Acute respiratory viral infection (ARVI) in children. Orvi - causes, symptoms and treatment in adults, prevention of acute respiratory viral infections Infectious orvi

Acute respiratory viral infections (ARVI) represent a large group of diseases that are clinically and morphologically similar acute inflammatory respiratory diseases caused by pneumotropic viruses. The frequency of acute viral infections fluctuates significantly at different times of the year, increasing in the autumn-winter period. However, they are constantly found in the population, this applies even to influenza during non-epidemic time. All these viruses RNA-containing- influenza (family Orthomyxoviridae), parainfluenza, respiratory syncytial (family Paramuchoviridae) and DNA containing adenoviruses (family Adenoviridae), enter the human body by airborne droplets. The pathological process that occurs in all these diseases proceeds in a fundamentally similar way.

Among SARS are of greatest importance influenza, parainfluenza, adenovirus and respiratory syncytial infections.

Pathogenesis. The reproduction of these viruses occurs primarily in the epithelial cells of the respiratory organs and consists of several main stages. Initially, the virus is adsorbed on the envelope of a susceptible cell, apparently due to interaction with cell receptors. The next step is the penetration of the virus or its nucleic acid into the cell. With the flu this is due to the enzyme of the virus - neuraminidase. Active absorption of the virus by the cell is also possible ("viropexy" or "pinocytosis"). Only a few tens of minutes can elapse between the penetration of a virus into a cell and the appearance of progeny in the form of many hundreds of viral particles. The reproduction of the virus is carried out by the host cell on viral matrices; therefore, its rate depends on the rhythm of the initial metabolism in the host cells.

Viruses can be detected by electron microscopy, although this is only possible when the virus particles are fully formed. It is easier to detect their antigen in an immunofluorescent study. Large accumulations of viruses are also detected by light microscopy in the form of basophilic granules.

Under the influence of a multiplying virus, cell damage occurs. First of all, alterative changes occur, reaching partial necrosis or leading to the death of the entire cell. Such areas of necrosis, intensely stained with basic fuchsin, are designated by the term fuchsinophilic inclusions. Perhaps their partial rejection along with the apical part of the cytoplasm. Along with this, there is a change in the shape of the affected cell - giant cell metamorphosis. Such cells significantly increase in size, both due to the cytoplasm and the nucleus. The nucleus in RNA viral infections remains light. In infections caused by parainfluenza viruses and respiratory syncytial, the affected cells are closely connected to each other. In this regard, they form outgrowths or thickenings, similar to those symplastam that occur in tissue cultures.

There are also circulatory disorders, manifested primarily by increased permeability of the walls of blood vessels. As a result of this, moderate edema develops, sometimes combined with the formation of hyaline membranes - dense protein masses formed from blood plasma proteins and located along the walls of the alveoli, as well as hemorrhages, usually small.

Focal collapse of the lungs is also naturally observed, more often with viral infections with a longer course. These focal collapses of the lungs (partial atelectasis or distelectasis) are associated with a violation of the formation of surfactant.

In the later stages of the disease, regeneration of the epithelium occurs, growing from the growth zones to the exposed surface. Regeneration is often complete. But sometimes, especially with repeated SARS, a multi-row epithelium develops and even true metaplasia of the epithelium.

Macroscopic changes in uncomplicated acute respiratory viral infections, including influenza, are moderate and consist in catarrhal inflammation of the respiratory tract. Their mucous membrane is pink, with delicate yellowish overlays. In the respiratory sections, sunken areas of moderate compaction of a reddish-cyanotic or red-violet color are found. Without a secondary infection (bacterial, in particular staphylococcal, or mycoplasmosis), hemorrhagic or fibrinous-necrotic tracheobronchitis or foci of abscessing or hemorrhagic pneumonia ("large motley lung"), even with influenza, no visible changes are detected.

In immunodeficiency states (primary or secondary), and in children and without them, there is the appearance of foci of generalization with damage to many organs (intestines, liver, kidneys, brain, etc.), where a process similar to the lungs develops with a predominant lesion of the epithelium or neuroepithelium.

FLU

Flu(from the French grippe- seize) - SARS caused by influenza viruses. In addition to humans, many mammals (horses, pigs, dogs, cattle) and birds suffer from it. source human disease is only sick person. Hybridization of animal and human viruses is possible, which leads to the variability of the pathogen and the emergence of pandemic dangerous strains.

Etiology. Influenza pathogens - pneumotropic RNA viruses three antigenically determined serological variants: A (A1, A2), B and C, belonging to the family Orthomyxoviridae. Influenza virus particles (virions) are round in shape, 80–100 nm in diameter, and consist of an RNA molecule surrounded by a lipoglycoprotein envelope (capsid). Influenza viruses have hemagglutinins, which are firmly connected to the carbohydrates of the outer membrane of epithelial cells and thus inhibit the action of the ciliated epithelium.

Pathogenesis. The infection is spread by airborne droplets. The incubation period lasts 2-4 days. Primary adsorption, introduction and propagation of the virus are happening in the cells of the bronchiolar and alveolar epithelium, in the capillary endothelium, leading to primary viremia. Via neuraminidase virus dissolves the shell and enters the host cell. RNA polymerase activates the reproduction of the virus. The reproduction of the virus in the epithelial cells of the bronchioles and lungs is accompanied by their death and the release of the pathogen, which colonizes the epithelium of the bronchi and trachea. Acute bronchitis and tracheitis are the first clinical signs of the onset of the disease.

The influenza virus has:

cytopathic (cytolytic) action on the epithelium of the bronchi and trachea, causes its degeneration, necrosis, desquamation;

vasopathic (vasoparalytic) action(plethora, stasis, plasma and hemorrhage);

immunosuppressive action: inhibition of the activity of neutrophils (suppression of phagocytosis), monocytic phagocytes (suppression of chemotaxis and phagocytosis), the immune system (development of allergies, the appearance of toxic immune complexes).

