existing seasonal influenza subtypes. In subsequent post-pandemic seasons, this variant of the virus was still present, although in a smaller percentage. Flu seasons are very variable.

2. Pathogenesis: influenza A viruses bind through hemagglutinin to the epithelial cells of the upper and lower respiratory tract, and then proliferate in them, causing swelling and necrosis of the epithelial cells of the trachea, bronchi and bronchioles. There is no viremia, and the general symptoms are the result of cytokines released during the inflammatory response. The exception is extrapulmonary replication of the avian influenza virus subtype H5N1. The replication cycle is 6–12 hours. Compared with conventional seasonal influenza viruses, the A/H1N1pdm09 virus has a higher affinity for epithelial cells of the lower respiratory tract, it penetrates deeper into the respiratory tract and affects the alveoli.

3. Reservoir and route of transmission: influenza A viruses - humans, also some animals (eg pigs, marine mammals, horses, cats, dogs, domestic and wild birds); the infection is transmitted by airborne droplets (infection is also possible through contact with contaminated objects). Avian influenza viruses - reservoir: infected birds; The infection can spread to people through direct, close contact with a sick or dead bird (touch), consumption of raw or undercooked meat, or raw eggs of sick birds.

4. Risk factors for infection:

1) prolonged stay in close proximity (up to 1.5–2 m) from a patient with influenza without protection (face mask);

2) direct contact with a sick person or infected objects;

3) insufficient hand hygiene;

4) touching the mouth, nose, eyes with infected hands;

5) staying in places where large numbers of people gather during seasonal flu (public transport, entertainment centers, etc.).

5. Incubation period and infection period: the incubation period ranges from several hours to 1–4 days (avg. 2 days). The infection period for adults is 1 day before and up to 5 days after the onset of symptoms (sometimes even up to 10 days), and for young children several days before and ≥10 days after the onset of symptoms. Severely immunocompromised patients may be contagious even for several months.

CLINICAL PICTURE AND NATURAL COURSE to top

Sudden onset of symptoms:

1) general - fever, chills, muscle pain, headache (usually in the frontal and retrobulbar areas), general malaise and weakness, lethargy, poor general health;

2) respiratory system - sore throat, “dry catarrh”, as well as a dry and tiresome cough;

3) others (less often) - symptoms of laryngitis or otitis media, nausea, vomiting, possible mild diarrhea.

In older people, the main symptoms may be lethargy or impaired consciousness. The illness usually resolves spontaneously in 3–7 days, but cough and malaise may persist for ≥2 weeks. Up to 50% of infections are asymptomatic.

DIAGNOSTICS up

Additional research methods

Identification of the etiological factor: detection of genetic material of the virus (reverse transcription-PCR), immunofluorescence method (direct [DFA] or indirect [IFA]), rapid diagnostic tests for viral antigen detection (RIDT), virus isolation in culture and antigen rapid test from samples taken from the nose and throat (aspirate, washes, smear; samples from the nose and throat should be combined). Etiological diagnosis in general is not mandatory, but at the same time, in patients with an increased risk of developing complications or in the case of severe (complications) or progressive influenza-like form of acute respiratory infection or the presence of other indications for hospitalization, the result determines treatment tactics. The most accurate method is the reverse transcription polymerase chain reaction (RT-PCR), the material must be taken with an instrument made entirely of artificial material that does not contain cotton, cotton wool or wood. Violations of the rules for collecting a sample of biological material, storage and transportation conditions may cause a false negative result. A repeat study is indicated in the event of the development of typical flu symptoms in patients with a burdened premorbid background or the development of complications. In case of infection of the lower respiratory tract, analysis of aspirate from the trachea and bronchi is characterized by a higher diagnostic value. Rapid tests (RIDTs) for influenza virus antigen are highly specific but also moderately sensitive, so a negative result does not rule out infection if clinical and epidemiological findings suggest influenza. Waiting time for test results: traditional cell culture 3–10 days, express method 1–3 days, immunofluorescence method 1–4 hours, reverse transcription PCR 1–6 hours, RIDT <30 minutes.

Serological studies are not of particular importance in practice.

