Influenza is a disease of infectious origin with localization in the upper respiratory tract. Many people confuse the flu with a common cold and do not take appropriate measures to prevent exposure to the virus and minimize infection through contact with a sick person.

The clinical symptoms of influenza are similar to those of other infectious diseases that primarily affect the respiratory system. In this situation, the use of specific laboratory tests is mandatory in the diagnosis.

Given global statistics, it can be said that about 15% of people are affected by the flu virus every year. Severe forms of influenza are the most common cause of irreversible damage to the structure of the cardiovascular system and the brain.

Manifestations of influenza

Influenza belongs to the category of infectious diseases that are ubiquitous and are accompanied by outbreaks that affect the majority of the population. The influenza virus is not only a medical but also a social problem.

The peak incidence occurs in the autumn-winter period, although outbreaks can occur at any time of the year. Fortunately, the death rate from influenza does not exceed five percent, and the cause of death is not so much the flu as additional bacterial infections.

The rapid spread of influenza is caused by its short incubation period, aerogenic transmission routes, the high sensitivity of the human body to the pathogen, and the conditions of social life.

If we consider the pathogenesis of influenza, it should be noted that the maximum replication of the virus occurs in the mucous membrane of the upper respiratory tract. Due to the adverse effects on epithelial cells, accumulations of bacteria appear on the mucous membrane, which increase the inflammatory response.

Influenza, as a rule, does not damage the lung parenchyma, but both adults and children, taking into account the individual anatomical features of the respiratory system, in some cases have lung damage.

In severe influenza and severe viremia, there is a hematogenous spread of the virus in all organs, causing microcirculation disorders with the subsequent development of degenerative changes.

Signs and symptoms of the flu

Influenza refers to infectious diseases with a short incubation period (less than three days). The disease occurs in mild, moderate and severe forms, it can be uncomplicated or accompanied by the development of complications. The basis of the clinical picture of simple influenza variants consists of intoxication, hemorrhagic and catarrhal symptoms.

Signs of intoxication - These are the main leading symptoms of influenza, characterized by a severe and rapid onset of the disease. High temperature with influenza develops in the first hours of the disease. Patients in the acute period complain of pain in the front of the head, progressive weakness, inability to perform even minimal physical work. As a result of violations of microcirculation in the muscles, painful sensations in the body, dizziness and non-specific pain in the joints appear.

Headache with influenza, it can range from minimal to severe, accompanied by insomnia, hallucinations, and episodes of vomiting.

Fever reaches a peak, as a rule, by the end of the first day of illness, then the patient may experience some decrease in body temperature. In some cases, there may be another peak in the increase in body temperature.

Objective signs of influenza are hyperemia of the eyes, scleritis, dry skin. Influenza symptoms may include tachycardia and hypotension. Typical flu symptoms are dryness, sore throat and pain when swallowing, nasal congestion.

At the congestive catarrhal stage, redness, dryness and swelling of the mucous membrane of the nasopharynx and oropharynx are expressed. Characteristic features of the catarrhal period are chest pain, shortness of breath and dry cough, which can be so severe that it causes the development of vomiting and severe pain in the muscles of the epigastric region and quadrant.

Influenza forms

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mild flu accompanied by a slight fever (no more than 38 ° C), moderate headaches and cold symptoms. Objective signs of intoxication in this case are a moderate heart rate of less than 90 beats per minute at a constant blood pressure. Respiratory distress is not characteristic of mild influenza.

moderate form influenza is accompanied by the development of febrile-type hemodynamic disorders, such as an increase in heart rate and a decrease in systolic blood pressure to moderate severity.

severe flu accompanied by prolonged fever with high body temperature, sudden hemodynamic disturbances and a compensatory increase in respiratory rate.

During epidemics, various patterns of influenza course are usually observed. Fortunately, the symptoms of avian hemorrhagic syndrome occur in only five percent of cases and occur as pinpoint bleeding in the oropharyngeal mucosa.

Influenza Diagnosis

In order to make an accurate diagnosis of influenza, a variety of laboratory diagnostic methods are used. Laboratory analysis methods are also used for the differential diagnosis of existing symptoms of influenza and other infectious diseases with a similar clinical picture.

For example, express diagnostics includes the use of fluorescent antibodies, and its principle is to detect virus antigens in the epithelial cells of the mucous membrane of the nasal cavity and conjunctiva. The condition for a successful analysis is the availability of a test sample of the material within five days of the onset of the disease. Using this method, you can not only determine the influenza virus, but also check its serotype, which is important when choosing a treatment regimen.

Flu treatment

The decision on the need for hospitalization of the patient is made by the doctor, taking into account clinically reliable information, as a rule, this happens in severe cases of influenza, or the presence of complications against its background. Other cases do not imply mandatory hospitalization and treatment is carried out on an outpatient basis.

The main element of successful treatment of influenza is not only taking anti-flu medicine, but also recommendations for patients to adjust the regimen and diet. All patients suffering from influenza during the acute period are required to observe bed rest and take an increased amount of fluid in the form of pure water, herbal infusions and juices.

With regard to the use of antibacterial agents, their administration is recommended for adult patients with a history of chronic respiratory diseases, as well as those suffering from immunodeficiency. Other cases of uncomplicated influenza are not a reason to take antibiotics.

Symptomatic treatment includes the use of ascorbic acid at a dose of 0.1 g three times a day, a dose of 0.15 g of calcium gluconate. The use of antipyretics for influenza is justified only when the patient's body temperature exceeds 38.5 ° C.

Severe flu symptoms require the use of a broader treatment regimen.

Preventive measures include mass immunization of the population and although flu shots are not currently mandatory, more and more people choose to get vaccinated to reduce the risk of contracting the flu virus during an epidemic.

Denial of responsibility: The information provided in this article about flu symptoms, treatment, and signs is intended to inform the reader only. It cannot be a substitute for the advice of a health professional.

Flu- a viral disease transmitted by airborne droplets, characterized by an acute onset, severe intoxication and a predominant lesion of the upper respiratory tract.

Types of influenza virus, what are the names of H1N1, H3 N2 ?

There are three types of influenza virus: virus A, B and C. And each of them is divided into different subtypes. The variety of variants of the influenza virus is determined by 2 protein complexes located on the surface of the virus envelope: hemagglutinin (H) and neuraminidase (N). These structures are factors of virus aggression. The properties of hemagglutinin determine the intensity of intoxication during the disease, and neuraminidase significantly reduces the body's immune functions. New variants of the influenza virus appear as a result of the variability of these surface complexes. Depending on the variant of the virus, it is designated by the corresponding formula. Example: virus A (H1N1), where A is a type of virus H - hemagglutinin, N- neuraminidase, and the numbers are their various options.

The cause and mechanism of the development of the disease

The influenza virus, getting on the surface of the mucous membrane of the upper respiratory tract, invades the cells and begins to multiply. It destroys the cell and, together with toxins, enters the bloodstream (viremia and toxinemia). Spreading throughout the body, the virus affects the immune, cardiovascular and nervous systems. All this creates a favorable background for the attachment of a microbial infection and the development of complications (sinusitis, tonsillitis, bronchitis, pneumonia, etc.).

Symptoms

The clinical picture of influenza is represented by 2 main groups of symptoms:

1. Symptoms of general intoxication

Symptoms of general intoxication

• Severe chills, soon replaced by fever
• Sharp headache (forehead, brow ridges, temples, eyes).
• Photophobia
• Dizziness, possible fainting
• Weakness
• Brokenness
• Decreased performance
• sweating
• Body aches
• Muscle pain (especially in the back)
• Joint pain
• Sleep disturbance
• High temperature 39-40 °C and above

• Dryness and itching in the throat
• Nasal congestion (scanty discharge)
• Dry cough, often painful, on the 3-5th day becomes softer with the release of scanty mucous sputum.

Appearance of a patient with influenza
In the first days of the illness, the appearance of the patient resembles a tearful child: pronounced redness and puffiness of the face, shiny and reddish eyes. The mucous membrane of the palate, arches, walls of the pharynx is bright red.

Possible Complications of the Flu

Complications can be divided into 2 groups:

1. Complications caused directly by the action of the virus
2. Complications caused by microbial infection (attached or activation of a chronic focus in the body).

1st group of complications:

• Pulmonary edema(shortness of breath, cyanosis of the skin, nervous agitation, often streaks of blood in expectorant sputum, lowering blood pressure, rapid heartbeat). This severe complication is rare, but can be fatal.
• Swelling of the vocal cords(more often in children, it develops suddenly, in most cases at night, asthma attacks, anxiety, palpitations, if appropriate assistance is not provided, death is possible).
• V inflammation of the membranes of the brain(meningitis - severe headache, nausea, vomiting without feeling better, convulsions).
• cerebral edema- diffuse headache, possible loss of consciousness, convulsions.
• Hemorrhage in the brain, as a result of the possible development of paralysis.
• Allergization of the body, the possible development of bronchial asthma, glomerulonephritis.
• Pain along the nerves (neuralgia)
• Radiculitis
• Myocarditis
• Heart rhythm disorders (arrhythmias)
• Endocarditis

2nd group of complications:

• Pneumonia (more often on the 4th-5th day of illness). Manifestations: cough with mucopurulent or purulent sputum, chest pain, shortness of breath.
• Acute sinusitis (sinusitis, frontal sinusitis)
• Pharyngitis
• Tonsillitis
• Influenza infection can activate hidden foci of infection in any part of the body (genitourinary system, respiratory, nervous, etc.).

Diagnostics

General blood analysis

• Leukocytes: reduced, for the first time days of illness may increase to 11.0-12.0 10 9 /l
• Eosinophils: lowered
• Lymphocytes: elevated (increase relative to the decrease in neutrophils)
• Monocytes: increased relatively, due to a decrease in neutrophils
• ESR: normal in most cases

Specific Diagnosis

• Immunofluorescent analysis (XRF) reaction- the test consists in the fact that, with the help of special protein molecules (antibodies) capable of emitting luminescence, the corresponding type of virus is determined.
• Enzyme immunoassay (ELISA)- the test is based on the fact that specific structures of the virus or antibodies produced by the body against it are determined from labeled enzymes.
• PCR- the test determines the genetic apparatus of the virus, DNA or RNA. It is currently the most sensitive method for diagnosing infectious diseases.

Virological study- isolation of the virus in chicken embryos is rarely used.

Additional research methods
Given the possible complications, it is recommended to do an ECG and an x-ray of the lungs.
In making a diagnosis flu, Epidemiological data are also of great importance (high incidence of morbidity among the population during the cold season).

Treatment

Influenza is treated at home. Only a severe course of the disease or the presence of one of the symptoms: temperature 40-41 ° C, vomiting, convulsions, shortness of breath, arrhythmia, lowering blood pressure - requires hospitalization.

General treatment

• Bed rest during periods of elevated body temperature
• Plentiful drink (juices, tea with lemon, raspberries, mineral alkaline waters, milk)
• Light food rich in vitamins and minerals

Treatment to fight the virus

Antiviral drugs are prescribed only in case of severe or moderate course of the disease. The drugs are effective only in the first days of illness(maximum up to 5-7 days).

• rimantadine- the drug is effective against the A virus. Application: the first day 300 mg in 3 doses, the second and third days 200 mg in 2 doses, on the fourth day 100 mg in one dose.
• Oseltamivir- effective against viruses A and B. Application: 150 mg, in 2 doses for 5-7 days.
• Arbidol- effective against viruses A and B. Application: 600 mg per day for three doses, 5-7 days.
• Viferon- the drug is well suited for children
• Alternative drugs: human leukocyte interferon, interferon alfa-2 , Tiloron , Cycloferon , Kagocel, Ridostin.