Vasopathic and immunosuppressive effects of the influenza virus define accession of a secondary infection, the nature of local (rhinitis, pharyngitis, tracheitis, bronchitis, pneumonia) and general (dyscirculatory disorders, degeneration of parenchymal elements, inflammation) changes. The introduction of the virus does not always lead to the development of an acute infectious process. Latent (asymptomatic) and chronic forms of the disease are possible, which are of great importance, especially in perinatal pathology.

pathological anatomy. Changes in influenza are different and depend on the severity of its course, which is determined by the type of pathogen (for example, influenza A2 always flows more severely), the strength of its impact, the state of the macroorganism and the addition of a secondary infection. Distinguish according to the clinical course:

light (outpatient);

moderate;

severe form of the flu.

Mild flu characterized by damage to the mucous membrane of the upper respiratory tract and the development acute catarrhal rhino-laringo-tracheobronchitis. The mucous membrane is hyperemic, swollen, edematous with serous-mucous discharge. Microscopically: hydropic degeneration of ciliated epithelium cells, loss of cilia, plethora, edema, infiltration of subepithelial layer by lymphocytes. Desquamation of epithelial cells is noted. In the goblet cells and in the cells of the serous-mucous glands, there is an abundance of CHIC - a positive secret. Characterized by the presence of epithelial cells in the cytoplasm basophilic and oxyphilic (fuchsinophilic) inclusions. small basophilic inclusions represent influenza virus microcolonies, which is confirmed by the method of fluorescent antibodies. Oxyphilic inclusions are a product of the cell's reaction to the introduction of the virus and focal destruction of its organelles. An electron microscopic examination of the bronchial epithelium, in addition to viral particles, can reveal ultrastructures associated with the cell membrane, which form pseudomyelin figures of a bizarre spiral shape. Cytoplasmic inclusions and influenza antigen can be detected in smears from the nasal mucosa at the earliest stage of influenza, which is important for its diagnosis. The mild form of influenza flows favorably, ends in 5-6 days with complete restoration of the mucous membrane of the upper respiratory tract and recovery.

moderate influenza proceeds with the involvement in the pathological process of the mucous membrane of not only the upper respiratory tract, but also small bronchi, bronchioles, as well as the lung parenchyma. Develops in the trachea and bronchi serosanguineous inflammation, sometimes with foci of mucosal necrosis. In the cytoplasm of the bronchial and alveolar epithelium there are inclusions of the virus.

Microscopically in the lungs: plethora, serous, sometimes hemorrhagic exudate, desquamated cells of the alveolar epithelium, single neutrophils, erythrocytes, areas of atelectasis and acute emphysema are visible in the alveoli; the interalveolar septa are thickened due to edema and infiltration by lymphoid cells, hyaline membranes are sometimes found.

The course of moderate influenza is generally favorable: recovery occurs in 3-4 weeks. In weakened people, the elderly, children, as well as patients with cardiovascular diseases, pneumonia can become chronic, cause cardiopulmonary failure and death.

Severe influenza has two varieties:

influenza toxicosis;

influenza with predominant pulmonary complications.

With severe influenza toxicosis comes to the fore severe general intoxication due to the cyto- and vasopathic action of the virus. Serous-hemorrhagic inflammation and necrosis occur in the trachea and bronchi. In the lungs, against the background of circulatory disorders and massive hemorrhages, there are many small (acinous, lobular) foci of serous hemorrhagic pneumonia, alternating with foci of acute emphysema and atelectasis. In cases of a fulminant course of influenza, toxic hemorrhagic pulmonary edema is possible. Small-point hemorrhages are detected in the brain, internal organs, serous and mucous membranes, skin. Often, such patients die on the 4-5th day of the disease from hemorrhages in vital centers or respiratory failure.

Severe flu with pulmonary complications due to the addition of a secondary infection (staphylococcus aureus, streptococcus, pneumococcus, Pseudomonas aeruginosa).

The degree of inflammatory and destructive changes increases from the trachea to the bronchi and lung tissue. In the most severe cases, fibrinous-hemorrhagic inflammation is found in the larynx and trachea with extensive areas of necrosis in the mucous membrane and the formation of ulcers. All layers of the bronchial wall are involved in the process - fibrinous-hemorrhagic panbronchitis occurs, or ulcerative-necrotic panbronchitis occurs. In the presence of diffuse bronchiolitis, the inflammatory process spreads to the lung tissue and the most common complication of influenza occurs - pneumonia. Influenza pneumonia has a number of its features:

it is, first of all, bronchopneumonia;

according to the affected area focal: lobular or lobular confluent;

according to the localization of the inflammatory process from the very beginning, it wears stromal-parenchymal character;

by the nature of the exudate hemorrhagic (fibrinous-hemorrhagic).

Influenza pneumonia differs in severity and duration of the clinical course.. It's connected with immunosuppressive effect of the influenza virus, which defines joining secondary infection. This is also facilitated by severe damage to the entire drainage system of the lungs: diffuse panbronchitis and lympho-, hemangiopathy. Destructive panbronchitis can lead to the development of acute bronchiectasis, atelectasis, and acute emphysema. A variety of morphological changes give the section of the affected lung a motley appearance, and such a lung is referred to as "large mottled influenzal lung". The lungs are macroscopically enlarged, in some places dense, dark red (hemorrhagic exudate), in some places grayish-yellow (foci of abscess formation), grayish (fibrinous exudate) in color.