Diagnostic criteria

1. Diagnosis of infection

(laboratory confirmed influenza): a positive result of a virological test is the basis for making a diagnosis.

2. The diagnosis of influenza must be excluded during the epidemic season in any patient with fever and respiratory symptoms (sore throat, runny nose and/or cough). Based on the clinical picture alone, only an acute respiratory infection can be diagnosed.

3. Classification of disease severity:

Severe case or complications of influenza (indications for hospitalization) - in addition to typical symptoms, also ≥1 of the following conditions:

1) diseases of the lower respiratory tract (pneumonia) - clinical symptoms (tachypnea more than 24 breaths per minute, hypoxemia (SрO2 <95%), shortness of breath at rest or with little physical exertion and other signs of respiratory failure) and/or radiographic symptoms (bilateral drainage (62%) and multilobar (72%) pulmonary infiltrative opacities extending from the roots of the lungs, which can simulate the picture of cardiogenic pulmonary edema, small pleural or interlobar effusion);

2) symptoms from the nervous system - convulsions (including febrile), disturbances of consciousness and encelopathy, focal encephalitis, neurological deficits, Guillain-Barré syndrome, acute transverse myelitis;

3) secondary complications, including myocarditis, renal failure, multiple organ failure, sepsis and septic shock, skeletal muscle breakdown;

4) exacerbation of major chronic diseases, including: bronchial asthma, COPD, coronary disease, chronic heart, liver or kidney failure, diabetes mellitus, obesity;

5) other, besides those listed above, severe conditions requiring hospitalization;

6) any of the symptoms of a progressive disease (→see below).

Progressive disease - the appearance of alarming symptoms in patients who previously consulted a doctor about uncomplicated influenza. The patient's condition may deteriorate very quickly (eg within 24 hours); the appearance of alarming symptoms is an indication for an immediate check of the patient’s treatment method, and in most cases, also for hospitalization (→below, points 1–3).

Alarming symptoms:

1) subjective, objective and laboratory symptoms of respiratory and cardiovascular failure: shortness of breath, cyanosis, hemoptysis, chest pain, hypotension, decreased hemoglobin oxygen saturation;

2) symptoms indicating complications from the central nervous system - disturbances of consciousness, loss of consciousness, pathological drowsiness, recurrent or persistent seizures, significant muscle weakness, paralysis or paresis;

3) symptoms of severe dehydration - dizziness or fainting when trying to stand up, pathological drowsiness or decreased urine output;

4) laboratory and/or clinical symptoms of persistent viral infection or secondary invasive bacterial infection;

5) persistence or recurrence of episodes of high fever or other symptoms after 3 days.

Differential diagnosis

Acute respiratory infections of other etiologies (viral respiratory tract infections, bacterial respiratory tract infections), exacerbation of COPD or asthma, infectious mononucleosis, acute HIV infection, acute myeloid leukemia, malaria, babesiosis.

TREATMENT

Algorithm of actions

→fig. 18.1-1 and fig. 18.1-2. up

Figure 18.1-1.

Initial clinical algorithm for uncomplicated influenza-like illness or influenza (WHO, 2009)

Figure 18.1-2.

Initial clinical diagnosis of pneumonia during influenza (WHO, 2009)

Symptomatic treatment

1. Bed rest, taking large amounts of fluid, isolating the patient

(especially from individuals at increased risk of influenza complications).

2. Antipyretic and pain-relieving medications: paracetamol, NSAIDs (eg ibuprofen); It is prohibited to use acetylsalicylic acid in children and adolescents until they reach 18 years of age (risk of developing Reye's syndrome).

3. If necessary: ​​antitussive drugs are not contraindicated, the prescription of mucolytics and expectorants is decided individually (in milder cases, a spoonful of honey / a glass of warm water before bed), medications that constrict the vessels of the nasal mucosa, isotonic or hypertonic NaCl solutions intranasally.

4. Commonly used drugs such as vitamin C and rutoside are ineffective. Homeopathic remedies (eg Oscillococcinum) - low level of evidence base.

