Flu at children – the sharp infection caused by viruses of flu of types A, B, C; characterized by defeat of a respiratory path, intoxication and high probability of development of secondary bacterial complications. Flu at children proceeds with high fever (to 39-40 °C), a fever, the general weakness, the catarrhal phenomena (irritation in a throat, cold, dry cough, pharynx hyperaemia). Diagnosis of flu at children is based on clinical and epidemiological data, laboratory detection of a virus (RIF, PTsR, IFA, RSK, RTGA). Symptomatic treatment of flu at children is carried out by the febrifugal, desensibilizing, expectorant means; etiotropny therapy - antiviral medicines.
Flu at children
Flu at children concerns to group of the acute respiratory viral infections (ARVI) which also enter paraflu, an adenoviral infection, respiratory an infection, a rinovirusny infection. Annually flu causes the seasonal epidemics striking up to 30% of the population, a half of which is made by children and teenagers. Incidences of flu children from 3 to 14 years are most subject. The susceptibility to flu at the child is 4-5 times higher, than at the adult. Flu at children quite often proceeds with complications (accession of bronchitis, pneumonia, sinusitis, etc.), causes exacerbations of chronic diseases therefore prevention of flu epidemics represents a serious problem of pediatrics.
The flu reasons at children
Flu represents the high-infectious infection which is easily extended from the person to the person. Epidemics of seasonal flu at children are caused by the RNA-containing viruses of three types – And, In and Page. The main superficial anti-genes of a virus of flu are (N) and a neuraminidase (N) on the basis of which allocate anti-gene subtypes of viruses.
The virus of A type capable to cause epidemics and pandemics has the highest variability of anti-gene structure. Its gemagglyutinina are presented by 15 subtypes (H1-H15), and neuraminidases – 10 subtypes (N1–N10). Usually during seasonal flu strains of H1N1 and H3N2 circulate. Strains of a virus of A type are widespread among people, birds and pets.
Anti-gene variability of a virus of V type is expressed to a lesser extent; usually the activator causes local flashes or epidemics within one country. The mass outbreaks of flu of V type often precede or coincide on time with the outbreaks of flu of A type. The virus of flu of V type circulates only in human population, to a thicket affecting children.
The virus of flu C possesses stable anti-gene structure; infects the person and pigs; causes only sporadic cases. Therefore all vaccines against flu (Inflyuvak, Vaksigripp, Grippol, Infleksal In, Agrippol, etc.) contain urgent superficial anti-genes of viruses A and B in this epidemiological season.
Flu viruses among children extend in mainly airborne way at a conversation, sneezing, cough. Also children can catch flu through kontaminirovanny a virus of means of hygiene, a toy and other objects. Spread of flu among children is promoted by variability of weather conditions (fluctuation of humidity and air temperature), decrease in immune responsiveness, hypovitaminosis, a lack of a sunlight, stay in children's collectives.
Viruses of flu get into an organism through a nose or a rotoglotka, are fixed in a cylindrical epithelium of airways. By means of a gemagglyutinin viruses of flu are attached to a cage, and thanks to the neuraminidase destroying cellular membranes get in a cage where production of virus proteins and replication of virus RNA begins. Then new viruses leave cages owners, affecting other healthy cells and continuing process of a reproduction. In clinical aspect these processes find expression in a catarrhal inflammation. Through the damaged epitelialny barrier viruses get to a blood-groove and are carried on an organism, causing specific influenzal intoxication.
Flu symptoms at children
The period of the latent virus infection carrier state lasts from several hours to 2-4 days. The beginning of flu at children sharp, with prevalence of an intoksikatsionny syndrome over the catarrhal phenomena. The baby the only display of flu can have a high fever; children up to 5 years have a high temperature to 39-40 °C, rhinitis and cough; more senior children have a fever, perspiration, a fever, dry cough, irritation and a sore throat.
All-toxic action on an organism is followed by deterioration in appetite, slackness, an adinamiya, a headache, a mialgiya and an artralgiya, vomiting. Kapillyarotoksikoz causes increase in permeability of vascular walls, development of a hemorrhagic syndrome - nasal bleedings, gemorragiya on skin and mucous membranes, an injection of vessels a skler. At flu children can have a toxic defeat of TsNS: encephalopathy, neurotoxicosis, spasms, hallucinations, nonsense. From cardiovascular system tachycardia and a priglushennost of warm tones is found; from bodies of urination - a mikroalbuminuriya, a mikrogematuriya, reduction of a diuresis.