Influenza pneumonia prone to being so ugly complications how abscess formation, gangrene of the lung. The inflammatory process can spread to the pleura and then a destructive fibrinous pleurisy develops. Perhaps the development pleural empyema which can be complicated purulent pericarditis and purulent mediastinitis. Due to the fact that influenza exudate does not resolve for a long time, it can occur carnification(replacement of exudate with connective tissue). Among other extrapulmonary complications, it should be noted the development of a very formidable complication - serous or serous hemorrhagic meningitis which may be associated with encephalitis. For influenza encephalitis perivascular lymphocytic infiltrates, neuroglial nodules, dystrophic changes in nerve cells, many small hemorrhages are characteristic. In the brain with a severe form of influenza, circulatory disorders lead to acute swelling of its substance, accompanied by wedging of the cerebellar tonsils into the foramen magnum, and death of patients. In addition, it is possible to develop acute nonpurulent interstitial myocarditis. Dystrophic changes in the cells of the intramural ganglia of the heart can cause acute heart failure. Influenza patients often develop thrombophlebitis and thrombarteritis. Finally, acute purulent otitis media (inflammation of the middle ear) is often observed, inflammation of the paranasal sinuses - sinusitis, frontal sinusitis, ethmoiditis, pasinusitis.

Features of the course of influenza in children. In young children, the disease is more severe than in adults; pulmonary and extrapulmonary complications often develop. There is a predominance of general intoxication with damage to the nervous system, an abundance of petechiae in the internal organs, serous and mucous membranes. Local changes are sometimes accompanied by catarrhal inflammation and swelling of the mucous membrane of the larynx, narrowing of its lumen (false croup) and asphyxia.

Acute respiratory viral infections (SARS, acute catarrhs of the upper respiratory tract, acute respiratory infections) are widespread, characterized by general intoxication and predominant damage to the respiratory tract. They belong to anthroponoses with an airborne transmission mechanism. Children get sick more often. They occur as sporadic cases and epidemic outbreaks.

Ordinary people often confuse acute respiratory infections and acute respiratory viral infections, not understanding how to correlate these abbreviations with such concepts as "cold", "pharyngitis", "laryngitis", "tracheitis", etc. At the same time, it is really important to know what the difference is - after all, the correct tactics of subsequent treatment depends on the specific diagnosis.

Doctors make the diagnosis of acute respiratory infections in a situation where they do not know anything about the causative agent of the infection, although its manifestations are obvious. Without specific tests, the results of which often take longer to wait than the disease lasts, it is difficult to say something definite, so experts are limited to this vague concept.

Acute respiratory viral infection (ARVI) is a slightly more specific diagnosis. In practice, an experienced doctor can distinguish between a cold caused by viruses and a cold caused by bacteria with a high degree of probability. These two diseases have a slightly different nature of the course and external manifestations, and a general blood test with an expanded leukocyte formula allows us to confirm the guess. Another nuance is that viral infections are much more likely to cause epidemics (they spread more easily by airborne droplets), therefore, if there are especially many patients with the same symptoms, doctors tend to think that the cause of complaints is SARS.

Pharyngitis, rhinitis, tracheitis, bronchitis, laryngitis and other terms mean the localization (location) of the pathological process. If the causative agent of acute respiratory infections struck the pharynx, then the diagnosis is pharyngitis, if the nose is rhinitis, if the trachea is tracheitis, if the bronchi are bronchitis, if the larynx is laryngitis. At the same time, it is not necessary that each catarrhal disease spreads to only one zone. Often pharyngitis turns into laryngitis (at first the patient complains of a sore throat, and then his voice disappears), and tracheitis - into bronchitis.

Both acute respiratory infections and SARS can occur at any time of the year, because microbes are constantly in the environment. However, in summer, when people's immunity is most resistant to hypothermia, and also in the dead of winter, when the concentration of pathogens in the air is low due to low temperatures, there are almost no mass outbreaks of diseases of this group. The "high" season for SARS is February, when the body's defenses are running out. And acute respiratory infections, in turn, are more often diagnosed in the off-season - in autumn and spring: people at this time often dress inappropriately for the weather.

Etiology

The causative agents of ARVI can be influenza viruses (types A, B, C), parainfluenza (4 types), adenovirus (more than 40 serotypes), RSV (2 serovars), rheo- and rhinoviruses (113 serovars). Most pathogens are RNA-containing viruses, with the exception of adenovirus, the virion of which includes DNA. Reo- and adenoviruses are able to persist in the environment for a long time, the rest quickly die when dried, under the action of UV radiation, conventional disinfectants.

In addition to the ARVI pathogens listed above, some of the diseases in this group may be caused by enteroviruses such as Coxsackie and ECHO.

SARS pathogenesis

The entry gates of infection are most often the upper respiratory tract, less often the conjunctiva of the eyes and the digestive tract. All ARVI pathogens are epitheliotropic. Viruses are adsorbed (fixed) on epithelial cells, penetrate into their cytoplasm, where they undergo enzymatic disintegration. Subsequent reproduction of the pathogen leads to dystrophic changes in cells and an inflammatory reaction of the mucous membrane at the site of the entrance gate. Each disease from the ARVI group has distinctive features in accordance with the tropism of certain viruses to certain parts of the respiratory system. Influenza viruses, RSV and adenoviruses can affect the epithelium of both the upper and lower respiratory tract with the development of bronchitis, bronchiolitis and airway obstruction syndrome, with rhinovirus infection, the epithelium of the nasal cavity is predominantly affected, and with parainfluenza, the larynx. In addition, adenoviruses have a tropism for lymphoid tissue and epithelial cells of the conjunctival mucosa.