5. A patient with respiratory failure should be transferred to a center that provides extracorporeal membrane oxygenation (ECMO).

Etiotropic treatment

1. Antiviral drugs are active only against influenza viruses:

1) neuraminidase inhibitors (active against influenza A and B viruses) - oseltamivir and zanamivir;

2) M2 inhibitors (active only against influenza A viruses) - amantadine and rimantadine. However, in recent years, the sensitivity of viruses to these drugs has decreased significantly.

The spectrum of resistance to antiviral drugs changes from year to year, so recommendations for empirical therapy are updated before each epidemic season, and, if necessary, during the season. Influenza A virus strains (H3N2, H1N1pdm09) circulating during recent epidemic seasons are resistant to M2 inhibitors. However, all strains of seasonal influenza viruses are generally sensitive to neuraminidase inhibitors. The earlier antiviral treatment is started, the more effective it is (ideally within 48 hours), so if you suspect influenza in at-risk groups and in seriously ill patients, do not wait for laboratory confirmation of the infection.

2. Indications for treatment with oseltamivir (or zanamivir):

1) suspected influenza or confirmed influenza in hospitalized patients;

2) severe, complicated or progressive course (criteria →above) - start treatment with oseltamivir as soon as possible. When oseltamivir is not available or cannot be used, or if the strain is confirmed to be resistant to this drug, → zanamivir should be prescribed.

3) in case of clinically reasonable suspicion or laboratory confirmed influenza in persons at increased risk of severe disease and complications (→see below), treatment with oseltamivir (or zanamivir) should be started as soon as possible after the onset of symptoms, regardless of their severity, optimally within 48 h.

When treating patients with bronchial asthma with zanamivir, it is necessary to be prepared for an exacerbation of the disease and have short-acting bronchodilators available.

Most people with mild or moderate influenza who are not at high risk and those who present when symptoms are subsiding do not need antiviral drugs. During long-term treatment with oseltamivir, especially in immunocompromised patients, resistance to this drug may develop. All strains of the A/H1N1 2009H1N1pdm09 virus that are resistant to oseltamivir are sensitive to zanamivir.

3. Dosage, treatment regimens and side effects:

1) oseltamivir - po 75 mg 2 times a day (dose for people weighing >40 kg or aged >12 years); typical treatment lasts 5 days. If there is no improvement after standard therapy → extend treatment. For patients who are unable to swallow the capsule, an oral suspension may be prepared with the contents of the capsule according to the manufacturer's instructions. In case of renal failure with creatinine clearance of 10–30 ml/min, it is necessary to reduce the therapeutic dose to 75 mg 1 × per day, and the prophylactic dose to 75 mg every 48 hours. Side effects - nausea/vomiting (less pronounced if the drug is given with food) , temporary psychoneurological symptoms (changes in the level of consciousness, confusion, abnormal behavior, delusions, hallucinations, agitation, anxiety, nightmares, delirium).

2) zanamivir (dry powder inhaler) - 2 inhalation doses (2 x 5 mg) 2 x per day for 5 days are recommended. Zanamivir in inhalation form is not used through a nebulizer - it contains lactose, which may interfere with the operation of the nebulizer; Contraindicated in patients with chronic lung diseases (bronchial asthma, COPD) or heart disease. In patients with severe renal impairment, dosage should not be changed.

Hospital treatment

Indicated for severe or progressive influenza →above.

1. Initial assessment of the patient:

1) monitor SpO2 in each patient, maintaining its value in pneumonia >90%, and in some patients (eg, pregnancy, children) in the range of 92-95% - oxygen therapy may be required;

2) in case of shortness of breath, a chest x-ray should be performed;

3) it is necessary to carry out (possibly repeat) a determination of the influenza virus (real-time PCR). If the result is negative in a patient with a high clinical likelihood of infection, repeat the test every 48–72 hours;

4) assess the patient's condition frequently (may rapidly deteriorate).