Treatment aimed at eliminating the mechanisms and symptoms of the disease:

• Antipyretic drugs(paracetamol, ibuprofen, indomethacin, etc.), are necessary only in cases of significant temperature rises and when the fever is difficult to tolerate and can lead to severe complications (eg. convulsions), in other cases, the body fights with the help of temperature
• Antihistamines(tavegil, diazolin, zyrtec, etc.). These drugs prevent the development of edema, relieve inflammation and prevent allergic reactions.
• Expectorants(acetylcysteine, bromhexine, ambroxol, etc.). The drugs thin the sputum and facilitate the separation of bronchial mucus.
• Drugs that improve nasal breathing(naphthyzine, xylometazoline, etc.). An important point in treatment. Ensuring good aeration of the respiratory tract reduces the risk of microbial complications and speeds up the healing process.
• Antibiotics do not act on the virus, and therefore, with influenza, they are used only in special cases: 1) the presence of a chronic focus of infection, 2) signs of microbial infection, 3) weakening of the body with severe immunodeficiency, 4) duration of high temperature for more than 5 days with symptoms of severe intoxication.

Prevention

Non-specific prophylaxis includes methods and means aimed at increasing the body's resistance to pathogens.

• hardening procedures ( dousing, walking barefoot, etc.).
• Multivitamin preparations(Undevit, Geksavit, Vitrum, Decamivit, etc.).
• Medicines that strengthen the immune system(Timalin, Prodigiosan, T - activin, etc.).

Specific prevention - These are vaccines against a specific type of virus.

Types of vaccines against influenza virus
There are two types of vaccines: live and inactivated (killed).

Live vaccines are weakened viruses (devoid of the ability to cause disease). The vaccine is sprayed into the nasal cavity. A high percentage of the formation of strong and long-term immunity to the virus. But with this and a large percentage of adverse reactions.

Inactivated vaccines are of two types:

1. Whole vaccines, which consist of purified unresolved virus bodies (virions). Benefits: Gives a more stable and reliable immunity against the virus. Disadvantages: Higher likelihood of side effects.

2. Split vaccines (split vaccines), contain various structures of the virus, highly purified from virus particles capable of causing unwanted reactions in humans.

• Fluarix
• Vaxigripp
• Begrivak

3. Vaccines consisting only of proteins located on the surface of the virus (subunit vaccines):

• Influvac
• Grippol
• Agrippal
• Fluad

Subunit vaccines are better tolerated than others, as they are the most well purified, and do not contain aggravating substances (virus toxins, egg white, etc.) that cause unwanted reactions from the body. Disadvantages: Immunity production and persistence are lower than whole vaccines.

Vaccine effectiveness

The effectiveness of vaccines has been proven by many studies. The U.S. Centers for Disease Control and Prevention, based on an analysis of all available influenza vaccination data, states that vaccines:

• reduce the incidence of influenza
• reduce the number of side effects after the flu,
• facilitate the recovery and course of the disease,
• reduce mortality from influenza.

Emergency prevention

• The use of an antiviral drug in small doses (Remantadine, 0.05 g once a day for 7 days). Start taking when the first sick person in the family or a person from a close circle appears.
• Oxolinic ointment 0.25%, 2 times a day, lubricate the nasal mucosa.
• Interferon, is mostly used for emergency prevention of influenza in children. Human leukocyte interferon is available in dry ampoules. The contents of the ampoule should be dissolved in 2 ml of boiled water, and instilled into the nose 2 times a day, 5 drops, throughout the entire dangerous period of possible infection.

Forecast

In most cases, the flu will end in a full recovery. On average, the terms of disability range from 5-7 days and up to 21 days in cases of pneumonia.

How is the flu transmitted?

Source of influenza virus- an infected person with erased or pronounced signs of the disease.

What's happening? During coughing, sneezing or talking, particles of saliva, sputum or mucus are ejected into the surrounding air from the patient's nasopharynx along with influenza viruses. Further, a healthy person becomes infected from a sick person by inhaling contaminated air - airborne transmission.

At the same time, on outdoors the influenza virus is maximally concentrated in a diameter of about 2-3 meters around the patient, indoors- about 7 meters. Whereas beyond this distance the number of viruses in the environment is reduced by almost 60-70%.

Also, the number of virus released into the environment by patients, decreases if he breathes through a medical mask, or when coughing or sneezing, covers his mouth and nose with a handkerchief.

Moreover, it is important to remember that flu patient is contagious before the first signs of illness appear: approximately 24 hours. After the onset of the disease, he continues to release the influenza virus into the environment until the 5th-7th day of illness.

How long does the influenza virus live?

The maximum incidence of influenza occurs in January-February. In other periods of the year, the flu is almost non-existent. However, there is still a small risk of catching the influenza virus in late autumn or early spring.

This is due to the fact that people spend more time indoors, which are not always sufficiently ventilated. Therefore, favorable conditions and temperature conditions are created for one sick person to infect a large number of people.

For example, when air temperature +4°С influenza viruses remain viable for up to 4 hours, with room temperature in the patient's room - from 2 to 9 hours.

In the same time influenza viruses contained in drops of dried saliva or sputum, settle on clothes or surfaces, can remain viable for about 2 weeks. True, much depends on the material from which the objects are made - for example, on a metal or plastic surface - 24-48 hours, glass - up to 10 days. but in room dust influenza viruses can persist for up to five weeks!

Therefore, it is necessary to timely and carefully carry out wet cleaning in the patient's room, as well as in other rooms during the period of maximum incidence of influenza. In addition, you should observe personal hygiene: wash your hands with soap and water after the street and visiting public places.

Moreover, it is important to remember that influenza A viruses, the causative agents of severe forms of the disease, have the greatest resistance in the external environment.

Who is more likely to get the flu?

People of all ages are susceptible to the flu. However, children, pregnant women, the elderly, patients with chronic diseases of the heart, lungs and kidneys (especially those with chronic renal failure) are at high risk.

Because their immune system is disrupted and the compensatory mechanisms of the body are weakened. And often the disease is severe, with the development of formidable complications: pneumonia, pulmonary edema (excessive accumulation of fluid in the lungs), meningitis (inflammation of the membranes of the brain), laryngotracheitis (inflammation of the larynx and initial parts of the trachea) and others.

In addition, children have a much higher risk of catching the virus due to the fact that they attend children's organized groups with high crowding: kindergartens, schools, sections, circles.

What are the symptoms of flu in children?

From the moment of infection to the appearance of the first signs of the disease, it takes from several hours to three days - the incubation period.

Moreover, the manifestations of the disease are not characteristic only of the flu. Therefore, in order to distinguish influenza from SARS or colds with 100% certainty, it is necessary to conduct special laboratory tests. For example, to isolate the influenza virus in throat swabs or to determine antibodies against it in the blood.

However, there are still certain signs that indicate the presence of the influenza virus in the body.

Manifestations of influenza in children consist of two complexes symptoms:

• General intoxication- occur from the first hours of the disease and grow rapidly.
• Upper and lower respiratory tract infections - joins a little later: usually on the 2-3rd day of the disease.

Moreover, the severity and duration of symptoms of influenza in children depend on the severity of the course of the disease.

Symptoms of general intoxication

They are caused by the introduction of the influenza virus into the body and the decay products of the cells of the mucous membrane of the respiratory tract, which have a toxic and allergic effect on the body.

They are actually the "calling card" of the flu, since it is for him that the onset of the disease is characteristic with a sharp increase in body temperature to high numbers. Moreover, the manifestations are often so pronounced that it is possible to accurately indicate the hour of the onset of the disease. Whereas with SARS or a cold, these symptoms appear gradually.

Increased body temperature and chills are caused by the production in the body of special substances - pyrogens, which transmit a signal to the thermoregulation center in the brain. Further, the mechanism of increasing body temperature is triggered: muscle tremor increases, which increases the formation of heat, and heat transfer decreases due to vasospasm.

Then, with the good work of the thermoregulation center, the vessels dilate, so the child becomes hot to the touch and sweats. If this does not happen, then the baby turns pale, and his limbs get cold.

Against the background of elevated body temperature, moderate shortness of breath (compensatory reaction of the body) may appear without the participation of auxiliary muscles: there is no retraction of the intercostal muscles and swelling of the wings of the nose.

It is important to remember that in most cases, the numbers of elevated body temperature indicate the severity of the child's condition: with moderate severity, they reach 38-38.5 ° C, with severe - 39-40 ° C. When the baby's condition improves, the body temperature quickly returns to normal.

A repeated increase in body temperature is a sign of the addition of a bacterial infection or an exacerbation of chronic diseases.

Influenza viruses irritate pain receptors and also lower the pain threshold, so children become more susceptible to pain. In addition, the infectious process triggers mechanisms to increase the production of inflammatory mediators (prostaglandins, substance P and others) - special substances that increase swelling and pain.

With influenza, the headache is severe, usually located in the area of ​​\u200b\u200bthe eyebrows, superciliary arches and temples. There are also pains in the area of ​​the eyeballs, which are aggravated by moving the eyes or pressing on them.

Pain in the muscles and joints, body aches are present even at rest and are greatly aggravated by movement.

Severe weakness, weakness, sleep disturbances (drowsiness or insomnia), poor appetite, nausea and vomiting

They are caused by intoxication of the body with a virus and decay products of the cells of the mucous membrane of the respiratory tract.

Moreover, nausea and vomiting are more characteristic of severe forms of influenza, and usually do not occur in mild cases.

Increased tendency to bleed from injection sites, nose, stomach, or intestines

Occurs very rarely and only in extremely severe influenza - hypertoxic form. The symptom is due to the toxic effect of the influenza virus on the body and the massive breakdown of the cells of the mucous membrane of the respiratory tract, which leads to impaired blood clotting.

Painful sensitivity of the eyes to light (photophobia)

It is caused by irritation of the sensitive nerve endings of the trigeminal nerve, embedded in the anterior sections of the eyes, by the influenza virus.

It is manifested by increased pain in the eyes with a bright light source, so the child squints his eyes or covers them with his palm.

Respiratory tract symptoms

Children are usually much more pronounced than adults.

Dryness and itching in the throat, nasal congestion, pain or pressure behind the sternum, hoarseness

Caused by the introduction of the virus and damage to the mucous membrane of the upper and lower respiratory tract (pharynx, trachea, vocal cords, bronchi), which leads to local inflammation and swelling.

In addition, with influenza, unlike ARVI, nasal congestion is not pronounced, and discharge from it is absent or scanty.

Also, it is with influenza that tracheobronchitis (inflammation of the trachea and bronchi) most often develops, which often proceeds severely, followed by prolonged coughing.

lacrimation

Associated with swelling of the mucous membrane of the nasolacrimal canal and nasal cavity due to inflammation, therefore, the natural outflow of tear fluid from the eyes is disrupted.

Cough

Caused by irritation of nerve endings in the respiratory tract, which leads to an impulse. Then it is transmitted to the respiratory center, which coordinates the movement of the muscles of the bronchi, diaphragm, larynx, chest and abdomen.