Through damaged epithelial barriers, ARVI pathogens enter the bloodstream. The severity and duration of the viremia phase depends on the degree of dystrophic changes in the epithelium, the prevalence of the process, the state of local and humoral immunity, the premorbid background and the age of the child, as well as on the characteristics of the pathogen. Cell decay products that enter the blood along with viruses have toxic and toxic-allergic effects. The toxic effect is mainly directed to the central nervous system and the cardiovascular system. Due to microcirculation disorders, hemodynamic disorders occur in various organs and systems. In the presence of previous sensitization, the development of allergic and autoallergic reactions is possible.

The defeat of the epithelium of the respiratory tract leads to a violation of its barrier function and contributes to the attachment of the bacterial flora with the development of complications.

signs

Characterized by moderately severe symptoms of general intoxication, a predominant lesion of the upper respiratory tract and a benign course. Localization of the most pronounced changes in the respiratory tract depends on the type of pathogen. For example, rhinovirus diseases are characterized by a predominance of rhinitis, adenovirus - rhinopharyngitis, parainfluenza is manifested by a predominant lesion of the larynx, influenza - trachea, respiratory syncytial viral disease - bronchi. Some etiological agents, in addition to damage to the respiratory tract, cause other symptoms. With adenovirus diseases, conjunctivitis and keratitis can occur, with enteroviral diseases - symptoms of epidemic myalgia, herpangina, exanthema. The duration of SARS, not complicated by pneumonia, ranges from 2-3 to 5-8 days. In the presence of pneumonia, the disease can be delayed up to 3-4 weeks.

SARS symptoms

Common features of SARS: a relatively short (about a week) incubation period, acute onset, fever, intoxication and catarrhal symptoms.

adenovirus infection

The incubation period for adenovirus infection can range from two to twelve days. Like any respiratory infection, it begins acutely, with a rise in temperature, runny nose and cough. The fever can last up to 6 days, sometimes it runs into two oxen. Symptoms of intoxication are moderate. For adenoviruses, the severity of catarrhal symptoms is characteristic: abundant rhinorrhea, swelling of the nasal mucosa, pharynx, tonsils (often moderately hyperemic, with a fibrinous coating). The cough is wet, sputum is clear, liquid.

There may be an increase and soreness of the lymph nodes of the head and neck, in rare cases - lienal syndrome. The height of the disease is characterized by clinical symptoms of bronchitis, laryngitis, tracheitis. A common symptom of adenovirus infection is catarrhal, follicular, or membranous conjunctivitis, initially, usually unilateral, predominantly of the lower eyelid. In a day or two, the conjunctiva of the second eye may become inflamed. In children under two years of age, abdominal symptoms may occur: diarrhea, abdominal pain (mesenteric lymphopathy).

The course is long, often undulating, due to the spread of the virus and the formation of new foci. Sometimes (especially when serovars 1,2 and 5 are affected by adenoviruses), a long-term carriage is formed (adenoviruses are latently stored in the tonsils).

Respiratory syncytial infection

The incubation period, as a rule, takes from 2 to 7 days, for adults and children of the older age group, a mild course of the type of catarrh or acute bronchitis is characteristic. Runny nose, pain when swallowing (pharyngitis) may be noted. Fever and intoxication are not typical for a respiratory syncytile infection; subfebrile condition may be noted.

The disease in young children (especially infants) is characterized by a more severe course and deep penetration of the virus (bronchiolitis with a tendency to obstruction). The onset of the disease is gradual, the first manifestation is usually rhinitis with scanty viscous secretions, hyperemia of the pharynx and palatine arches, pharyngitis. The temperature either does not rise, or does not exceed subfebrile numbers. Soon there is a dry obsessive cough like that of whooping cough. At the end of the coughing fit, thick, clear or whitish, viscous sputum is noted.

With the progression of the disease, the infection penetrates into smaller bronchi, bronchioles, the respiratory volume decreases, and respiratory failure gradually increases. Dyspnea is mainly expiratory (difficulty exhaling), breathing is noisy, there may be short-term episodes of apnea. On examination, increasing cyanosis is noted, auscultation reveals scattered fine and medium bubbling rales. The disease usually lasts about 10-12 days, in severe cases, an increase in duration, recurrence is possible.

Rhinovirus infection

The incubation period of rhinovirus infection is most often 2-3 days, but can vary within 1-6 days. Severe intoxication and fever are also not typical, usually the disease is accompanied by rhinitis, abundant serous-mucous discharge from the nose. The amount of discharge serves as an indicator of the severity of the flow. Sometimes there may be a dry moderate cough, lacrimation, irritation of the mucous membrane of the eyelids. The infection is not prone to complications.

Diagnostics

Clinical differential diagnosis of sporadic cases of ARVI is difficult, therefore, in the work of a practical doctor, the etiological characteristics of the disease often remain undisclosed. During epidemic outbreaks, characteristic clinical manifestations suggest the etiology of the disease. Confirmation of the diagnosis is the increase in the titer of specific antibodies in paired sera. The first serum is taken before the 6th day of illness, the second - after 10-14 days. The diagnosis is confirmed by an increase in titers by 4 times or more. Use RSK and RTGA. A quick method for deciphering the etiology of diseases is the detection of pathogens using the immunofluorescence method. With the similarity of clinical manifestations, the transferred diseases leave behind only type-specific immunity. In this regard, the same person can carry SARS 5-7 times during the year. This is especially true in children's groups.

Treatment

Regular intake of vitamin C does not reduce the chances of ARVI in the general population, however, in some cases it can reduce the severity and duration of the disease (from 3% to 12% in adults), especially in patients subject to strong physical exertion. Chemotherapy drugs have not yet been developed against most pathogens of acute respiratory viral infections, and timely differential diagnosis is difficult.