2. Immediately after admission, empirical treatment with oseltamivir (or another first-line drug if recommendations have changed in this season) should be started - as a rule, after the onset of complications that are an indication for hospitalization, it should be used for > 5 days or ≥ 10 days (or until it is proven, based on the weakening of clinical symptoms and/or the results of virological tests, that viral replication does not continue). If severe influenza symptoms persist despite treatment with oseltamivir, in a patient with confirmed influenza virus infection, consider zanamivir or peramivir (not registered in the Russian Federation) intravenously.

3. Pneumonia (especially severe) with influenza - in addition to antiviral treatment with oseltamivir, it requires the appointment of empirical antibiotic therapy in accordance with the recommendations for community-acquired pneumonia. Bacterial pneumonia in patients with influenza is most often caused by Staphylococcus aureus and pneumococci, but in each case it is necessary to carry out standard bacteriological diagnostics. It is not recommended to use antibiotics for prophylaxis. If clinical assessment and microbiological test results do not indicate a bacterial infection in a patient with laboratory-confirmed influenza, consideration should be given to discontinuing the antibiotic.

4. If indicated (eg ARDS), mechanical ventilation.

5. GCS: it is not indicated for use in large doses in the treatment of viral pneumonia due to the risk of serious side effects, including opportunistic infections and prolongation of viral replication. The use of small doses of GCS is possible in case of septic shock requiring the use of vasopressor drugs → section. 18.8.

COMPLICATIONS

1) pneumonia: top

a) primary influenza - no regression of influenza symptoms is observed; the most common cause of severe pneumonia during the epidemic influenza season is the development of viral pneumonia, which can occur in the form of ARDS;

b) secondary bacterial caused by S. pneumoniae, S. aureus or H. influenzae - during the period of regression of influenza symptoms or in the convalescence phase (return of fever and increased shortness of breath, cough, malaise);

2) streptococcal tonsillitis;

3) exacerbation of a concomitant chronic disease;

4) rarely - meningitis and encephalitis, encephalopathy, transverse myelitis, Guillain-Barré syndrome, myositis (in extreme cases with myoglobinuria and renal failure), myocarditis, pericarditis, sepsis and multiple organ failure;

5) very rarely (usually in children) Reye's syndrome - usually associated with taking acetylsalicylic acid;

Risk factors for severe disease and complications (including hospitalization and death):

1) age ≥65 years or <5 years (especially before 24 months of age);

2) pregnancy (especially the 2nd and 3rd trimester) and the first 2 weeks after birth;

3) significant obesity (BMI ≥40);

4) some chronic diseases (regardless of age): lungs (e.g. COPD, bronchial asthma), heart (e.g. coronary disease, congestive heart failure), kidneys, liver, metabolic (including diabetes mellitus), blood (including including hemoglobinopathies), immunodeficiencies (primary, HIV infection, immunosuppressive therapy), neurological diseases that impair the function of the respiratory system or the removal of secretions from the respiratory tract (for example, cognitive disorders, post-traumatic spinal cord injuries, diseases that occur with seizures, neuromuscular diseases).

SPECIAL SITUATIONS

Pregnancy and breastfeeding top

Pregnant women have an increased risk of complications from influenza, including adverse pregnancy outcomes (miscarriage, premature birth, threat to fetal life). In case of reasonable suspicion or confirmation of influenza, pregnant patients need careful monitoring and, regardless of the development of symptoms, antiviral treatment should be prescribed as quickly as possible, even before laboratory test results are obtained. For analgesic and antipyretic treatment, paracetamol is indicated (acetylsalicylic acid and NSAIDs are contraindicated during pregnancy). There is insufficient data regarding the use of oseltamivir at a dose higher than 75 mg every 12 hours during pregnancy. Breastfeeding women can safely continue breastfeeding during treatment with oseltamivir and zanamivir (however, they must follow the rules of prevention). up

PREVENTION

Specific methods to top

1. Vaccination

→section 11/18 is the main method of prevention. up

2. Pharmacological prevention: oseltamivir or zanamivir - as soon as possible after the onset of flu symptoms; recommended in high-risk groups (→see above) after close contact with a sick person. Homeopathic remedies and vitamin C are not effective.