How does this happen? First, there is an inhalation, then a tense exhalation follows with a closed glottis and contracted bronchi. At this moment, intrathoracic pressure rises, which leads to the opening of the vocal cords and rapid exhalation through the oral cavity - a cough occurs, with which particles of mucus or sputum are ejected from the respiratory tract.

At the beginning of the disease flu cough dry, rough, hacking and painful and sometimes paroxysmal. Sputum is either absent or scanty. Subsequently, the cough becomes moderately wet.

During a strong cough (at a height), young children sometimes experience vomitingassociated with the fact that the vomiting and cough centers are nearby. Therefore, they can simultaneously become irritated due to the fact that the brain structures in children are immature.

Pain in the abdominal muscles

They occur due to muscle contraction during a painful and prolonged cough.

Small hemorrhages in the mucous membrane of the mouth and eyes, skin of the face and neck

During coughing, the pressure in the superior vena cava increases, therefore, with the tendency of capillaries to fragility, small hemorrhages occur.

How is the flu in the baby?

Children under one year of age have less contact with others, so they are less likely to get the flu than children of school and preschool age. In addition, if the child is breastfed, then breast milk antibodies often protect the baby well from infection.

And yet, babies are at risk, because they have an imperfect immune system that cannot give a worthy rebuff to the virus. Therefore, in the case of an illness, the flu is difficult for them: complications are formed and / or a secondary infection joins.

Flu symptoms in infants develop in the usual way, as in older children:

• Initially, symptoms of intoxication appear: the body temperature rises, the child refuses to eat, and so on.
• After a short time, signs of damage to the respiratory tract appear: there is a cough, nasal congestion and other symptoms.

but there is a difference: manifestations of the disease develop much faster - within a few hours or one or two days. In addition, the situation is further aggravated by the fact that children under the age of one do not know how to talk.

Therefore, a mother should be attentive to her baby - and then he will “tell” everything that happens to him with his behavior.

At moderate course

With the onset of the disease, the baby's behavior changes dramatically: he becomes very capricious, cries, refuses to eat, he develops a hoarse voice and a painful cough.

In case of severe

The child is lethargic, apathetic (abandoned to everything that happens around), the skin becomes pale, and the limbs may be cold.

Often appears dyspnea, which indicates the development of complications: swelling of the vocal cords (laryngotracheitis) or lungs, influenza pneumonia and others. At the same time, auxiliary muscles participate in the act of breathing: the intercostal spaces are drawn in and / or the wings of the nose swell.

What are the types of influenza?

Based on the severity of general toxic manifestations and symptoms of respiratory tract damage, There are several variants of the course of influenza.

Moreover, the severity of the course of the disease depends not only on the type of influenza virus, but also largely on the initial state of health of the patient. Since in the presence of chronic diseases or disorders in the functioning of the immune system, there is a high risk of a severe course of the disease with the development of a large number of complications.

Also available rule for children: The younger the child, the more severe the flu. This is the case because young children have imperfect body compensatory mechanisms and an immature immune system. In addition, the influenza virus further suppresses its work. Therefore, a bacterial infection quickly joins, further aggravating the course of the disease.

Light form

It is characterized by an increase in body temperature up to 38 ° C, which responds well to the effects of antipyretics, normalizing on the second or third day of illness.

Symptoms of damage to the upper respiratory tract are not expressed.

In general, the general condition of patients is moderately disturbed, therefore, in terms of manifestations, the mild form of influenza is more reminiscent of SARS.

Moderate form

Occurs most often.

The phenomena of intoxication expressed and come to the fore:

• Body temperature rises sharply to 38-39.5 ° C and lasts for four to five days, falling when taking antipyretics.
• Patients develop lethargy, weakness, severe headache, muscle pain and body aches.
• There is photophobia and lacrimation.

Respiratory tract symptoms also manifest themselves more clearly: a painful dry cough, dryness and sore throat, "scratching" pain behind the sternum, nasal congestion.

Moreover, a bacterial infection often joins with the development of viral-bacterial or bacterial pneumonia, leading to a worsening of the general condition of the patient.

Severe form

It develops somewhat less frequently, while the condition of patients is rapidly aggravated over a short period of time.

Manifestations of intoxication:

• The disease begins acutely with an increase in body temperature to 39.5-40 ° C, which is difficult to respond to conventional antipyretic drugs based on paracetamol or ibuprofen.
• The patient develops a sharp and pronounced weakness, severe headaches and muscle pain, sleep is disturbed, there are dizziness, sometimes up to fainting.
• Rarely, delusions, hallucinations, seizures, and loss of consciousness may occur.
• Sometimes viral meningitis (inflammation of the lining of the brain) develops. In this case, there is such a severe headache that the adult groans, and the child screams. There are also pronounced pains in the back and neck, aggravated by turning the head.
• Sleep is disturbed: drowsiness or insomnia occurs.
• Often there is nausea and repeated vomiting.

Respiratory damage:

• There is a painful pronounced cough that does not bring relief.
• Nasal breathing is disturbed.
• There is persistent shortness of breath that worsens with movement or slight exertion, a sign of a high risk of complications from the flu.
• Viral or viral-bacterial pneumonia often develops. In this case, auxiliary muscles usually participate in breathing: the intercostal spaces are drawn in and / or the wings of the nose swell.
• Often there is laryngotracheitis, which leads to a sharp and rapid narrowing of the larynx. Manifested by a "barking" cough, shortness of breath on inspiration and a change in voice.

Characteristic appearance of patients with severe influenza: facial expression - suffering, skin - pale with an earthy tint. Often there is a positive symptom of "pinch": the formation of a bruise when squeezing a fold of skin in the subclavian region due to increased fragility of blood vessels.

Hypertoxic form

Occurs rarely. In this case, the disease begins with a sharp increase in body temperature up to 40-41°C. In the future, all the symptoms of influenza increase very quickly, often within a few hours or one or two days, determining the extremely severe course of the disease.

This form is characterized by toxic damage to the brain (neurotoxicosis) and cerebral edema (excessive accumulation of fluid in the cells of the brain or spinal cord), impaired blood clotting, the functioning of the cardiovascular system and kidneys, pulmonary edema with the development of respiratory failure.

If patients are conscious, they are restless and complain of a feeling of lack of air. However, consciousness is often quickly disturbed: hallucinations and delusions appear. With further aggravation of the general condition, patients lose consciousness or fall into a coma.

If timely medical care is not provided, then with the hypertoxic form of influenza, in 40-60% of all cases of the disease, patients die within a few hours or days.

How does the flu manifest itself in pregnant women?

During pregnancy, a woman's immunity decreases physiologically. As a result, the immune system "does not see" the fetus, which is a foreign body for the mother's body. This condition is necessary to maintain pregnancy. Therefore, the expectant mother has a high risk of contracting any infectious diseases, including the flu.

And the flu during pregnancy is manifested by the usual symptoms. However, during an “interesting situation”, the signs of the disease usually develop much faster, and the disease itself often proceeds in a severe form. In addition, a secondary bacterial infection often joins: viral-bacterial or bacterial pneumonia develops, inflammation of the sinuses (sinusitis) and others.

Why is the flu dangerous during pregnancy?

Much depends on the period of pregnancy in which the expectant mother fell ill with the flu.

In the first trimester of pregnancy - up to 12 weeks

There is a laying of all organs and systems in the fetus, so the influence of the influenza virus often adversely affects these processes. As a result, there is a high risk of developing any congenital malformations - for example, heart, lung or kidney defects.

Moreover, there is reliable information that malformations of the central nervous system are most often formed: hydrocephalus (excessive accumulation of fluid in the brain), brain cysts, spina bifida (malformation of the spine in combination with spinal cord defects) and others.

How is influenza treated in children?

The main task is to suppress the reproduction of influenza viruses, as well as their ability to damage healthy cells in the body.

In addition, the fight against intoxication and damage to the respiratory tract, as well as the treatment of complications, is carried out.

Antiviral medicines for children with influenza

An important condition: start taking antiviral drugs as soon as possible. Optimally - in the first 48 hours from the onset of the disease.

Name of the drug	Mechanism of action	How to use
First line drugs considered to be the most effective.
Remantadine	At an early stage of the disease, it inhibits the reproduction of the influenza A virus mainly after it has penetrated the cells of the mucous membrane of the respiratory system.	It is prescribed from the age of one year in the form of 0.2% syrup, from the age of seven - in tablets.
Arbidol	It acts on influenza viruses A and B, inhibiting their reproduction. It also enhances the production of interferon in the body (a protein that has antiviral activity) and moderately improves the functioning of the immune system.	It is prescribed orally in capsules or tablets before meals, starting from the age of three.
Tamiflu and Zanamivir	They act on influenza A and B by inhibiting the activity of neuraminidase in their shell, which contributes to the release of mature viruses from infected cells of the respiratory tract. According to statistics, when using these drugs from the first days of the disease, in 40% of cases there is a significant improvement in the condition of patients and a reduction in the period of illness, in 50% - the incidence of complications decreases.	Tamiflu Appointed from the age of one year. It is taken orally with or without food, but is better tolerated when taken with food. Zanamivir It is prescribed from the age of five years in the form of inhalations using the supplied inhaler.
Second line drugs acting against a larger number of varieties of viruses: influenza viruses, ARVI pathogens and others.
Viferon - synthetic interferon preparation	Interferon actions: Protects the cells of the body from the penetration of viruses. It starts processes in the cells, due to which the reproduction of the virus is inhibited. Violates the release of viral particles from the infected cell. Moderately stimulates the immune system.	The drug is available in the form of suppositories and is administered rectally - into the rectum. It is used in children from the neonatal period, including premature babies.
Grippferon and Amiksin	Promote the production of interferon in the body. The mechanism of action is the same as that of Viferon.	Amiksin is prescribed to children older than seven years once a day on the 1st, 2nd and 4th day of use. Grippferon for the treatment of influenza is used in drops for the nose.
Groprinosin (Isoprinosine)	Blocks the reproduction of viruses. Stimulates the activity of some cells of the immune system - macrophages, which capture and digest viruses, bacteria and foreign particles. Improves the functioning of the immune system in general.	It is prescribed orally after meals in tablets, starting from the age of three, in syrup - from one year.

On a note!

The duration of taking antiviral drugs for uncomplicated influenza is usually 5 days, for severe - up to 8-10 days. If longer treatment is necessary, the doctor makes a decision individually in each case.

It is important to take antiviral drugs at regular intervals.

Dealing with symptoms of general intoxication

It is aimed at lowering body temperature, reducing pain and improving general condition.

Drinking plenty of water is recommended

Babies can drink mineral water without gases or plain water, weak warm chamomile tea. Older children, if they do not have allergies, can be offered to drink warm tea with raspberries, lemon or honey.

Antipyretics and painkillers

They act on the center of pain and thermoregulation in the brain, helping to lower body temperature and reduce pain.

They also inhibit the production of inflammatory mediators (special substances) in the tissues, which reduce swelling, pain and inflammation.

In children, only drugs based on paracetamol are allowed to be used.(Ceficon D, Panadol, Tylenol) and ibuprofen (Nurofen, Ibuprofen, Advil).

Medicines for ease of use are available in the form of syrups, suppositories and tablets.

Moreover, paracetamol has a more pronounced antipyretic effect, while ibuprofen has an anti-inflammatory and analgesic effect.

In severe cases, a lytic mixture is injected intramuscularly, containing a solution of Analgin, Dimedrol and Papaverine.

Indications for administration:

• The temperature is above 39°C.
• At temperatures up to 38 ° C: age up to three months, there is evidence of the occurrence of seizures against the background of elevated body temperature, the presence of severe chronic diseases.