SARS is caused by viruses against which antibiotics are useless. Of the antipyretic drugs, non-steroidal anti-inflammatory drugs are used, including paracetamol, and more recently, ibuprofen.

To date, there is only symptomatic treatment. Many people use over-the-counter medications that contain antihistamines, decongestants, analgesics, or a combination of both as a stand-alone treatment for a cold. A review of 27 studies with over 5,000 participants shows some benefit in terms of overall recovery and symptom management. The combination of an antihistamine and a decongestant is most effective, but many people experience side effects such as drowsiness, dry mouth, insomnia, and dizziness. There is no evidence of a beneficial effect in young children. The included trials studied very different populations, procedures, and outcomes, but overall the methodological quality was acceptable. There are no antiviral agents effective for colds (nasopharyngitis of a viral nature).

Folk remedies

Folk remedies for the treatment of flu and colds do not destroy viruses, but facilitate the course of the disease.

In the treatment of colds, the following medicinal herbs are used:

Bactericidal - chamomile, calamus root, pine and spruce needles, sage.
2. Diuretic - lingonberry leaf, nettle, strawberry leaf, carrot tops.
3. Diaphoretics - lime blossom, raspberries, ginger with honey.
4. Immunostimulating - strawberries, calendula, wild rose, plantain.
5. Vitamin - rosehip, nettle, mountain ash.

Here are some recipes for anti-cold decoctions :

Brew in a thermos 1 tbsp. a spoonful of dried parsley in half with celery or dill 0.5 liters of boiling water. Insist the night, strain. Drink the resulting decoction during the day in small portions with an interval of 2-3 hours.
When the voice disappears during a cold, a decoction of lungwort helps well: 1 tbsp. a spoonful of flowers in a glass of boiling water, leave for 1 hour, strain, take in small sips throughout the day.

Complications of SARS

ARVI can be complicated in any period of the disease. Complications can be either viral in nature or result from the addition of a bacterial infection. Most often, acute respiratory viral infections are complicated by pneumonia, bronchitis, bronchiolitis. Common complications also include sinusitis, sinusitis, frontal sinusitis. Often there is inflammation of the auditory apparatus (otitis media), meninges (meningitis, meningoencephalitis), various kinds of neuritis (often - neuritis of the facial nerve). In children, often at an early age, false croup (acute stenosis of the larynx), which can lead to death from asphyxia, can become a rather dangerous complication.

With high intoxication (in particular, characteristic of influenza), there is a possibility of developing seizures, meningeal symptoms, heart rhythm disturbances, and sometimes myocarditis. In addition, SARS in children of different ages can be complicated by cholangitis, pancreatitis, infections of the genitourinary system, and septicopyemia.

Disease prevention

By now, 100% protection against acute respiratory infections or SARS is impossible: even if you have been vaccinated, it is likely that the disease will be caused by another pathogen. However, this does not mean that we must accept the prospect of taking a sick leave every year and dropping out of life for a few days, catching a cold.

An important method of preventing both acute respiratory infections and acute respiratory viral infections is regular hand washing: we often become infected as a result of touching objects that have particles of saliva or mucus discharged from the nose of a sick person. During the period most conducive to respiratory diseases - in spring and autumn - try not to overcool and ventilate the rooms where you live and work more often. Avoid close contact with people who have a cold.

ARI is a large group of diseases, the most common of which are SARS. They affect both adults and children. Without treatment, viral infections are often complicated by secondary bacterial pathologies, which can be dangerous not only for health, but also for life. Only a competent doctor can distinguish acute respiratory infections from acute respiratory viral infections - based on the results of the examination and laboratory diagnostics, so in no case neglect a visit to the doctor.

Acute respiratory infections (SARS)

a group of viral infectious diseases, the pathogens of which are transmitted by airborne droplets; characterized by damage to the mucous membranes of the upper respiratory tract and pharynx. This group of diseases includes Influenza, parainfluenza, adenovirus, respiratory syncytial and rhinovirus infection.

The source of ARVI pathogens are only people - sick or virus carriers. Transmission of the virus from person to person occurs mainly by airborne droplets; it is also possible through household items (for example, dishes, towels). Most people get SARS every year, sometimes several times. Especially often children get sick, starting from the second half of the year of life (in the first 6 months, congenital, received from the mother during pregnancy, is usually preserved). Children attending kindergartens get ARVI up to 5-10 times a year, which can lead to a significant weakening of their immune system, the development of chronic diseases of the respiratory system, kidneys, ears, paranasal sinuses, allergic diseases, delayed physical and mental development. Adults get sick with SARS more easily and less often, but, carrying them “on their feet”, they are often a source of infection for children.

With all SARS, epithelial cells of the mucous membranes of the upper respiratory tract are affected, which are a barrier to penetration into many microbes, therefore, with SARS, various complications caused by these microbes are possible.

The clinical picture of various SARS is similar. All of them are manifested by an increase in body temperature, general intoxication in combination with cough, runny nose, sneezing, sore throat. The most common complications of SARS are otitis, in children -. SARS can be accompanied by an exacerbation of chronic diseases (nephritis, pyelitis, rheumatism, chronic pneumonia, etc.). At the same time, each of this group has its own characteristics.

parainfluenza infection() is characterized by a predominant lesion of the mucous membrane of the larynx and nose. Individual cases of parainfluenza are observed throughout the year, the incidence rises in the autumn-winter period. Children are more often ill, especially up to 2 years. The incubation (hidden) period is from 2 to 7 days. In adults, the disease begins with a slight malaise, headache, weakness. normal or subfebrile. In children, it can reach 38-39 ° and stay for several days. From the first day of illness appear rough barking, hoarseness, nasal congestion and abundant mucous, and then mucopurulent discharge from the nose. In an uncomplicated course, the disease lasts 7-10 days.

