Flu – the sharp viral respiratory infection caused by the RNA-containing viruses of flu A, B and C, which is shown fever, intoxication and defeat of an epitelialny vystilka of the top airways. Flu enters into group of acute respiratory viral infections – a SARS. The person sick with flu constitutes the greatest infectious danger in the first 5-6 days from the beginning of a disease. A way of transfer of flu - aerosol. Disease duration, as a rule, does not exceed weeks. However at flu such complications as otitis, sinusitis, pneumonia, cystitis can be observed, miozit, perikardit, a hemorrhagic syndrome. Flu is especially dangerous to pregnant women as it can lead to threat of termination of pregnancy.
Flu – the sharp viral respiratory infection caused by the RNA-containing viruses of flu A, B and C, which is shown fever, intoxication and defeat of an epitelialny vystilka of the top airways. Flu enters into group of acute respiratory viral infections – a SARS.
Characteristic of the activator
The virus of flu belongs to the sort Influenzavirus, the virus of A type can affect the person and some animals, types B and C breed only in a human body. Viruses of flu are characterized by high anti-gene variability (it is to a large extent developed at viruses of A type and in, it is less at C). Anti-gene polymorphism promotes frequent epidemics, repeated incidence during the season, and also does not allow to develop rather reliable group specific prevention. The virus of flu is unstable, easily perishes at temperature increase to 50-60 degrees, under the influence of chemical disinfectants. At 4 °C can keep viability up to 2-3 weeks.
The tank and source of an infection – the sick person (with obvious clinical manifestations or the erased infection form). The maximum allocation of a virus takes place in the first 5-6 days of a disease, contageousness depends on expressiveness of catarrhal symptomatology and concentration of a virus in a secret of a mucous membrane of airways. The virus of flu of A type is allocated by also sick pigs, horses and birds. One of modern theories assumes that a part in spread of a virus of flu on a global scale is played by migratory birds, mammals serve as the tank of an infection and promote formation of the new strains capable in the subsequent to infect the person.
The mechanism of transfer of flu – aerosol, a virus extends in the airborne way. Allocation happens to saliva and a phlegm (at cough, sneezing, a conversation) which in the form of a small aerosol extends in air and it is inhaled by other people. Realization kontaktno of a household way of transfer is in certain cases possible (mainly through ware, toys).
Natural susceptibility of the person to a flu virus high, especially concerning new serotypes. Immunity is type-specific, duration reaches it at flu of A type – 1-3 years, type B – 3-4 years. The children who are on breastfeeding receive antibodies from mother, but often this immunity does not protect from development of an infection. Prevalence of a virus of flu universal, epidemics, often world scale regularly flash.
The incubatory period of flu usually makes from several hours to three days, the beginning mainly sharp, the current can be easy, medium-weight, heavy, with complications and without. The clinical picture of flu is presented by three main simptomokompleks: intoxication, Qatar and gemorragiya.
Development of an intoksikatsionny syndrome begins from the first hours of a disease, body temperature can increase up to 40 degrees, the fever, headaches and dizziness, the general weakness is noted. Moderate mialgiya and artralgiya, spasms, consciousness violations can take place. Intensity of an intoksikatsionny syndrome defines weight of a course of uncomplicated flu and can fluctuate in very wide limits, from a moderate indisposition before intensive feverish reaction, vomiting of the central character, spasms, confusion of consciousness and nonsense.
Fever quite often proceeds in two waves, the symptomatology usually begins to abate by 5-7 day of a disease. At survey during the feverish period the giperemirovannost of the person, a hyperthermia and dryness of skin is noted, tachycardia, perhaps some lowering of arterial pressure is found. The catarrhal symptomatology is shown soon after development of intoxication (sometimes it is expressed poorly or can be absent at all). Patients complain of dry cough, discomfort and morbidity in a throat and a nasopharynx, cold. The clinic of laryngitis and bronchitis can be shown: a voice osiplost, a sadneniye behind a breast at the dry accruing on intensity, strained cough. At survey sometimes note slight hyperaemia of a pharynx and a back wall of a throat, .
In 5-10% of cases flu can promote development of a hemorrhagic symptom. At the same time small hemorrhages in a mucous membrane of a rotoglotka, bleeding from a nose join the catarrhal phenomena. At development of a heavy gemorragiya its progressing to sharp hypostasis of a lung is possible. Flu usually is not followed by symptomatology from abdominal organs and a small pelvis if that clinic takes place, then it has mainly neurogenetic character.
Intestinal frustration at flu at children of early age are connected with an intoksikatsionny syndrome. Diarrhea at flu at adults, most likely, speaks about existence of the chronic diseases of a gastrointestinal tract provoked to an aggravation by an infection. Flu duration on average does not exceed 3-5 days, in the subsequent sometimes for several days the general adynamy remains. Cases of an atypical course of flu, lungs, the erased forms, and an infection, also combined with other viruses, are noted.