It is recommended to use the lytic mixture no more than two or three times during the entire period of the disease.

Important!

Children do not use acetylsalicylic acid, as well as preparations based on it (Amidopyrin, Aspirin). Because it causes the development of a large number of complications - for example, Reye's syndrome (acute inflammation of the brain and rapid accumulation of fat in the liver).

Treatment of respiratory tract injury

It is aimed at improving the function of the respiratory system, which contributes to recovery.

To combat a painful dry cough antitussive drugs are prescribed, which reduce its intensity, but do not completely suppress the work of the cough center - for example, Libeksin.

For wet cough means are prescribed that thin and improve sputum discharge: Ambroxol, Bromhexine, Plantain syrup and others.

To restore breathing through the nose drugs are used that reduce local edema: Nazivin, Rinofluimucil, Pinosol and others.

Antihistamines for influenza

Antihistamines reduce swelling of the mucous membrane of the respiratory tract and increase the effect of painkillers. Therefore, breathing through the nose improves, the intensity of coughing decreases and the general condition is facilitated.

When dry coughing Dextromethorphan is used, which, unfortunately, depresses the excitability of the cough center. Therefore, it is used starting from the second trimester of pregnancy. In the first semester - only in case of urgent need.

You can also carry out inhalations 3-4 times a day using an ultrasonic or compressor inhaler, using mineral water or 0.9% saline. They will arrange a kind of "shower" in the airways, moisturizing and washing out mucus from them. Therefore, not only does coughing decrease, but breathing also improves.

Good help inhalations with pharmaceutical preparations, from which solutions for inhalation are prepared. For example, you can use Rotokan, which has an anti-inflammatory effect and promotes the restoration of the respiratory mucosa.

To facilitate nasal breathing

It is allowed to use Pinosol in drops or spray containing essential oils, which locally reduce swelling and inflammation, and also help restore the nasal mucosa.

It is not recommended to use drugs containing vasoconstrictors during pregnancy - for example, Nazivin. Since it has been proven that they can cause the formation of malformations in the fetus.

To fight the influenza virus

It is allowed to use Viferon: in candles from the 14th week of pregnancy, and ointment - at any time. You can also use Grippferon in the form of nasal drops throughout pregnancy.

Tamiflu is prescribed at any stage of pregnancy, but only if the benefit to the expectant mother is higher than the possible risk to the fetus.

Prevention of the development of placental insufficiency

Small doses of drugs are used to prevent blood clotting (Fragmin) and platelet adhesion (Kurantil, Dipipiridamole). Means are also prescribed to improve metabolism and oxygen supply to tissues (Actovegin)

With the addition of a bacterial infection

Antibiotics are prescribed, approved for use during pregnancy, depending on the period: penicillins (Ampicillin, Amoxiclav), cephalosporins (Cefazolin, Ceftriaxone), macrolides (Erythromycin, Vilprafen).

Treatment of severe forms of influenza

It is carried out only in a hospital setting: the symptoms of intoxication are being combated (solutions are administered intravenously), glucocorticoids are prescribed for pulmonary or cerebral edema, and other drugs.

The use of folk remedies

figs helps to reduce dry cough and "scratching" pain behind the sternum.

Pour 100 grams of dried fruits with 400 milliliters of hot milk or water. Then simmer the learned raw materials on low heat for 15-20 minutes, then remove from heat and leave for two to three hours. Take 100 milliliters 2-3 times a day.

turnip juice used to thin and improve sputum discharge during a wet cough.

Method of preparation and use

Grate the turnip on a fine grater and squeeze the juice. Then mix the juice with honey in the ratio: 3 parts turnip juice and 1 part honey. Next, place the resulting raw material on fire and bring to a boil, then remove from heat and cool. Take one tablespoon three to four times daily 10-15 minutes before meals.

However, unfortunately, some folk remedies, instead of benefit, can to harm future mother and fetus - for example, increase the tone of the uterus or provoke the development of uterine bleeding.

Therefore, it is not recommended to use oregano, licorice root and elecampane, pine buds, plantain, coltsfoot, thyme, violet and sage on your own during pregnancy. If necessary, some herbs can be used, but only after consulting a doctor.

An acute infectious highly contagious (highly contagious) disease, which is characterized by damage to the respiratory tract with severe intoxication and fever, provoked by various types of influenza virus, is appropriately called "influenza".

INTERESTING FACT

Raspberry, raspberry jam - not the best remedy for the flu. This berry contains salicylates (similar to acetylsalicylic acid), which help bring down the temperature during a cold. But since the influenza virus acts on the blood vessels and can cause bleeding, even more blood thinning with salicylates can lead to sad consequences.

PHOTO flu

TYPES OF FLU

Distinguish typical and atypical(asymptomatic, erased) forms of the disease.

Influenza viruses have two types of proteins - hemagglutinins (denoted by the letter H) and neuraminidase (denoted by the letter N). Depending on the combination of these proteins, influenza is classified into types - H1N1, H2N2, H3N2 and others.

Clinical forms of influenza

In addition to classification according to the severity of the disease (mild, moderate, severe) and the presence of complications (complicated / uncomplicated course), types of influenza can be differentiated by manifestations. Clinical forms of the disease are divided according to the predominance of certain symptoms and the severity of their manifestations.

Typical forms include: Atypical forms include:

Erased form It proceeds easily, in the absence of intoxication and significant severity of clinical manifestations: without fever (afebrile); without runny nose, cough, other catarrhal symptoms (akataral).

Fulminant (hypertoxic), without the development of hemorrhagic pneumonia stormy start; occasionally possible (or absent) manifestations of catarrh of the upper respiratory tract (pharyngitis, rhinitis, etc.); excruciating headache; high temperature - up to 40 degrees and above (in some cases, a low temperature may be noted); severe adynamia and hypotension; loss of consciousness; muffled heart sounds; weak frequent pulse; vomit; convulsions (in children); rave; cyanosis; dyspnea; meningeal manifestations; intoxication up to a coma; depression of cardiovascular activity (collapse); hemorrhagic syndrome; damage to the nervous system; death after 10 hours - 2 days; occurs rarely, mainly during pandemics, significant epidemics; affects more often children (the probability of development is higher, the younger the child), adults - less often.

Fulminant form with the development of hemorrhagic pneumonia ("Spanish flu" of pathologists, "pulmonary" form, "pneumoflu") Viral damage affects (in addition to the mucous membranes of the upper respiratory tract) the lungs and bronchioles, which manifests itself: the development of pneumonia in the first days of the disease; the formation of hemorrhagic foci of lung lesions, accompanied by the release of bloody-mucous sputum; severe intoxication; shortness of breath; cyanosis; tachycardia; rapid onset of death. There are also signs characteristic of a form of fulminant flow without the development of hemorrhagic pneumonia.

Afebrile and acataral erased forms, like typical ones, proceed in different ways: with or without the development of complications, easily or severely. Fulminant forms are extremely severe, often leading to the death of the patient even before diagnosing the development of complications.

SYMPTOMS OF FLU

The typical form of influenza is characterized by the following symptoms:

• acute onset;
• severe symptoms of intoxication (headache, body aches, pain in the eyeballs, sleep and appetite disorders, lethargy or anxiety, etc.);
• up to 5 days - high (up to 40 ° C) temperature;
• tachycardia and high blood pressure at the onset of the disease, followed by a decrease in pressure and heart rate;
• weak severity of catarrhal symptoms (dry, turning into wet, cough, pain when swallowing, congestion of the pharynx, nasal congestion, poor discharge from it), developing by the 3rd day of the disease;
• recovery on the 7th - 8th day.

In severe form diseases, nosebleeds, convulsions, meningeal symptoms, impaired consciousness, etc.

Atypical erased form is manifested by minor catarrhal symptoms. The asymptomatic form has no manifestations at all and is diagnosed only on the basis of an analytical determination of the increase in the titer of specific antibodies.

The clinical picture of influenza in older children and pregnant women does not differ from the manifestations of the disease in other population groups.

Features of influenza in young children

• Predominant disease after the 3rd - 4th month of life, after a decrease in the level of maternal specific antibodies.
• Gradual onset, blurred symptoms, low temperature, restlessness alternating with lethargy in children of the 1st year of life.
• Lack of development of hemorrhagic syndrome and hyperthermia.
• Possible encephalic reactions with loss of consciousness, repeated vomiting.
• The predominant development of secondary bacterial complications, in most cases, pneumonia.
• Higher mortality compared to older children.

IMPORTANT TO DIFFERENT FROM

• other acute respiratory viral infections (adenoviral infection, parainfluenza);
• diseases, the characteristic manifestations of which are febrile-intoxication syndrome with early development (tonsillitis, scarlet fever, pneumonia, meningococcal infection, salmonellosis, etc.).

DIAGNOSTICS OF THE FLU

• Clinical signs.
• The presence of an epidemic growth of influenza in a given time period.
• Detection of viral antigens in cells of the respiratory tract by enzyme immunoassay and immunofluorescence assays.
• Serological determination of the increase in specific antibodies in the blood serum.
• Virological diagnosis.
• General blood analysis.
• X-ray studies for suspected complications.

flu treatment

FIRST AID

• Ensuring bed rest.
• Doctor's call.
• Reception at the expressed fever of febrifugal means.
• Plentiful drink.
• Wet cleaning of the room, ventilation.

Therapy of a severe disease is carried out in a hospital, for other options home treatment is indicated.

Treatment includes:

• compliance with bed and drinking regimen, diet;
• symptomatic therapy (antipyretics and painkillers - paracetamol, ibuprofen, vasoconstrictor drugs, nasal lavage with saline solutions, etc.);
• in severe cases, antiviral therapy on the first day of the disease or when the condition worsens with oseltamivir and zanamivir (Tamiflu, Relenza);
• antibiotic therapy (determined by the alleged pathogen) in the development of a bacterial complication.

In children and pregnant women in the presence of indications, preparations containing oseltamivir are more often used as an antiviral agent, which is due to the greater knowledge of this substance in these categories of the population. Previously popular rimantadine, amantadine have lost their relevance due to the development of resistant strains.

• start an independent, without medical consultation, taking antibacterial agents;
• use drugs based on acetylsalicylic acid (aspirin) as an antipyretic, especially in children, due to the high risk of developing a life-threatening condition - Reye's syndrome;
• to live an active lifestyle.

VIDEO

FOLK REMEDIES

All traditional medicines, like any other medicinal treatment, have their own contraindications and side effects, so before using them, you should definitely consult with your doctor. Popular means are:

• drinks (decoctions, infusions) based on wild rose, linden;
• honey and other bee products (propolis, etc.);
• garlic (it has been shown that the use of this product for three months does somewhat reduce the risk of colds, however, its therapeutic activity has not yet found sound scientific confirmation);
• vitamin C and products containing it.

CAUSES AND MECHANISM OF THE DEVELOPMENT OF THE INFLUENZA

Influenza viruses belong to the Orthomyxoviridae family (RNA viruses that infect the respiratory tract) and are divided into three types:

• The influenza A virus poses the greatest danger due to its high variability, causing widespread epidemics (every 1-3 years) and pandemics (every 10-30 years) of an explosive nature and a certain seasonality.
• Influenza B virus causes only localized epidemics and outbreaks.
• Influenza C virus causes exceptionally sporadic cases, predominantly in young children.

source of influenza infection- an infected person, starting from the moment of the day before the onset of the first manifestations of the disease and ending with a two-day period after recovery.