adenovirus infection manifested by fever, cough, runny nose, sore throat when swallowing, swollen lymph nodes, lesions, and sometimes diarrhea. Sick people secrete the pathogen (adenovirus) not only when they cough and, but also with feces, so infection occurs both by airborne droplets and through contaminated household items. Children (from 6 months to 5 years) get sick more often in the cold season. lasts from 3 to 14 days. The first sign of the disease is a rise in body temperature to 38-39 °, and sometimes even higher. Moderate, weakness, loss of appetite are noted, in some patients - abdominal pain, diarrhea. From the very first day of the illness, watery discharge from the nose appears, nasal obstruction. and the mucous membrane of the pharynx are inflamed. Often there is a wet cough. The eye is characteristic, first one, and after 1-2 days - the second. At the same time, pain appears in the eyes, swell, redden. The neck enlarges and becomes painful, sometimes the spleen and enlarge.

Respiratory syncytial infection characterized by a predominant lesion of the bronchi and lungs. Mostly children from 4-5 months are ill. up to 3 years. Among adults and older children, there are isolated cases of the disease. As with other acute respiratory viral infections, the incidence is observed in the cold season. The incubation period lasts from 3 to 7 days. In adults and older children, the general condition is slightly disturbed, the body temperature is normal or does not exceed 38 °. The most characteristic of the disease is a persistent painful dry cough. in the absence of complications lasts up to 10 days. In children under 1 year old, there is a high body temperature, nasal congestion, sneezing, dry cough, which quickly intensifies, becomes paroxysmal, sometimes accompanied by vomiting. In severe cases, there are signs of respiratory failure (increased breathing, blue face, swelling of the wings of the nose), caused by bronchitis or pneumonia.

Rhinovirus infection characterized by a predominant lesion of the mucous membrane of the nose and pharynx. Especially often recorded in the autumn-winter period. People of all ages get sick, but more often children visiting and schoolchildren. The incubation period is 2-4 days. The onset of the disease is acute. There is a slight malaise, chilling, fever up to 38 °, nasal congestion, sneezing, sore throat. By the end of the first day, abundant mucous discharge from the nose appears, on the 2-3rd day they become mucopurulent. The acute stage of the disease lasts about 7 days.

The diagnosis of various SARS can be confirmed by special laboratory methods. The vast majority of patients are treated at home. At the same time, it is better to place a patient with ARVI in a separate room or fence off his bed with a screen. The room is systematically ventilated, wet cleaning is carried out daily. The patient is given a separate dish. During the entire period of elevated body temperature, patients must comply with bed rest. A special diet is not required, but pickles, spicy seasonings, and fried foods should be excluded. It is advisable to drink plenty of water: tea with honey, raspberry or lingonberry jam, warm milk, fruit drinks, compotes. Desirable fruits and C and group B in age dosages. Useful inhalations with menthol, eucalyptus oil. A good effect is given by the use of an inhaler (camphomen, inhalipt, etc.), thermal procedures (, mustard foot, rubbing with camphor alcohol, turpentine ointment). At high body temperature, acetylsalicylic acid, analgin, from the common cold, antitussive and leukocyte are used. Antibiotics are not effective for ARVI either, they should be used only as directed by a doctor if complications are present or threatened.

The prognosis of the disease is favorable, but in young children, severe complications are possible. Persons who have had contact with patients with acute respiratory viral infections are prescribed leukocyte interferon. When caring for the sick, it is necessary to wear a gauze bandage that covers the nose as well. Hardening procedures are of great preventive importance.

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what "Acute respiratory infections" is in other dictionaries:

Acute respiratory infections- (ARVI) a group of viral infectious diseases, the pathogens of which are transmitted by airborne droplets; characterized by damage to the mucous membranes of the upper respiratory tract and pharynx. This group of diseases includes influenza, parainfluenza, ... ... First aid - popular encyclopedia

ACUTE RESPIRATORY VIRAL INFECTIONS (ARVI)- - a group of acute human infectious diseases transmitted by airborne droplets and characterized by a predominant lesion of the respiratory system. SARS are the most common human infectious diseases. ARVI includes ... ... Encyclopedic Dictionary of Psychology and Pedagogy

Acute contagious diseases, manifested by sneezing, stuffy nose, runny nose, inflammation of the nasopharynx and cough. These diseases, also called acute respiratory viral infection (ARVI), are extremely common and occur in all ... ... Collier Encyclopedia

Acute respiratory viral infection (ARVI), obsolete. ARI (acute respiratory disease), CVDP (upper respiratory tract catarrh), in the common cold, a common viral disease of the upper respiratory tract. The main symptoms of SARS ... Wikipedia

- (ARI) catarrhs of the upper respiratory tract, a group of infectious diseases (mainly of viral origin), characterized mainly by lesions of the upper respiratory tract. The source of infection is a sick person or a virus carrier. Great Soviet Encyclopedia

CHILDREN INFECTIONS- a group of infections. diseases occurring preim. in children. A common symptom of all infections. diseases, the ability to be transmitted from an infected organism to a healthy one and, under certain conditions, to take on a mass (epidemic) distribution. Source ... ... Russian Pedagogical Encyclopedia

Nosocomial infections ... Wikipedia

Children's infections- a group of diseases that occur mainly in children and can be transmitted from an infected organism to a healthy one and, under certain conditions, take on a massive (epidemic) spread. The source of infection can be not only ... ... Pedagogical terminological dictionary

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A service list of articles created to coordinate work on the development of the topic. This warning did not install ... Wikipedia

Acute respiratory viral infections (ARVI) is a group of acute infectious diseases caused by RNA and DNA-containing viruses and characterized by damage to various parts of the respiratory tract, intoxication, and frequent addition of bacterial complications.