Flu can be complicated by various pathologies as in the early period (are usually caused by the joined bacterial infection), and later. The heavy complicated course of flu usually occurs at children of younger age, the elderly and weakened faces having chronic diseases of various bodies.
Quite seldom at extremely heavy intoxication flu is complicated by a serious, life-threatening condition – sharp hemorrhagic hypostasis of lungs. At the same time sharp increase of difficulty of breath, and cyanosis is noted, the bloody foamy phlegm is allocated. The progressing respiratory insufficiency and a hypoxemic coma, often the leader by death is result of sharp hemorrhagic hypostasis of lungs.
Accession of an infection during the course of flu most often promotes development of pneumonia, lungs are surprised mainly streptococcal and staphylococcal flora, pneumonia of this etiology proceeds with tendency to destruction of pulmonary fabric, can be complicated by pulmonary bleedings, hypostasis, to provoke infectious and toxic shock. After the postponed pneumonia the residual phenomena in the form of bronkhoektaz, a pneumosclerosis often remain.
Flu can promote development of otitis, and also be complicated by sinusitis, antritises, frontita. From other bodies and systems nephrites can be noted, piyelotsistit, (perikardit) miozita, an inflammation of a warm bag. Complications from heart at flu it is considered the increase reason in the period of epidemic of frequency of myocardial infarctions, development of sharp cardiovascular insufficiency.
Flu can cause spontaneous termination of pregnancy or pre-natal death of a fruit in pregnant women.
Diagnosis of flu
Preliminary diagnostics is performed on the basis of a clinical picture and data of express diagnostics of RNIF or IFA (identification of an anti-gene of a virus of flu in dabs taken in nose cavities), as confirmation of the diagnosis serve methods of serological diagnostics: increase of a caption of antibodies by means of RTGA, RSK, RNGA, IFA is defined. Diagnostic value has more than quadruple increase.
At suspicion on development of pneumonia consultation of the pulmonologist and carrying out a X-ray analysis of lungs can be required by the patient with flu. At development of complications from ENT organs survey of the otolaryngologist with carrying out from - and rinoskopiya is necessary.
Treatment of flu
Flu treat mainly on an outpatient basis, hospitalizing only patients with the heavy and complicated infection forms. Besides, hospitalization are subject pupils of orphanages and boarding schools.
For fever the bed rest, plentiful drink, the balanced full-fledged diet, vitamins is recommended to patients. As means of etiotropny therapy in the first days of a disease remantadin is appointed (has contraindications: age up to 14 years, pregnancy and a lactation, pathologies of kidneys and a liver), . Late purpose of antiviral means is inefficient. Purpose of interferon can be recommended. Besides antiviral therapy, vitamin C, calcium a gluconate, routines, febrifugal, antihistamines is appointed.
The heavy course of flu quite often demands carrying out dezintoksikatsionny measures (parenteral infusion of solutions a haemo misinformation, a reopoliglyukina) with speeding up of a diuresis. Quite often add to dezintoksikatsionny solutions , ascorbic acid, Dimedrol. At the developing hypostasis of lungs or a brain increase a dosage of saluretik, appoint Prednisolonum intravenously, hold necessary events of intensive therapy. The developing cardiovascular insufficiency is the indication to purpose of a tiaminpirofosfat, sulfocamphor acid with prokainy, medicines of potassium and magnesium. At the same time make necessary correction of an internal acid and main homeostasis, control passability of airways.
Forecast and prevention of flu
Mainly the forecast of an influenzal infection – favorable, recovery comes in 5-6 days. Deterioration in the forecast causes a heavy current in children of early age, old men, development of life-threatening complications. The forecast of a course of pregnancy is adverse – flu quite often provokes its interruption.
Now measures of the specific prevention of flu which is performed concerning the most widespread strains are developed. The multianti-gene structure of flu epidemics does not allow to exclude completely by means of vaccination a possibility of a disease of flu, but the sensibilized organism transfers an infection much easier, the risk of development of heavy complications in immunizirovanny children is considerably reduced. It is expedient to do flu inoculations several weeks prior to the predicted epidemic period. Anti-influenza immunity – not long-term, it is desirable to make immunization every year.
The general prevention includes usual measures for prevention of spread of the infections which are transmitted in the airborne way in the periods of mass epidemics. Personal prevention consists in avoiding of contacts with patients, places of a congestion of people, wearing the gauze mask covering airways, preventive reception of antiviral medicines in case of risk of infection and also - the actions directed to strengthening of immune properties of an organism.