Non-specific methods

1. Isolate patients: for 7 days after the onset of symptoms or if they last longer - 24 hours after the end of fever and acute respiratory symptoms. During this period, a person with uncomplicated influenza should stay at home and limit their contacts to the minimum necessary. Patients with immunodeficiency require longer isolation.

2. Personal protective equipment:

1) hand hygiene - during the flu season, especially in case of close contact with a person with the flu (e.g. at home, at work, in a hospital, clinic) frequent (10 × per day for 20 seconds hand washing with soap (preferably with an alcohol-based product) ), then drying with a disposable towel: after each contact with the sick, after using the toilet, before eating or touching the mouth and nose, upon returning home, after clearing the nose or closing the mouth during sneezing and coughing;

2) use of a face mask (eg surgical or dental) in a situation of close contact with the patient (up to 1.5–2 m). A mask should also be worn by someone who has the flu to reduce the risk of infecting others. Masks must be replaced with new ones after each contact with a patient, and used ones must be disposed of in a special way. Healthy people are not recommended to wear a mask outside for prevention. During procedures involving the respiratory tract that produce aerosolized secretions (e.g., bronchoscopy, suctioning of respiratory secretions, etc.), N95 (or similar) filter masks must be worn, as well as safety glasses, a gown, and gloves.

3) other hygiene rules during the flu season: it is necessary to cover your mouth with a disposable tissue when coughing and sneezing, then throw it in the trash and wash your hands thoroughly (if disposable tissues are not available, it is recommended to cover your mouth with your forearm, not your hand); face-to-face contact with other people must be avoided; avoid crowds; Avoid touching your mouth, nose and eyes with unwashed hands; Ventilate the room thoroughly often.

3. The obligation to report to the regional executive authorities in the field of healthcare and the management of Rospotrebnadzor in the constituent entity of the Federation: only cases confirmed by virological research.

How to treat the flu?

In the standard course of ARVI without bacterial complications, a minimum set of medications will be required. How to treat influenza at home in relation to symptoms must be decided as signs of pathology arise. If infection is detected at the very beginning of the progression of the disease, it is advisable to take a course of antiviral medication.

Treatment of influenza - medications

During the expected incubation period and in the first 1-3 days after infection, it is advisable to take etiotropic drugs. Antiviral tablets against influenza:

• Tamiflu;
• Amantadine;
• Engystol;
• Midantan;
• Amizon;
• Grippferon;
• Agri;
• Kagocel;
• Remantadine;
• Adapromine;
• Lavomax;
• Ergoferon;
• Arbidol;
• Relenza;
• Anaferon;
• Triazavirin and others.

Comprehensive treatment of influenza involves the use of symptomatic medications. Antihistamines:

• Telfast;
• Suprastin;
• Zodak;
• Loratadine;
• Fenistil and analogs.

Anti-inflammatory with analgesic effect:

• Nalgesin;
• Ibuprofen;
• Naproxen;
• Pentalgin;
• Nurofen and synonyms.

Antipyretic:

• Paracetamol;
• Ibuklin;
• Efferalgan;
• Viburcol;
• Antiflu and analogues.

Nasal drops:

• Xymelin;
• Nazivin;
• Otrivin;
• Tizin;
• Nazol and others.

Cough medicines:

• Lazolvan;
• Ambroxol;
• Gerbion;
• Bronholitin;
• Clenbuterol and synonyms.

Treatment of influenza with folk remedies

Natural medicines are an effective therapy that provides support for the immune system and relief of ARVI symptoms. Treatment of influenza at home with folk remedies may be sufficient for a complete recovery. Parents of babies and expectant mothers, who should not use most pharmacological drugs, should pay special attention to the recipes presented.

Anti-flu drink at an early stage

Ingredients:

• warm boiled water – 1.5 l;
• coarse table or sea salt - 1 teaspoon;
• ascorbic acid powder – 1 g;
• lemon juice – 50 ml.

Preparation, use:

1. Dissolve all components in water.
2. Stir the liquid well.
3. Drink the resulting remedy within 2-2.5 hours, preferably on the first day after infection.

Anti-flu medicine recipe

Ingredients:

• hot water (not boiling water) – 1 glass;
• grated ginger root - 1 heaped teaspoon;
• lemon – 1 thick slice;
• honey – 2 teaspoons;
• mint leaves – 5-7 pcs.