Two important antigen proteins are present in the structure of the virus envelope - hemagglutinin (denoted by the Latin H) and neuraminidase (N). In turn, these proteins are of different types, denoted by the corresponding number.

• Hemagglutinin ensures the introduction of the pathogen and its production by the cell.
• Neuraminidase destroys the cell membrane, facilitating the release of the virus.

The production of antibodies that ensure the formation of stable immunity in the body is carried out precisely to these antigens. The particular variability of the type A virus is due to mutations of the mentioned antigens (antigenic drift, antigenic shift). Virus types C and B do not show antigenic drift.

Stages of the pathological process

• The introduction of the virus, its reproduction (duration from a few hours to four days).
• Viremia (the effect of viruses and cellular decay products on the organs, structures and systems of the body, manifested by prodromal phenomena).
• Secondary viral reproduction (accompanied by the development and generalization of the inflammation process with the corresponding symptoms).
• The development of complications of a bacterial nature (not in all episodes of the disease).
• The production of specific antibodies by the body, the extinction of the pathological process.

HOW TO PREVENT?

A specific measure for the prevention of influenza and its grave consequences is vaccination. This event is especially recommended for people from risk groups:

• pregnant women (the frequency of identified post-vaccination complications in this group was 20 episodes per 2 million vaccinated);
• children aged six months to two years;
• the elderly (the risk of death is reduced by 80%, and severe forms of the disease - by 60%);
• residents of nursing homes and nursing homes;
• having chronic pathologies;
• healthcare workers, etc.

Non-specific activities:

• isolation of patients;
• quarantine measures in preschool institutions and schools;
• wearing a sick gauze bandage of industrial production;
• frequent hand washing (a significant reduction in the risk of infection has been proven when following this recommendation and with other SARS).

POSSIBLE COMPLICATIONS

Pulmonary complications:

• bronchiectasis (purulent process in irreversibly changed bronchi);
• pneumosclerosis (proliferation of lung connective tissue);
• pleurisy (inflammation of the serous membrane of the lung);
• purulent mediastinitis (inflammation of the organs of the middle sections of the chest cavity).

Extrapulmonary complications:

• pericarditis (inflammation of the heart bag);
• toxic myocarditis (inflammation of the heart muscle);
• otitis (inflammation of the ear);
• sinusitis (inflammation of the sinuses);
• serous meningitis (inflammation of the meninges);
• purulent encephalitis (inflammation of the brain);
• glomerulonephritis (inflammation of the renal glomeruli);
• neuritis (inflammation of peripheral nerves);
• activation of chronic diseases, etc.

A lethal outcome is possible in severe form - toxic influenza ("acute influenza toxicosis", fulminant form). Much more often, death occurs from cardiopulmonary insufficiency caused by pneumonia (or its complications). In children, croupous asphyxia occurs - a rapidly growing attack of suffocation.

HISTORY REFERENCE

The modern name of the disease comes from the French verb "gripper", meaning "grab, grab". Until the beginning of the last century, the term "influenza" was used, due to the opinion popular in Italy in the Middle Ages that the spread of the epidemic is associated with the influence of heavenly bodies (to influence - "influenze", to invade - "influere").

Actually, a similar pathology was mentioned by Hippocrates in his writings, and she received a detailed description in 1403 thanks to Etienne Pasquier. The influenza virus was discovered in 1933 by the virologists Laidlaw, Smith and Andrews.

Notable pandemics of the 20th century are:

• the "Spanish flu" of 1918-1920, caused by influenza A (H1N1), which claimed more than 40 million lives;
• the "Asian flu" of 1957-58, caused by influenza A (H2N2), 2 million victims;
• Hong Kong flu 1968 (A(H3N2), 1 million).
• pandemic "swine flu" in 2009 (A (H1N1), about 220 thousand).

Influenza is an acute disease with a short incubation period, a sudden onset and a cyclic course, which is characterized by severe toxicosis and damage to the upper respiratory tract and lungs.

The duration of the incubation period for influenza ranges from several hours to 3 days, most often it is 1-2 days.

The influenza clinic can vary significantly depending on the age of the patients, the state of the immune system, the serotype of the virus, its virulence, and the like. It is advisable to consider the following clinical forms of influenza: common (typical) and atypical (afecile, acatarrhal); according to the presence of complications - uncomplicated and complicated. The severity of uncomplicated influenza is determined by the severity and duration of intoxication.

The typical course of the flu

In the clinical picture, two main syndromes are distinguished: intoxication and catarrhal (with damage to the respiratory tract).

Intoxication syndrome

The symptoms of intoxication come to the fore: chills or chilliness, a sharp headache with overwhelming localization in the frontal region and temples, aching muscles, sometimes in the joints, pain when moving the eyeballs or when pressing on them, photophobia, lacrimation, severe weakness and fatigue , lethargy; these symptoms on the first day of the disease dominate the catarrhal syndrome. Weakness in severe cases can reach adynamia. Often it is accompanied by dizziness and fainting.

Already in the first hours of the disease, the body temperature reaches a maximum of 39-40°C. The level of fever reflects the degree of intoxication, but in general these concepts cannot be identified.

Sometimes at a sufficiently high temperature, signs of intoxication are not pronounced, which is mainly observed in young patients with influenza, which is caused by the A (H1N1) virus. Their hyperthermia is short-term, and in the future the disease manifests itself as a moderate degree of severity. The temperature reaction in influenza is acute and relatively short-lived. The fever lasts for 2 to 5 days in influenza A, a little longer in influenza B, and then the temperature decreases by accelerated lysis. In 10-15% of patients, fever has a two-wave character, which is associated with complications caused by the bacterial flora, or exacerbation of chronic diseases.

Headache is the main sign of intoxication and one of the first symptoms of the disease. The pain is usually localized in the frontal region, especially in the region of the superciliary arches, sometimes it is retroorbital in nature. In elderly patients, headache is often diffuse, its degree may vary, but in most cases it is moderate.

Severe headache in combination with insomnia, delirium, repeated vomiting is observed in patients with a severe course of the disease, may be accompanied by meningeal syndrome. In the study of cerebrospinal fluid changes are not detected. In adults, unlike children, seizures rarely occur.

catarrhal syndrome

It is one of the two leading syndromes, often receding into the background. In some cases, it is insufficiently expressed or completely absent. It is manifested by dryness and a sensation of perspiration in the throat, nasal congestion. But the most typical symptom of catarrhal syndrome is tracheobronchitis. It is manifested by a feeling of perspiration or pain behind the sternum, which is due to the inflammatory process of the mucous membrane of the trachea and bronchi, a rough, hacking cough, sometimes paroxysmal with a small amount of sputum. This can lead to an increase in pressure in the system of the superior vena cava and, in case of increased fragility of blood vessels, can contribute to manifestations of hemorrhagic syndrome (nosebleeds, small hemorrhages in the mucous membrane of the oropharynx, sometimes on the skin). During an uncontrollable dry cough, which joins vomiting, there are very severe pains in the upper sections of the rectus abdominis muscles and intercostal muscles along the line of attachment of the diaphragm to the chest. Subsequently, the cough becomes wet. Often joins hoarseness, a feeling of squeezing in the chest. Some experts believe that "scratching" pain behind the sternum is a pathognomonic sign of the flu. The catarrhal syndrome lasts about 7-10 days, the cough lasts the longest.

During an objective examination of patients in the first days of influenza, hyperemia and swelling of the face, hyperemia of the neck, injection of scleral vessels, eye moisture, lacrimation, and moderate conjunctivitis are noted. These symptoms combined resemble the face of a crying baby. From the 3-4th day of illness, herpetic eruptions may appear on the lips, wings of the nose. In severe cases of the disease, pallor of the skin with a cyanotic tint is observed (as manifestations of hypoxia and hypoxemia).

On the mucous membrane of the palate, arches, posterior pharyngeal wall, there is a bright hyperemia, which in patients with severe course has a cyanotic hue (due to circulatory disorders), the injection of the vessels of the soft palate is more pronounced. In some patients, the granularity of the soft palate is revealed, less often - the tongue and arches. The posterior pharyngeal wall is dryish in appearance and has enlarged lymphatic follicles. By the 3rd-4th day of the disease, the hyperemia of the mucous membranes decreases and only the injection of blood vessels remains. Against this background, the granularity of the soft palate becomes more noticeable and petechial hemorrhages are often noticeable.

The mucous membrane of the nose is usually hyperemic with a cyanotic tint, edematous, so nasal breathing is difficult from the first day of the disease, but the amount of discharge from the nose is small. There may be plethora and swelling of the lower conchas of the nose, dryness, and sometimes bleeding of the mucous membrane. Later, as noted, mild serous or mucous discharge appears. Abundant rhinorrhea for influenza is not characteristic. The tongue is moist, evenly lined with a thin white coating. Sometimes there may be a slight increase in the cervical lymph nodes, but usually lymphadenopathy is not characteristic.

The defeat of the respiratory system with influenza is natural. In the feverish period, there may be shortness of breath. With percussion of the lungs, a box sound is often detected. On auscultation of the lungs (in the absence of complications), breathing is vesicular, with a hard tone, sometimes single dry rales are heard. On Rg-grams, an increase in the vascular pattern is visualized, an expansion of the roots of the lungs, which can be mistakenly diagnosed as pneumonia.

On the part of the cardiovascular system, the following changes are noted: the pulse at first more often corresponds to temperature, relative bradycardia or tachycardia is less often noted. Persistent tachycardia at the height of the disease is prognostically unfavorable, especially in elderly and senile patients with chronic diseases of the heart, blood vessels and respiratory apparatus. In many patients muffled heart sounds are heard, especially in severe forms of the disease. In older patients, unlike young ones, complaints of pain in the heart area, angina pectoris attacks are possible. Arterial pressure during the height of the disease tends to decrease. The ECG reveals changes typical of toxicosis: a decrease and serration of the P wave, a decrease in the T wave in various leads, a relative lengthening of the Q-T interval, and a lengthening of the P-Q interval. This indicates diffuse toxic damage to the myocardium. The described changes disappear within 1-2 weeks. However, the nature of myocardial damage in influenza has not yet been elucidated. Some researchers consider it as a manifestation of influenza myocarditis, the second attribute changes in the heart to nonspecific dystrophic disorders, and others attach primary importance to vascular lesions.

The use of echocardiography in the dynamics of influenza expands the prevailing views on the nature of myocardial changes in this infection. Echocardiography allows to detect changes in the myocardium in cases where it is not possible to diagnose changes in the myocardium clinically and by means of ECG. Echocardiographic changes are manifested by such signs: a moderately pronounced expansion of the ventricular cavities (mainly the right one), the appearance of local disturbances in the contractile function of the myocardium, changes in central hemodynamics with a tendency to hyperkinetic type. The basis of these processes is the deterioration of blood circulation in a small circle, an increase in pressure in a. pulmonalis as a result of an increase in peripheral resistance in the vessels of the lungs, an increase in the load on the right heart.