SARS is the most common disease, including in children. Even in non-epidemic years, the recorded incidence of SARS is many times higher than the incidence of all major infectious diseases. During pandemics, more than 30% of the world's population is involved in the epidemic process in 9-10 months, more than half of them are children. The incidence among children of different age groups may differ depending on the properties of the virus that caused the epidemic. However, in most cases, the highest incidence rate is observed in children from 3 to 14 years. SARS often occur with complications (the addition of inflammatory processes in the bronchi, lungs, paranasal sinuses, etc.) and cause exacerbations of chronic diseases. Transferred SARS usually do not leave behind a long-term stable immunity. In addition, the lack of cross-immunity, as well as a large number of serotypes of ARVI pathogens, contribute to the development of the disease in the same child several times a year. Repeated SARS lead to a decrease in the overall resistance of the body, the development of transient immunodeficiency states, a delay in physical and psychomotor development, cause allergization, prevent preventive vaccinations, etc. The economic losses caused by ARVI are also very significant, both direct (treatment and rehabilitation of a sick child) and indirect (associated with the disability of parents). All the circumstances listed above explain the priority of this problem for the health care of any country.

ETIOLOGY

The causative agents of ARVI can be influenza viruses (types A, B, C), parainfluenza (4 types), adenovirus (more than 40 serotypes), RSV (2 serovars), rheo- and rhinoviruses (113 serovars). Most pathogens are RNA viruses, with the exception of adenovirus, the virion of which includes DNA. Reo- and adenoviruses are able to persist in the environment for a long time, the rest quickly die when dried, under the action of UV radiation, conventional disinfectants.

In addition to the ARVI pathogens listed above, some of the diseases in this group may be caused by enteroviruses such as Coxsackie and ECHO. The clinical characteristics of these infections are described in the Enteroviral infections caused by Coxsackie and ECHO viruses section of the Enteroviral infections chapter.

EPIDEMIOLOGY

Children of any age get sick. The source of infection is a sick person. Ways of transmission of infection - airborne and contact-household (less often). The natural susceptibility of children to SARS is high. Patients are most contagious during the first week of illness. ARVI is characterized by seasonality - the peak incidence occurs in the cold season. After the transferred disease, type-specific immunity is formed. SARS are ubiquitous. Large epidemics of influenza occur on average once every 3 years, they are usually caused by new strains of the virus, but it is possible to recirculate strains similar in antigenic composition after several years of their absence. With ARVI of a different etiology, sporadic cases and small outbreaks in children's groups are mainly recorded, there are practically no epidemics.

PATHOGENESIS

the epithelium of the nasal cavity is affected, and with parainfluenza - the larynx. In addition, adenoviruses have a tropism for lymphoid tissue and epithelial cells of the conjunctival mucosa.

The defeat of the epithelium of the respiratory tract leads to a violation of its barrier function and contributes to the attachment of the bacterial flora with the development of complications.

CLINICAL PICTURE

Intoxication and fever are most pronounced with influenza. Parainfluenza occurs with less pronounced intoxication and short-term viremia, but is dangerous, especially for young children, due to the frequent development of false croup. Adenovirus infection is distinguished by gradually descending damage to the respiratory tract, reproduction of the virus not only in the epithelium, but also in the lymphoid tissue, prolonged viremia, some virus serotypes (40, 41) can multiply in enterocytes with the development of diarrhea. RSV affects the small bronchi and bronchioles, which leads to impaired ventilation of the lungs and contributes to the occurrence of atelectasis and pneumonia.

There is no generally accepted classification of SARS in children. According to the severity of the course, mild, moderate, severe and hypertoxic forms are distinguished (the latter is isolated from influenza). The severity of the disease is determined by the severity of symptoms of intoxication and catarrhal phenomena.

Flu

The duration of the incubation period ranges from several hours to 1-2 days. A feature of the initial period of influenza is the predominance of symptoms of intoxication over catarrhal ones. In typical cases, the disease begins acutely, without a prodromal period, with an increase in body temperature up to 39-40 ? C, chills, dizziness, general weakness, feeling of weakness. In children of early

age intoxication is manifested by fever, lethargy, adynamia, loss of appetite. Older children complain of headache, photophobia, pain in the eyeballs, abdomen, muscles, joints, a feeling of weakness, sore throat, burning behind the sternum, sometimes vomiting and meningeal signs appear. Catarrhal phenomena at the height of the disease are usually moderately expressed and are limited to dry cough, sneezing, scanty mucous discharge from the nose, moderate hyperemia of the mucous membrane of the pharynx, "graininess" of the posterior pharyngeal wall. Sometimes pinpoint hemorrhages are found on the soft palate. Slight flushing of the face and injection of sclera vessels are often observed, less often - nosebleeds. Tachycardia and muffled heart sounds are noted. With severe toxicosis, transient changes in the urinary system (microalbuminuria, microhematuria, decreased diuresis) are observed.

The condition of patients improves from the 3-4th day of illness: body temperature becomes lower, intoxication decreases, catarrhal phenomena can persist and even intensify, they finally disappear after 1.5-2 weeks. A characteristic feature of influenza is prolonged asthenia during convalescence, manifested by weakness, fatigue, sweating and other symptoms that persist for several days, sometimes weeks.

In severe cases, it is possible to develop hemorrhagic bronchitis and pneumonia that occur within a few hours. Sometimes within 2 days from the onset of the disease, a progressive increase in dyspnea and cyanosis, hemoptysis, and the development of pulmonary edema are observed. This is how fulminant viral or mixed viral-bacterial pneumonia manifests itself, often ending in death.

