Acute Respiratory Viral Infections (ARVI)
SARS – various acute infectious diseases resulting from defeat of an epithelium of airways of RNA - and the DNA-containing viruses. Usually are followed by temperature increase, cold, cough, a sore throat, dacryagogue, intoxication symptoms; can be complicated by tracheitis, bronchitis, pneumonia. Diagnosis of a SARS is based on the kliniko-epidemiological data confirmed with results of virologic and serological analyses. Etiotropny treatment of a SARS includes administration of drugs of antiviral action, symptomatic – application of febrifugal, expectorant means, rinsing of a throat, instillation of vasoconstrictive drops in a nose, etc.
Acute Respiratory Viral Infections (ARVI)
SARS - the airborne infections caused by the virus activators affecting, mainly, respiratory organs. SARS are the most widespread diseases, in particular at children. During the periods of peak of incidence of a SARS diagnose for 30% of the population of the planet, respiratory viral infections many times surpass other infectious diseases in emergence frequency. The highest incidence is characteristic of children aged from 3 up to 14 years. Growth of incidence is noted in cold season. Prevalence of an infection – universal.
SARS are classified by weight of a current: distinguish easy, medium-weight and heavy forms. Define weight of a current on the basis of expressiveness of catarrhal symptomatology, temperature reaction and intoxication.
SARS are caused by the various viruses relating to various childbirth and families. They are united by the expressed affinity to cages of the epithelium covering airways. SARS can cause various types of viruses of flu, paraflu, adenoviruses, rhinoviruses, 2 serovar of RSV, a reovirusa. In the majority (except for adenoviruses) activators belong to the RNA-containing viruses. Practically all activators (except reo-and adenoviruses) are unstable in the environment, quickly perish during the drying, effect of ultra-violet light, disinfectants. SARS can sometimes cause Koksaki's viruses and ESNO.
Source of a SARS is the sick person. The greatest danger is constituted by patients on the first week of clinical manifestations. Viruses on the aerosol mechanism in most cases are transmitted in the airborne way, realization of a contact and household way of infection is in rare instances possible. The natural susceptibility of people to respiratory viruses is high, in particular at children's age. Immunity after the postponed infection unstable, short-term and type-specific.
Due to the large number and variety of types and serovar of the activator repeated incidence of a SARS at one person during the season is possible. Approximately each 2-3 years are registered the flu pandemics connected with emergence of a new strain of a virus. SARS of not influenzal etiology often provoke flashes of incidence in children's collectives. Pathological changes of the epithelium of respiratory system affected with viruses promote decrease in its protective properties that can lead to developing of a bacterial infection and development of complications.
Common features of a SARS: rather short-term incubatory period (about a week), sharp beginning, fever, intoxication and catarrhal symptomatology.
The incubatory period at infection with adenovirus can fluctuate ranging from two up to twelve days. As well as any respiratory infection, begins sharply, with rise in temperature, cold and cough. Fever can remain up to 6 days, sometimes proceeds in two oxen. Symptoms of intoxication are moderate. Expressiveness of catarrhal symptomatology is characteristic of adenoviruses: plentiful , puffiness mucous a nose, a throat, almonds (quite often moderately hyperemic, with a fibrinozny raid). Cough is damp, the phlegm is allocated transparent, liquid.
Increase and morbidity of lymph nodes of the head and neck, in rare instances – a liyenalny syndrome can be noted. The heat of a disease is characterized by clinical symptomatology of bronchitis, laryngitis, tracheitis. A frequent symptom of an adenoviral infection is catarrhal, follicular or filmy conjunctivitis, originally, usually, unilateral, mainly lower eyelid. In a day or two the conjunctiva of the second eye can inflame. At children up to two years abdominal symptoms can be noted: diarrhea, belly-ache (mezenterialny limfopatiya).
The current is long, quite often wavy, due to spread of a virus and formation of the new centers. Sometimes (in particular at defeat adenoviruses of 1,2 and 5 serovar), form a long carriage (adenoviruses latentno remain in almonds).
The incubatory period, as a rule, takes from 2 to 7 days, and children of the senior age group the easy current as Qatar or an acute bronchitis is characteristic of adults. Can note cold, pain when swallowing (pharyngitis). Fever and intoxication are not characteristic of a respiratory sintsitilnoy of an infection, it can be noted subfebrilitt.
Heavier course and deep penetration of a virus is characteristic of a disease at children of younger age (in particular babies) (bronkhiolit with tendency to obstruction). The beginning of a disease gradual, the first manifestation usually happens rhinitis to poor viscous allocations, hyperaemia of a pharynx and palatal handles, pharyngitis. Temperature either does not rise, or does not exceed subfebrilny figures. Soon there is dry persuasive cough as that at whooping cough. Upon termination of a fit of coughing allocation of a dense, transparent or whitish, viscous phlegm is noted.