Changes in the gastrointestinal tract are not typical for influenza. In severe forms, appetite is reduced up to anorexia. The tongue remains moist, covered with a white coating. The abdomen is soft, painless on palpation. The liver and spleen are not enlarged. The stool is often delayed, it can rarely be loosened. Sometimes with such erroneous diagnoses as “influenza with intestinal syndrome”, “influenza intestinal form”, it usually turns out to be a pathology that is caused by adenoviruses or intestinal Coxsackie and ECHO viruses, shigella and salmonella, and sometimes by the action of drugs. Sometimes short-term diarrhea with influenza can be associated with an exacerbation of chronic diseases of the gastrointestinal tract. These changes are nonspecific, they are associated with changes in the tone of the autonomic nervous system under the influence of toxins. The opinion of some doctors about the "intestinal form" of the flu is completely unfounded.

Damage to the central nervous system in a severe course of the disease is manifested by dizziness, sleep disturbance, vomiting, and manifestations of meningism. With damage to the peripheral nervous system, there are local hyperesthesias and paresthesias of the skin, trigeminal neuralgia, intercostal and other nerves. Especially often there are functional disorders of the autonomic nervous system in the form of facial flushing, sweating, pulse lability.

Clinical signs of damage to the urinary system in uncomplicated influenza are not detected.

From general clinical laboratory research with influenza, a complete blood count is important. On the first day, 1/3 of patients develop leukocytosis (up to 10-12x10 9 /l) with a moderate stab shift due to an increase in the number of circulating neutrophils. On the second day, the number of neutrophils rapidly decreases, leukopenia develops, which persists until the end of the fever period, and sometimes longer.

The dynamics of the content of lymphocytes in such patients is different. When volunteers were infected with influenza, a significant decrease in the number of lymphocytes in the circulating blood was detected several hours before the onset of the disease. Absolute lymphopenia is characteristic of influenza and is observed throughout the entire period of the disease. At the height of the disease, relative lymphocytosis (due to neutropenia) occurs. At the beginning of convalescence, there is a tendency to normalize the blood count. ESR in most cases remains close to normal. Indicators of hemoglobin, erythrocytes, hematocrit usually do not change.

The decrease in the level of neutrophils in the peripheral blood is explained by their migration to the focus of inflammation, as well as increased production of cortisol in a stressful situation, which is an influenza infection for the body.

Changes in urine are not typical. But at the height of the fever, slight proteinuria is possible as a result of toxicosis and circulatory disorders.

Based on the degree of toxicosis, the severity of the catarrhal syndrome, light, moderate, severe and fulminant (fulminant, hypertoxic) forms of influenza are distinguished. The latter form is considered by many experts as a complication of influenza.

At mild form flu body temperature does not exceed 38 ° C and normalizes after 2-3 days. Symptoms of general intoxication and catarrhal syndrome are mild. In some cases, in the clinic, this form is not much different from acute respiratory infections of another etiology.

Moderate form influenza is characterized by an increase in body temperature up to 39 ° C, pronounced symptoms of intoxication and damage to the respiratory system. The fever lasts up to 4-5 days. This form of influenza is the most commonly reported.

Severe form influenza is manifested by the rapid development and significant severity of intoxication, fever and catarrhal phenomena. Characteristic:

• acute onset;
• high and longer fever (39-40°C) with pronounced intoxication;
• severe weakness up to complete adynamia;
• severe muscle pain and headache;
• drowsiness or insomnia, dizziness;
• possible delirium, hallucinations, loss of consciousness, convulsions;
• nausea, repeated vomiting;
• earthy skin tone;
• constant shortness of breath, aggravated by movement;
• positive pinch symptom;
• often develop meningeal and postencephalitic syndromes;
• respiratory complications are often observed, and first of all - viral-bacterial pneumonia.

Complicated forms of influenza

Lightning (hypertoxic) form.

An extreme manifestation of a severe form of influenza, which is characterized by severe neurotoxicosis with the development of cerebral edema; cardiovascular, respiratory failure (acute hemorrhagic pulmonary edema, bronchiolitis, stenosis of the larynx, etc.); progressive DVM syndrome; characterized by a rapidly progressive deterioration of the patient's condition, tachypnea, tachycardia, stabbing chest pains, "rusty" sputum, increased shortness of breath, cyanosis of the skin with a gray tint. There is an extreme severity and rapid course of the disease.

The most common syndrome in severe and complicated forms of influenza is acute respiratory failure (ARF). It may be due to:

• reduction of the respiratory surface of the lungs;
• obstruction of the bronchial tree with sputum;
• violation of diffuse properties;
• reduction of functioning areas (atelectasis, collapse);
• inadequate function of the respiratory muscles;
• violation in the surfactant system;
• dysfunction of the respiratory center or blockade of the afferent links in the regulation of the respiratory muscles;
• mismatch between ventilation and perfusion.

The main clinical signs of ARF are shortness of breath, acrocyanosis, sweating, tachycardia, respiratory rhythm disturbance and neuropsychic status, which depends on the degree of hypoxemia and hypercapnia, metabolic or mixed acidosis. The clinical picture of ARF is divided into three degrees.

I degree characterized by complaints of a feeling of lack of air, anxiety, euphoria. The skin is moist, pale, with slight acrocyanosis. There is increasing shortness of breath (25-30 breaths per minute), a moderate increase in blood pressure. Pa02 reduced to 70 mm Hg. Art., PaCO2 increased to 50 mm Hg. Art.

II degree. Delirium, agitation, hallucinations, profuse sweat, cyanosis (sometimes with hyperemia), significant shortness of breath (35-40 breaths per minute), tachycardia, arterial hypertension.

Pa02 reduced to 60 mm Hg. Art., PaCO2 increased to 60 mm Hg. Art.

III degree. There comes a coma with clonic and tonic convulsions, pupils are wide, significant cyanosis, breathing is superficial, frequent (more than 40 per minute), and only before cardiac arrest does breathing become rare. BP is drastically reduced. Pa02 less than 50 mm Hg. Art., PaCO2 above 70 mm Hg. Art.

The second, no less frequent syndrome in severe and complicated forms of influenza is acute circulatory failure, which, in particular, develops in patients with infectious-toxic shock. The leading role in the development of this complication belongs to viral and bacterial toxins, which cause dysregulation of the peripheral circulation.

The ITSH clinic is divided into 3 stages.

1st stage:

• intoxication without clinical signs of shock. There are chills followed by an increase in temperature to febrile numbers, nausea, vomiting, possible diarrhea;
• hyperventilation - alkalosis (respiratory), cerebral disorders in the form of anxiety or lethargy;
• Blood pressure is normal or slightly reduced, sometimes it can be slightly elevated.

2nd stage:

• the stage of "warm hypertension", which is characterized by low peripheral resistance and high cardiac output;
• symptoms: tachycardia, tachypnea, hypotension, pallor of the extremities with acrocyanosis, oliguria and cerebral disturbances. The lethality of patients reaches 40%.

3rd stage:

• "cold hypotension" - shock with high peripheral resistance and low cardiac output;
• soporous state, which turns into a coma. The skin is pale, cold; may be a petechial rash. Tachycardia, tachypnea, oligoanuria. Violation of thermoregulation - hypothermia. Profound metabolic acidosis. The lethality of patients reaches 60%.

Depending on the phase and depth of shock, the minute volume of circulating blood may be normal, increased or decreased.

In the early stages of shock, a decrease in blood pressure leads to a compensatory increase in the tone of the sympathetic-adrenal system with an increase in blood levels of adrenaline and norepinephrine, which cause spasm of the vessels of parenchymal organs (liver, kidneys), intestines, and skeletal muscles. The result is the stabilization of blood pressure, improvement of blood circulation in the brain and heart.

In the late stages of shock, with insufficient compensatory mechanisms, vasospasm can lead to prolonged ischemia and the development of irreversible changes in tissues and the homeostasis system.

In the terminal phase of the disease, a complication such as brain swelling may occur, which is a consequence of brain tissue hypoxia, hypercapnia, metabolic acidosis, and hyperthermia. The first clinical manifestations are severe diffuse headache, dizziness, nausea, vomiting, the presence of meningeal signs, congestion in the fundus, loss of consciousness, convulsions, increased blood pressure, bradycardia. Bradycardia is the earliest, and oligopnea, on the contrary, is one of the latest symptoms of cerebral edema. When providing assistance to reduce intracranial pressure, a lumbar puncture is indicated, and this must be done very carefully, due to the danger of wedging the cerebellum or medulla oblongata into the foramen magnum.

Toxic hemorrhagic pulmonary edema may appear already in the first days of illness and be the cause of death in severe and fulminant forms of influenza. Against the background of severe intoxication, shortness of breath appears, cyanosis increases; respiratory failure is accompanied by excitation. An admixture of blood appears in the sputum, although this admixture does not cause the development of hemorrhagic pulmonary edema. During auscultation of the lungs, a significant number of different-sized moist rales is heard; shortness of breath, tachycardia increases. In such cases, death occurs very quickly with symptoms of severe respiratory failure.

Swelling of the vocal cords, reflex spasm of the muscles of the larynx can lead to the development of a false croup. This condition occurs in children and young adults and is characterized by the sudden onset of an asthma attack. The attack usually occurs at night, accompanied by anxiety, tachycardia. If you do not provide urgent assistance, the disease can end in death.

A wide variety of changes in the heart muscle - from mild myocarditis, which are detected only on the ECG, to, although rarely, myocardial infarction - can cause vascular disorders. A significant role in the development of such complications is played by the severe course of influenza, the age of the patient. At a later date, endocarditis of an infectious-allergic genesis may occur.

Flu complications can be caused by bacterial flora. More often they appear after the 4-5th day of illness, sometimes even earlier. The most characteristic of them is pneumonia of a diverse nature: focal, segmental, confluent. The very presence of viral pneumonia is not recognized by everyone. It is assumed that viruses cause a violation in the system of local defense of the lungs (T-cell deficiency, impaired phagocytic activity, damage to the ciliary apparatus), which contributes to the occurrence of bacterial pneumonia. Viral (or "post-viral") pneumonia is often not recognized even in patients who have a "protracted course" of acute respiratory viral infections, develop signs of bronchial obstruction, and changes in the blood are detected. Such patients are often diagnosed with residual effects of an acute respiratory viral infection. The clinical picture is dominated by manifestations of the corresponding viral infection - influenza. Physical and radiographic symptoms in viral pneumonia are generally scanty.

Clinically, pneumonia is manifested by a cough, and a dry flu-like cough is often replaced by a cough with sputum (mucopurulent, purulent). Often patients complain of chest pain, shortness of breath. Objectively, a change in percussion sound is determined over the focus of inflammation; against the background of weakened breathing, crepitus or small bubbling rales are heard. The right lung is most commonly affected.

A severe course of such a complication is more often observed with pneumonia that occurs in the first days of an influenza infection, in contrast to pneumonia that develops at a later date. Pneumonia caused by staphylococcus aureus is especially severe and is known to be prone to abscess formation in debilitated patients. The etiological factor of pneumonia can be another flora (enterobacteria, streptococci, pneumococci, Haemophilus influenzae).

Severe forms of pneumonia can complicate adult respiratory distress syndrome (ARDS), which has a high mortality rate of up to 60%. ARDS is known to have three stages:

1. preclinical, which is characterized by morphological signs of damage to the capillaries of the alveolar membranes;
2. the acute stage, which develops during the first week after the action of the damaging factor, is characterized by the development of interstitial and alveolar edema, inflammatory changes with a large number of polymorphonuclear leukocytes and fibrin both in the exudate inside the alveoli and in tissue infiltrates, hyaline membranes;
3. the stage of organization of exudate and proliferation of second-order pneumocytes, which lead to interstitial fibrosis. The processes of organization begin from the 2-3rd day of the disease.