Preparation, use

1. Mix ginger root and honey.
2. Pour the composition with hot water.
3. Add lemon and mint, crush them with a spoon.
4. Leave the product for 15-30 minutes.
5. Take the drink 1-4 times a day.

Herbal tea for flu

Ingredients:

• chamomile flowers - 1 tbsp. spoon;
• initial letter – 1 tbsp. spoon;
• sage – 1 tbsp. spoon;
• boiling water – 500 ml;
• honey, jam or sugar - to taste.

Preparation, use

1. Grind and mix herbs.
2. Pour boiling water over them.
3. Leave in a sealed container for 40 minutes.
4. Strain and sweeten the tea.
5. Drink the drink throughout the day, you can add a few fresh mint leaves.

Antipyretic decoction

Ingredients:

• pearl barley – 100 g;
• water – 1 l;
• honey – 1 teaspoon.

Preparation, use

1. Boil the cereal over low heat for 15 minutes.
2. Cool, strain the broth.
3. Mix the resulting liquid with honey.
4. Take the medicine before going to bed.

Can you take antibiotics for the flu?

The described disease is a viral infection, so antimicrobial drugs are powerless in this case. Antibiotics against the flu are not only ineffective, but can also be harmful. These medications weaken the body's immune system, causing the virus to multiply and spread faster. The only situation when it is necessary to use antimicrobial agents is the treatment of complicated influenza. When a bacterial infection occurs, antibiotics help suppress it, but only a doctor should prescribe them.

Canine flu

0
Source:

However, the horse flu that raged in Mongolia in 2007, of course, appeared much earlier. Some scientists believe that it was his mutation, or rather one of them, that later developed into an independent virus and was called dog flu. It’s not hard to guess, precisely because our four-legged friends began to be affected instead of horses. The first deaths were recorded in January 2004 in Jacksonville, Florida, where 8 greyhounds died at the same time. And by mid-2005, US veterinarians were already sounding the alarm with all their might, trying to warn everyone about a new deadly virus that was spreading with tremendous speed in dog kennels and shelters in America. Many years have passed since then, the epidemic was avoided, but a vaccine against the H3N2 strain was never developed. The virus itself has not gone away. Although not on a huge scale, it continues to infect and, saddest of all, kill dogs. In 2019, 1,100 cases of canine influenza were reported in America, and about 10 dogs died.

In order not to confuse the flu with other infectious diseases or the common cold, be sure to read the post about the main differences between the flu, colds and ARVI. Everything there is short and very clear.

Types of influenza

The insidiousness of any type of virus lies in constant mutations, changes, and adaptation to drugs.

Influenza A affects humans and animals with moderate to severe disease. Dangerous strains of bird and swine flu are known. Influenza B is transmitted between people, although the virus is also modified to cause serious epidemics. Type C is little studied and sometimes does not cause infection.

Penetrating the cell, influenza B or A actively multiplies, provoking viral symptoms and infection.

The variability of viruses manifests itself in new subspecies, strains that the human immune system has not yet encountered, which is why it is so difficult to recover, and the medications that helped do not work. Vaccination against influenza B strain or any other subtype does not provide complete protection, but the risk of infection is reduced in the same way as the manifestation of the disease.

Avian

The H5N1 strain or avian flu did not cause mass epidemics; it is a classic acute viral disease of birds. The first human infection was recorded in 1997. Bird flu has a high mortality rate among those infected. No evidence of transmission of the virus from person to person has been identified, but cases of infection have been recorded through contact with an infected bird or through surfaces contaminated with bird feces.

The symptoms of bird flu in humans are similar to the usual virus (headache, sore throat, cough, fever, chills, etc.), complications such as pneumonia are fatal in 50% of cases. To avoid infection with this type of virus, it is necessary to follow general preventive recommendations, as well as thoroughly heat-treat poultry meat and eggs, and avoid contact with infected birds.

Complications

When a virus attacks the body, the immune system is weakened, and the risk of complications from a viral infection increases. You can quickly get over the flu, but suffer from complications.