With progressing of a disease the infection gets into smaller bronchial tubes, bronchioles, respiratory volume decreases, respiratory insufficiency gradually increases. Short wind generally expiratory (difficulties at an exhalation), breath noisy, there can be short-term episodes . At survey the accruing cyanosis is noted, the auskultation reveals disseminated small - and srednepuzyrchaty rattles. The disease usually proceeds about 10-12 days, at a heavy current increase in duration, a retsidivirovaniye is possible.
The incubatory period of a rinovirusny infection most often makes 2-3 days, but can fluctuate within 1-6 days. The expressed intoxication and fever are also not characteristic, usually the disease is followed by rhinitis, plentiful serous and mucous allocations from a nose. The quantity separated serves as an indicator of weight of a current. Dry moderate cough, dacryagogue, irritation mucous can sometimes be noted a century. The infection is not inclined to complications.
SARS can become complicated in any period of a disease. Complications can carry as virus character, and to result from accession of a bacterial infection. Most often SARS are complicated by pneumonia, bronchitis, bronkhiolita. Antritis, sinusitis also belong to widespread complications, plays the dandy. Quite often there is an inflammation of the hearing aid (average otitis), brain covers (meningitis, an encephalomeningitis), different neuritis (it is frequent – neuritis of a facial nerve). At children, often at early age, quite dangerous complication can become to lead a false croup (a sharp stenosis of a throat) able to death from asphyxia.
At high intoxication (in particular it is characteristic of flu) there is a probability of development of spasms, meningealny symptomatology, violations of a warm rhythm, sometimes – myocardites. Besides, SARS at children of various age can be complicated by holangita, pancreatitis, infections of urinogenital system, septikopiyemiy.
Diagnosis of a SARS
Diagnosis of a SARS is performed on the basis of complaints, these poll and survey. The clinical picture (fever, catarrhal symptoms) and the epidemiological anamnesis are usually sufficient for identification of a disease. The laboratory techniques confirming the diagnosis are RIF, PTsR (reveal virus anti-genes in an epithelium of a mucous membrane of a cavity of a nose). Serological techniques of a research (IFA of pair serums in an initial stage and during a convalescence, RSK, RTGA) usually specify diagnostics in a retrospective.
At development of bacterial complications of a SARS consultation of the pulmonologist and otolaryngologist is required. The assumption of development of pneumonia is the indication for a X-ray analysis of lungs. Changes from ENT organs demand carrying out a rinoskopiya, faringo-and otoskopiya.
Treatment of a SARS
SARS treat at home, send to a hospital of patients only in cases of a heavy current or development of dangerous complications. The complex of therapeutic measures depends on a current, expressiveness of symptomatology. The bed rest is recommended to patients with fever up to normalization of body temperature. It is desirable to observe a diet full-fledged, rich with protein and vitamins, to use a lot of liquid.
Medicines, generally appoint depending on prevalence of this or that symptomatology: febrifugal (paracetamol and complex medicines containing it), expectorant means (Bromhexine, Ambroxol, root extract , etc.), antihistaminic medicines for desensitization of an organism (). Now there is a mass of the complex medicines including in the structure active ingredients of all these groups, and also the vitamin C promoting increase in natural protection of an organism.
Locally at rhinitis appoint vasoconstrictive means: naphazoline, , etc. At conjunctivitis in the affected eye put ointments with bromnaftokhinony, fluorenonilglioksaly. Antibiotic treatment is appointed only in case of detection of the joined bacterial infection. Etiotropny treatment of a SARS can be effective only on early terms of a disease. It means introduction of interferon of the person, anti-influenza gamma globulin, and also synthetic medicines: remantadin, oksolinovy ointment, .
From physiotherapeutic ways of treatment of a SARS the mustard bathtub, can massage and inhalations are widespread. The supporting vitamin therapy, vegetable immunostimulators, adaptogens is recommended to the persons who had a SARS.
Forecast and prevention of a SARS
The forecast at a SARS generally favorable. Deterioration in the forecast happens at emergence of complications, heavier current often develops when weakening an organism, children of the first year have lives, persons of senile age. Some complications (hypostasis of lungs, encephalopathy, a false croup) can lead to a lethal outcome.
Specific prevention consists in application of interferon in the epidemic center, vaccination with application of the most widespread strains of flu in the period of seasonal pandemics. It is desirable to apply to personal protection at contacts with patients the gauze bandages covering a nose and a mouth. Individually it is also recommended to increase protective properties of an organism (a balanced diet, a hardening, vitamin therapy and application of adaptogens) as prevention of viral infections.
Now specific prevention of a SARS is not rather effective. Therefore it is necessary to pay attention to general measures of prevention of respiratory infectious diseases, in particular in children's collectives and medical institutions. As measures of the general prevention allocate: the actions directed to control of observance of sanitary and hygienic standards, timely identification and isolation of patients, restriction of density of the population during the periods of epidemics and quarantine actions in the centers.