There are 4 periods in the clinical picture of RDSD.

I period - hidden, or the period of action of the etiological factor (lasts about 24 hours). In this period there are no clinical and radiological manifestations. However, tachypnea (more than 20 breaths per minute) is often observed.

II period - initial changes that occur on the 1st-2nd day from the onset of the etiological factor. The main clinical symptoms of this period are moderate dyspnea and tachycardia. Auscultation of the lungs may reveal harsh vesicular breathing and scattered dry rales. On radiographs of the lungs, there is an increase in the vascular pattern, mainly in the peripheral regions. These changes indicate the onset of interstitial pulmonary edema. The study of the gas composition of the blood either has no deviations from the norm, or a moderate decrease in Pa02 is detected.

III period - deployed, or the period of pronounced clinical manifestations, which is characterized by severe symptoms of acute respiratory failure. Severe shortness of breath appears, auxiliary muscles take part in the act of breathing, swelling of the wings of the nose and retraction of the intercostal spaces are clearly visible, pronounced diffuse cyanosis is observed. During auscultation of the heart, tachycardia and deafness of heart tones are noted, arterial pressure is significantly reduced.

Percussion of the lungs reveals dullness of percussion sound, more in the posterior lower sections, auscultatory - hard breathing, hard wheezing can be heard. The appearance of wet rales and crepitus indicates the appearance of fluid in the alveoli (alveolar pulmonary edema of varying degrees).

X-rays of the lungs reveal pronounced interstitial pulmonary edema, as well as bilateral infiltrative shadows of irregular cloudy shape, which merge with the root of the lungs and with each other. Very often, in the marginal sections of the middle and lower lobes, against the background of an enhanced vascular pattern, foci-like shadows appear.

Characteristic for this period is a significant drop in Pa02 (less than 50 mm Hg, despite oxygen inhalation).

IV period - terminal. It is characterized by a pronounced progression of respiratory failure, the development of severe arterial hypoxemia and hypercapnia, metabolic acidosis, the formation of acute cor pulmonale as a result of increasing pulmonary hypertension.

The main clinical symptoms of this period are:

• severe shortness of breath and cyanosis;
• profuse sweating;
• tachycardia, deafness of heart tones, often various arrhythmias;
• a sharp drop in blood pressure up to collapse;
• cough with pink frothy sputum;
• a large number of wet rales of various calibers in the lungs, abundant crepitus (signs of alveolar pulmonary edema);
• development of signs of increasing pulmonary hypertension and acute pulmonary heart syndrome (splitting and accent of II tone on the pulmonary artery; ECG signs - high spike P waves in leads II, III, avL, VI-2; pronounced deviation of the electrical axis of the heart to the right; radiographic signs of an increase pressure in the pulmonary artery, protrusion of its cone);
• development of multiple organ failure (impaired kidney function, which is manifested by oligoanuria, proteinuria, cylindruria, microhematuria, increased blood levels of urea, creatinine; impaired liver function in the form of mild jaundice, a significant increase in blood levels of alanine aminotransferase, fructose-1-phosphate aldolase, lactate dehydrogenase; dysfunction of the brain in the form of lethargy, headache, dizziness, clinical signs of cerebrovascular accident are possible).

The study of the gas composition of the blood reveals deep arterial hypoxemia, hypercapnia; study of acid-base balance - metabolic acidosis.

With influenza, the development of arachnoiditis is also possible. Its development is based on a violation of cerebrospinal fluid dynamics as a result of hyperproduction of cerebrospinal fluid and damage to blood vessels with the formation of a focal adhesive process that disrupts the absorption of cerebrospinal fluid by the venous network, which, in turn, increases the violation of CSF circulation. Clinical manifestations of this process are regularly recurring attacks of headache, dizziness, as well as nausea, weakness. These symptoms may appear as early as 2-3 weeks after the flu.

A severe course of influenza, especially in persons with a burdened history (hypertension, atherosclerosis), may be accompanied by hemorrhage in the brain tissue, followed by the development of paralysis.

Guillain-Barré syndrome can also occur with the flu. It is characterized by the development of peripheral paralysis of the muscles of the limbs while maintaining superficial sensitivity. The process can spread from the bottom up with damage to the muscles of the face, pharynx, larynx. In the cerebrospinal fluid, protein-cell dissociation is detected. Fortunately, this syndrome is very rare. Allow infectious-allergic genesis of its development.

Damage to the nervous system during influenza can also be represented by sciatica, neuralgia of various localization, polyneuritis. These complications develop more often already in the period of convalescence and can last from several days to several weeks.

A peculiar and infrequent complication of influenza is Reye's syndrome, which was described as early as 1963. It is characterized by the development of acute encephalopathy and fatty degeneration of internal organs. More often, Reye's syndrome is associated with influenza A and occurs almost exclusively in children under the age of 16 years. This complication begins after the extinction of the clinic of the underlying disease in the period of initial convalescence. The first symptom is sudden vomiting. Encephalopathy, which then grows, is manifested by increased agitation, extreme irritability, aggressiveness, but at the same time there are bright intervals of adequate behavior. This syndrome can develop very quickly: sometimes within a few hours after the onset of vomiting, the child quickly falls into a coma. In 30% of patients at the very beginning of the disease, a slight increase in the liver is also detected, but jaundice does not develop. This is characterized by an increase in the activity of transaminases and an increase in the concentration of ammonia in the blood in combination with hypoglycemia. It is important to note that Reye's syndrome is difficult to differentiate from acute encephalopathies of other etiologies. The diagnosis is considered unquestionable only after it is confirmed by the results of a liver biopsy. In patients, violations of amino acid and fat metabolism are detected. The reasons for the development of the syndrome remain unknown. Possible genetic predisposition. The only thing that is unquestionable is that a previous viral infection is a prerequisite for the development of the disease. Mortality is very high and is 20-56%.

The presence of symptoms of vegetative dystopia and general asthenia is one of the most characteristic features of influenza infection. Usually, all these disorders quickly disappear after the temperature normalizes, but in some patients they persist after the extinction of all clinical manifestations of the infection, sometimes up to a month, that is, they acquire the character of an influenza complication. Symptoms of asthenia (general weakness, sweating, poor sleep, decreased appetite, insomnia, increased fatigue, distracted attention) are combined with pulse lability, unstable blood pressure, and frequent heartbeats. Often there are violations of the emotional sphere (patients become whiny, irritated). In this regard, the concept of “post-viral asthenia syndrome” (SAS) was formed in medicine, which was described back in the 60s by P. Kendell. Asthenia is associated with the action of a biological agent. Many researchers believe that the long-term persistence of viruses is most likely the main reason for the development of SPA. Viremia is accompanied by infection of macrophages and other subpopulations of lymphocytes, which remain carriers of the pathogen for a long time, which forms the development of immunosuppression. SPA often occurs within a month after a viral illness. The duration of this syndrome can be years and depends both on the persistent virus itself, and on the state of the macroorganism and its immune system, as well as on the quality of the treatment of the viral infection that has been carried out.

SPA can also be accompanied by mental disorders - from mild depression to significant behavioral disorders. Neurological symptoms in SPA include sensory impairment, autonomic disorders and myalgia. Often patients are concerned about hyperesthesia in the form of "socks and gloves", a slight subfebrile increase in body temperature.

The phenomenon of neuromyalgia attracts the greatest attention. Pain occurs in an isolated muscle group and is accompanied by muscle weakness and fatigue even with little physical exertion.

The results of clinical analyzes of urine and blood fluctuate within the normal range, and serological examination often allows diagnosing a previous viral infection. Assessment of the immune status indicates a change in the function of lymphocytes, a change in the complement system, as well as suppressor cells. The transferred influenza causes inhibition of the activity of macrophages and neutrophils, in connection with which a syndrome of phagocytosis dysfunction is formed. Against such a background, unmotivated fatigue, an increase in emotional lability cause a misunderstanding in the doctor, who regards them as aggravation.

In addition to the central nervous system, complications from other internal organs are also possible. Thus, sensitization of the mucous membrane of the trachea and bronchi directly by the influenza virus and the decay products of cells infected with the virus is the basis for the development of bronchial asthma. Kidney sensitization by this virus, its antigens, immune complexes underlies the development of glomerulonephritis 1-2 months after the illness. The reliability of the occurrence of such a complication should be determined by the doctor, who, in order to prevent it, may recommend that the patient avoid hypothermia in the coming months.

Vasculitis is the basis of long-term residual effects after the flu.

The transferred influenza, given the decrease in immunological reactivity (anergy), can lead to an exacerbation of chronic diseases that the patient had: tuberculosis, rheumatism, tonsillitis, cholecystocholangitis, pyelonephritis, and the like.

Separately, it should be noted the possibility of complications of influenza in pregnant women, which in the II and III trimesters of pregnancy can lead to miscarriages, stillbirths and congenital defects. They can develop 9-14 days after the flu. If a woman has been ill with the flu in the first half of pregnancy, then the child's risk of developing schizophrenia is significantly increased in the future.

Influenza in different age groups

There are some features of the influenza clinic in different age groups.

At young children symptoms of neurotoxicosis with repeated vomiting, meningism, convulsions against the background of subfebrile or normal body temperature may come to the fore. Sometimes such patients develop bronchiolitis, laryngitis, croup. Cough with croup is rough, barking, breathing is noisy, there is tension on the part of the auxiliary respiratory muscles. Unlike diphtheria croup, the phenomena of stenosis of the larynx are weakly expressed.

For the elderly and senile influenza is dangerous primarily because chronic cardiovascular and respiratory diseases are exacerbated against its background, other chronic foci are activated. Clinically, these patients have a state of hyperactivity. Influenza occurs in patients of this group more often with low body temperature, but with severe symptoms of intoxication, complicated by severe pneumonia. Increased susceptibility to other diseases.

convalescence

Fever in uncomplicated influenza is short-term and ranges from 2 to 5 days, much less often - 6-7 days. Body temperature decreases critically or accelerated lysis, accompanied by sweating. In the future, subfebrile condition may persist. Reducing and even normalizing body temperature does not mean recovery from influenza. From the moment the temperature drops, the general condition of patients improves, the intoxication syndrome quickly decreases. Headaches, catarrhal phenomena disappear, appetite resumes and sleep improves. By this time, the cough becomes softer, mucous sputum appears, which alleviates it, the feeling of perspiration behind the sternum disappears. Usually, the cough, gradually subsiding, lasts another 2-4 days, but if it persists longer and purulent sputum appears, this is already an indicator of the occurrence of a bacterial complication.

The convalescence period for influenza lasts 1-2 weeks. Many convalescents have asthenia that lasts from several days to 2-3 weeks (fatigue, irritability, sleep disturbance, sweating, sensory excitability to light, sound). Diencephalic disorders may appear - low-grade fever, vestibular disorders.

Mostly the flu ends with a full recovery. In recent decades, influenza mortality has not exceeded 1-3 cases per 100,000 population. But there is the so-called "adjusted mortality" during epidemics, which is not directly related to influenza and ranges from 76.7 to 540 cases per 100,000 population in different countries. The risk group, as already noted, primarily includes elderly and senile people with diseases of the cardiovascular system and chronic inflammatory processes. For example, it is known that hypertensive crises and acute disorders of cerebral circulation are more likely to occur in patients with hypertension during the period of influenza.