On weight of expressiveness of the catarrhal phenomena and symptoms of intoxication allocate easy, medium-weight, heavy and hypertoxical forms of flu at children. At a typical lung and the medium-weight course of flu at children improvement of a state occurs in 3-4 days, however the catarrhal inflammation remains within 1,5-2 weeks. In the convalescence period the long time can remain an adynamy (bystry fatigue, weakness, perspiration). The hypertoxical form of flu at children proceeds with high percent of a lethality owing to developing of fatal hypostasis of lungs, lightning pneumonia, the DVS-syndrome, a sharp respiratory, cardiovascular and renal failure.
Flu complications at children share on respiratory and not respiratory. Most often complications of the first group occur at children 5 years are younger and include the viral and secondary bacterial pneumonia caused by a pneumococcus, pathogenic staphylococcus, a hemolytic streptococcus; the false croup, bronkhiolit, average otitis, sinusitis. Complications of not respiratory type are presented by myocarditis, miozity, encephalitis, Ray's syndrome, etc.
Are most subject to risk of heavy complications of flu children are younger than 2 years, and also the children having associated diseases (bronchial asthma, congenital heart diseases, an immunodeficiency, diabetes, diseases of kidneys).
Diagnosis of flu at children
At diagnosis of flu at children the pediatrician considers epidemiological data and a clinical picture of a disease (fever, intoxication, the catarrhal phenomena, fizikalny changes).
Laboratory confirmation of flu at children can be carried out by means of express techniques (PTsR and REEF) by means of which virus anti-genes in dabs prints from a mucous cavity of a nose and a rotoglotka are defined. In some cases serological and virologic methods are used (IFA, RSK - reaction of binding of a complement, RTGA-hemagglutination braking reaction, etc.).
For an exception of complications of flu consultations of narrow experts (the children's otolaryngologist, the children's neurologist, the children's pulmonologist, the children's nephrologist), a research of the general analysis of urine and blood, a X-ray analysis of bodies of a thorax, a bacteriological research of a phlegm, crops of blood on sterility can be required by children.
Treatment of flu at children
Treatment of children with an easy and medium-weight form of flu is carried out in house conditions. To children of younger age, and also at the heavy or complicated course of an infection hospitalization in an infectious hospital is shown. Throughout the period of fever it is necessary to observe a bed rest, to use plentiful warm drink.
It is necessary to appoint Etiotropny therapy of flu at children in the earliest terms. In pediatric practice the following antiviral medicines are used: remantadin, , , alpha interferon, , etc. Symptomatic therapy of flu at children includes reception febrifugal and resolvents (paracetamol, an ibuprofen), mucolytics (Ambroxol, Bromhexine, a fenspirid), protivokashlevy medicines (a butamirat of citrate, a prenoksdiazin, an okseladin), an instillation of vasoconstrictive drops in a nose, etc.
In a flu pharmacotherapy complex at children antihistaminic medicines, vitamin complexes are applied. At development of laryngitis or tracheitis ultrasonic inhalations are effective (medicinal, alkaline). In case of bacterial complications antibacterial medicines are appointed (penicillin, macroleads, tsefalosporina, etc.). In the period of a convalescence after flu reception of adaptogens and immunomodulators is recommended to children.
The forecast and prevention of flu at children
Typical cases of seasonal flu usually come to an end with recovery of children. The threat for life arises at the severe, hypertoxical and complicated flu forms at children from risk groups.
For prevention of mass outbreaks of a seasonal infection and increase in collective immunity additional vaccination of children against flu is annually carried out. At incidence of the child in a family of flu, other children and family members need to perform the emergency prevention by antiviral medicines and interferona. In the period of a flu epidemic measures to dissociation of children (isolation of patients, restriction of mass actions, extraordinary vacation) are taken, anti-epidemic events are held (damp cleaning of rooms with dezsredstvo, airing, quartz treatment).