A bacterial infection joins a viral one, so antibacterial therapy is needed. Influenza is complicated by pathologies: otitis media, sinusitis, bronchitis, meningococcal infection, pneumonia, myocarditis. The risk group includes young children, elderly and frail people, those with chronic diseases, and pregnant women.

Flu affects all important organs, so it needs to be accurately diagnosed and treated early.

Causes

Influenza is an acute viral disease that affects the upper and lower respiratory centers and is accompanied by severe intoxication of organs and systems and dangerous complications, including death. Included in the group of respiratory infections.

An infected person is especially dangerous for the first time 5-6 days after the first symptoms appear. Transmission of infection occurs through the air, upon contact, droplets expelled during sneezing and coughing. Worldwide epidemics occur every year, leading to serious consequences or death.

The area of ​​infection is 2-3 m around the patient. Many sick people mistake the flu for a cold or ARVI, without taking measures to destroy the virus. The high incidence in all months of the autumn-winter period is due to the accumulation of people in enclosed spaces for a long time and the lack of ventilation of the rooms.

If there is a sick person in the house

Despite some differences, doctors still combine influenza A and B (symptoms and treatment). First of all, it is recommended to give the body a chance to rest. Due to this, you will help the immune system. A necessary requirement is compliance with bed rest. And the most important thing is to call a doctor at home, because it may not be the flu, but what it is is impossible to say without an examination by a specialist.

In order to reduce the possibility of infecting family members, the patient is placed in a separate room or fenced off from the main room. The patient is provided with separate dishes and hygiene items.

Wet cleaning with disinfectants is also necessary, since thanks to it the concentration of viruses drops by more than half. Ventilation at least 3 times a day provides a good healing effect.

Symptoms and features of the course

It should be mentioned when talking about influenza type A that this is a disease that is characterized by rapid spread. The incubation stage lasts from two to five days, and a period begins that is characterized by acute clinical manifestations.

For mild flu, it lasts three to five days. And after 5-10 days the person recovers. But for another 20 days a person may feel tired, weak, have a headache, be irritable and suffer from insomnia.

Here is a list of the symptoms influenza A causes in children:

• the temperature rises to 40 °C;
• the child is shivering;
• the baby stops playing, whines, and becomes very weak;
• complains of headache and muscle pain;
• he has a sore throat;
• possible abdominal pain and vomiting;
• a dry cough begins.

How does the virus spread?

The causative agent of influenza is a virus that penetrates the airspace through saliva and discharge from the catarrhal organs of a sick person (spread can occur during sneezing or coughing). The spread of infection can occur at a distance of up to four meters from person to person.

To prevent this process, all sick people must be isolated; if this cannot be achieved, it is imperative to wear a protective mask. It will restrain the spread of saliva with viral particles, the main thing is to change it for a new one at least every two hours.

Healthy people may not wear masks to protect themselves from infection. When viral particles have already spread through the air, the mask will not be able to filter them, so the process of wearing them loses its purpose.

In addition to what is described above, influenza can spread through contact. Recently, this type of transmission of infection has been the most frequent, due to the fact that large numbers of people live in cities and are forced to be close to each other.

Infection occurs as follows: the carrier of the virus coughs or sneezes, while covering the mouth with his own hand, which he then places on the handrail of public transport, the handle of a store cart, or an elevator button. After infection penetrates the skin of a healthy person from these objects, he simply needs to touch the mucous membranes of the mouth, nose, or just his face to become infected.

On the skin, viral particles can remain active for at least 15 hours, all this time remaining a threat to the body.

Therefore, it is very important to accustom yourself to the fact that outside the home you should not touch your own face or eat anything without first washing your hands with soap. While at school or work, you should periodically clean your hands using wet wipes that have an antibacterial effect. And when returning home, you need to thoroughly wash your hands and also clean your nasal cavity with saline solutions.

Does alcohol kill the flu virus? Recent research by scientists has confirmed the fact that ethyl alcohol can only act on surfaces that are being treated. Alcohol cannot overcome an infection that has already penetrated a person.