It should be noted that a feature of the influenza infection is also its ability to "show" secret foci of infection, regardless of their location (inflammatory diseases of the urinary, nervous system, etc.). Accession of a secondary infection at any stage of the disease (high, convalescence) significantly worsens the patient's condition, increases the frequency of adverse outcomes. On this occasion, French clinicians even say that "the flu pronounces a sentence, and the bacterial flora carries it out."

Outcomes of the disease in the direction of virus carriers have not been studied enough. It is known that the immunodeficiency state of the body contributes to the formation of the persistence of the influenza virus. It is still necessary to establish whether immunodeficiency is the main and necessary condition for such an outcome of the disease.

Due to the lack of clear criteria for distinguishing between moderate and severe influenza, dynamic active monitoring of the patient is necessary the day after the initial examination and in the future. If high temperature and intoxication persist, there is no improvement and complications of the disease are detected, the patient is subject to mandatory hospitalization in an infectious diseases hospital.

This disease is characterized by an acute onset. At the same time, it is characterized by a short course, proceeds with the phenomena of general intoxication. It is characterized by an increase in body temperature, damage to the mucous membranes of the upper respiratory tract.

The influenza virus is of several types. Mostly the type of virus is A, A1, A2 and B. The source of infection is only a sick person. Patients are especially contagious in the first one or two days of the disease. What is the transmission mechanism of the influenza virus?

The transmission mechanism of influenza is associated with the spraying of a pathogenic virus in the air when the patient coughs and sneezes. Also important is the conversation of the patient, in which the virus successfully spreads. Including objects containing the smallest droplets of mucus can be contagious.

Transmission is facilitated by close contact between sick and healthy susceptible individuals. Along with isolated cases of influenza, an epidemiological outbreak is observed. That is, mass infection of people is possible.

What it is?

Influenza is a highly contagious human disease. Infection is possible through human contact. This contact is provided as follows:

• at home;
• in transport;
• in a production environment.

In this case, widespread infection is possible. The infection enters the mucous membranes of the throat, nose, upper respiratory tract. The influenza virus is introduced through the mucous membranes, entering the bloodstream.

The flu does not develop immunity. That is, the patient can become infected again. Within the same year, the contagiousness especially develops.

Causes

Influenza is caused by viruses. But factors that reduce immunity are also important. Factors that reduce the body's defenses include:

• hypothermia;
• catarrhal catarrh of the upper respiratory tract.

In the latter case, catarrhal catarrhs ​​of the upper respiratory tract facilitate the introduction of the virus. Vigorous activity of pathogenic bacterial flora is of great importance in the etiology of the disease. At the same time, pathogenic microflora lives:

• oral cavity;
• nasal cavity;
• mucous membrane of the trachea.

Even stress can trigger the flu virus. In this case, the influenza virus spreads into the upper respiratory tract. In the absence of proper treatment, the disease becomes more severe. The risk of complications is high.

Symptoms

The duration of the incubation period is about one to two days. Variations are possible ranging from twelve hours to three days. First, you can consider the usual course of the disease. Uncomplicated influenza is acute.

Uncomplicated influenza is characterized by intoxication and a short period of fever. At the beginning of the disease, chills appear, then the body temperature rises. After four or five hours, the body temperature reaches a value of thirty-eight to thirty-nine degrees.

The patient's condition worsens significantly. The patient is worried about headache, especially in the forehead and superciliary arches. This includes the following symptoms:

• weakness;
• weakness throughout the body;
• pain in the joints;
• dizziness;
• noise in ears.

There is slight hyperemia in the pharyngeal area. The initial period of influenza is manifested by the following symptoms:

• feeling of dryness;
• scratching pain in the throat;
• scratching pain in the pharynx and larynx;
• pain in the chest.

Soon there is a pain sensation in the eyeballs. The pain is especially pronounced when the eyes are turned to the side. Decrease in sense of smell is noted, sound and visual sensitivity becomes aggravated. Some patients experience the following symptoms:

• conjunctivitis;
• lacrimation;
• runny nose;
• dry cough.

Decreased appetite, especially during a fever. The stool may linger. On the part of the nervous system, irritability and significant excitability are noted.

The number of breaths increases. In severe forms of the disease, the nervous and cardiovascular systems are affected. In this case, hemorrhagic phenomena on the skin and mucous membranes are possible.

Significantly improves the patient's condition after a period of fever. Appetite appears, the patient becomes calm. Complications of influenza are the following diseases:

• otitis;
• sinusitis.

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Diagnostics

In influenza, diagnosis includes epidemiological and clinical data. Moreover, there is a correlation between the clinical picture and the presence of a mass epidemic. Consultation of a specialist is widely used in the diagnosis of a disease. It is the therapist who can determine the disease by the clinical picture.

It is also appropriate to consult an otolaryngologist. Especially with the defeat of the pharynx, pharynx. Influenza primarily affects the upper respiratory tract. In laboratory studies, the following picture is revealed:

• leukopenia in the blood;
• lymphocytosis;
• neutropenia with accelerated ESR.

When measuring the respiratory rate, an increase in respiratory movements is observed. When measuring pressure, a decrease in blood pressure is observed. When measuring the pulse, bradycardia is traced. Diagnostics also includes the following studies:

• muffled heart sounds;
• expanding the boundaries of the heart;
• deafness of tones at the apex of the heart

In the later stages of the disease, it is appropriate to use the hemagglutination inhibition reaction. Used in the diagnosis of influenza and serological studies. It is necessary to differentiate the disease with the following diseases:

• water fever;
• rash and;
• hemorrhagic fever.

Prevention

In order to prevent the most severe complications, patients are hospitalized in the infectious diseases department. If the patient stays at home, then isolate him from the people around him in order to prevent mass infection. There are ways to prevent the spread of infection.

• the patient is isolated with a screen;
• carry out current disinfection with a wet method.

Measures to prevent influenza is quarantine. This is especially true in crowded places. Under the condition of quarantine in hospitals, visitors are not allowed.

Active immunization is widely used in the prevention of influenza. Live vaccines are available for influenza vaccinations. Live vaccines are usually prepared from a pure culture of filtering virus. The effectiveness of vaccines is tested in a wide epidemiological experience.

However, influenza vaccination has a number of consequences. Various adverse reactions may occur. Including adverse reactions that contribute to various consequences for the body.

Prevention in most cases includes measures of personal prevention of the disease. Personal hygiene and sanitation matter. Nonspecific prophylaxis includes isolation of the patient. Prevention is also based on the following activities:

• wearing gauze masks;
• separate dishes for the patient;
• using a handkerchief when coughing and sneezing.

A prerequisite for the prevention of influenza is strict adherence to the rules of personal hygiene. This includes strengthening the immune system. It is possible to strengthen the immune system with the help of some activities:

• hardening of the body;
• playing sports;
• the use of vitamins;
• exclusion of stressful situations.

Treatment

Flu patients are isolated at home. Only in severe cases of patients, the treatment is hospitalization. The patient is hospitalized in the infectious diseases department of the hospital. Bed rest is necessary for the entire febrile period.

After lowering the body temperature, the patient is allowed to leave the house. Terms of temporary disability are determined strictly individually. The flu patient is placed in a warm, bright and well ventilated room. For isolation from others, the patient is fenced off with a sheet, a screen.

The room where the patient is located often needs to be ventilated. But so as not to catch a cold of the patient. It is necessary to warmly wrap the patient, put heating pads at the feet. It is necessary to give the patient a hot drink:

• milk;
• sweet strong tea;
• coffee;
• cocoa.

Diet food is also used in the treatment. The diet focuses on easily digestible, high-calorie foods. Food should be varied, rich in vitamins. Treatment is predominantly symptomatic.

Persons caring for the sick must observe personal hygiene. Hygiene includes:

• washing hands with hot water;
• wearing gauze bandages.

The patient needs to allocate individual dishes. After using it, the dishes are boiled. In the presence of complications, influenza is treated as follows:

• antibiotics;
• chemotherapeutic agents.

Of the antibiotics, penicillins, albomycin, streptomycin, norsulfazol are used. In seriously ill patients, penicillin is used. For the treatment of children, intramuscular administration of convalescents is used.

In adults

Influenza in adults can be more severe. The flu develops at any age. It affects both men and women equally. In weakened adults, influenza acquires the most severe course.

Influenza in adults is caused by airborne infection. Mass cases of morbidity are of particular importance. Influenza symptoms in adults are as follows:

• increase in body temperature;
• chills;
• headache;
• cough;
• weakness;
• decrease in work capacity.

The cough may be dry. In the future, when coughing, bronchial secretions may be released. That is wetness. The upper respiratory system is predominantly affected.

If treatment in adults is started in a timely manner, then complications do not arise. In the presence of repeated episodes of the disease, the flu becomes severe. Bronchitis, pneumonia can be detected.

Even with antibiotic treatment, relapses can occur. This is due to the addition of a bacterial infection. It is also associated with insufficient treatment, with interruptions in medical therapy. The virus can adapt to drugs.

In the elderly, the disease also contributes to severe complications. Influenza in older people is most dangerous. The causative agents of the disease are influenza viruses of groups A, B, C.

In children

Influenza in children is a widespread disease. Influenza usually occurs in children with a high body temperature. In children, the flu often inflames the nasopharynx, intoxication of the body occurs.

The causative agents of influenza in children are group A and B viruses. Young children with weakened immune systems are most at risk of infection. A child can become infected in kindergarten, school and in the family.

There are certain measures to prevent influenza in children. These preventive measures include:

• exclusion of contact with the patient;
• wearing a disposable mask.

What are the main symptoms in children? The main symptoms of influenza in children include:

• chills;
• Pain in the eyes;
• photophobia.

On the fourth day of the flu, the child's body temperature drops. That is, it usually drops to normal levels. The trend of the disease in children is as follows:

• after a few days, inflammation of the respiratory tract begins;
• excruciating cough.

After normalization of body temperature in children, sleep disturbance is observed. Including fatigue, weakness and headache. In the treatment of children, antiviral drugs, for example, interferon, are widely used. Including the appropriate use of the following drugs:

• immunostimulating agents;
• cough remedy.

In children with reduced immunity, special importance is attached to drugs that increase immunity. Of the modern drugs, there are antiviral agents that help increase the body's resistance. For example, Anaferon.

Forecast

Influenza is a respiratory disease with a prognosis that depends on the condition of the patient. Most often, the prognosis is favorable. Especially if treatment is started on time.

An unfavorable prognosis is possible with severe influenza. Especially if there are complications. Complications of influenza are various, up to the addition of a bacterial infection.

The state of human immunity has a huge impact on the prognosis. With a weakened immune system, the prognosis may be unfavorable. With strong immunity, the prognosis is best.

Exodus

With influenza, the outcome is usually favorable. A favorable outcome is recovery. Recovery occurs after the inflammatory process.

Complications play an important role in the outcome. In the presence of pneumonia, the outcome is unfavorable. Treatment and recovery can be protracted.

Mortality from influenza is possible in a small percentage of cases. The fatal outcome is a consequence of the severe course of the flu. Therefore, it is necessary to prescribe treatment on time.

Lifespan

With the flu, life expectancy usually does not decrease. With the exception of a severe case of the development of the disease. Life expectancy is higher if the patient complies with the following measures:

• bed rest in the presence of fever;
• antibiotics in severe cases;
• antiviral drugs;
• antitussive drugs.

The condition of the patient influences life expectancy. Namely, the immunity of a sick person. Strong immunity prevents re-infection with the flu. So boost your immunity!