Indicators of the general blood test: from the 2-3rd day of illness - leukopenia, neutropenia, lymphocytosis with normal ESR.

parainfluenza

The duration of the incubation period is 2-7 days, on average 2-4 days. The disease begins acutely with a moderate increase in body temperature, catarrhal phenomena and minor intoxication. In the next 3-4 days, all symptoms increase. Body temperature usually does not exceed 38-38.5 ° C, rarely remaining at this level for more than 1 week.

Catarrhal inflammation of the upper respiratory tract is a constant symptom of parainfluenza from the first days of illness. They note a dry, rough "barking" cough, hoarseness and a change in the timbre of the voice, soreness and pain behind the sternum, sore throat, runny nose. Discharge from the nose are serous-mucous. Examination of the patient reveals hyperemia and

swelling of the tonsils, palatine arches, graininess of the mucous membrane of the posterior pharyngeal wall. Often the first manifestation of parainfluenza in children 2-5 years old is croup syndrome. Suddenly, more often at night, there is a rough "barking" cough, hoarseness of voice, noisy breathing, i.e. stenosis of the larynx develops (see the chapter "Acute obstruction of the upper respiratory tract"). Sometimes these symptoms appear on the 2-3rd day of illness. In young children with parainfluenza, not only the upper, but also the lower respiratory tract can be affected; in this case, a picture of obstructive bronchitis develops. With an uncomplicated course of parainfluenza, the duration of the disease is 7-10 days.

adenovirus infection

The incubation period is from 2 to 12 days. The main clinical forms of adenovirus infection in children are pharyngo-conjunctival fever, rhinopharyngitis, rhinopharyngotonsillitis, conjunctivitis and keratoconjunctivitis, pneumonia. The disease begins acutely with fever, cough, runny nose. Fever in typical cases lasts 6 days or more, sometimes it is two-wave. Intoxication is expressed moderately. Permanent symptoms of adenovirus infection - pronounced catarrhal phenomena with a significant exudative component, rhinitis with profuse serous-mucous discharge, granular pharyngitis, rhinopharyngitis, rhinopharyngotonsillitis, tonsillitis with swelling of the tonsils (often with fibrinous overlays), wet cough, polylymphadenopathy, less often enlargement of the liver and spleen. At the height of the disease, signs of laryngitis, tracheitis, and bronchitis are observed. The pathognomonic symptom of adenovirus infection is conjunctivitis (catarrhal, follicular, membranous). The process often involves the conjunctiva of one eye, mainly the lower eyelid (Fig. 19-1 on the insert). After 1-2 days, conjunctivitis of the other eye occurs. In young children (up to 2 years), diarrhea and abdominal pain are often observed due to damage to the mesenteric lymph nodes.

Adenovirus infection proceeds for a rather long time, possibly an undulating course associated with a new localization of the pathological process. Some serotypes of adenoviruses, in particular 1st, 2nd and 5th, can be stored in the tonsils in a latent state for a long time.

Respiratory syncytial infection

The incubation period is from 2 to 7 days. In older children, respiratory syncytial infection usually occurs as a mild catarrhal disease, less often as an acute

bronchitis. Body temperature is subfebrile, intoxication is not expressed. Rhinitis and pharyngitis are observed. In young children, especially the first year of life, the lower respiratory tract is often affected - bronchiolitis develops, which occurs with broncho-obstructive syndrome. The disease begins gradually with damage to the mucous membranes of the nose, the appearance of a scanty viscous discharge, moderate hyperemia of the pharynx, palatine arches, posterior pharyngeal wall against the background of normal or subfebrile body temperature. Note frequent sneezing. Then a dry cough joins, which becomes obsessive, somewhat reminiscent of whooping cough (see the chapter "Whooping cough and parapertussis"); at the end of a coughing fit, thick, tenacious sputum is produced. As the small bronchi and bronchioles are involved in the pathological process, the phenomena of respiratory failure increase. Breathing becomes more noisy, shortness of breath increases, mainly of an expiratory nature. Indrawing of compliant parts of the chest during inspiration is noted, cyanosis increases, short periods of apnea are possible. In the lungs, a large number of scattered medium and fine bubbling rales are heard, emphysema is growing. In most cases, the total duration of the disease is at least 10-12 days, in some patients the process becomes protracted, accompanied by relapses.

In the general blood test, pronounced changes are usually not detected. The content of leukocytes is normal, there may be a slight shift of the leukocyte formula to the left, ESR is within normal limits.

Rhinovirus infection

The duration of the incubation period is 1-6 days, on average 2-3 days. Rhinovirus infection proceeds without severe intoxication and fever, accompanied by abundant serous-mucous discharge from the nose. The severity of the condition is usually determined by the number of handkerchiefs used per day. Discharge during rhinovirus infection is very abundant, which leads to maceration of the skin around the nasal passages. Along with rhinorrhea, dry cough, hyperemia of the eyelids, and lacrimation are often observed. Complications rarely develop.

COMPLICATIONS

Complications in acute respiratory viral infections can occur at any time of the disease and are due to both the direct influence of the pathogen and the addition of bacterial microflora. The most common complications of SARS are pneumonia, bronchitis and bronchiolitis. The second most common place is occupied by sinusitis, otitis media, frontal sinusitis and sinusitis. to severe complications, especially in

children of early age, acute stenosis of the larynx (false croup) should be attributed. Less common are neurological complications - meningitis, meningoencephalitis, neuritis, polyradiculoneuritis. With high fever and pronounced intoxication with influenza, cerebral reactions are possible, proceeding according to the type of meningeal and convulsive syndromes. Severe forms of influenza may be accompanied by the appearance of a hemorrhagic syndrome (hemorrhages on the skin and mucous membranes, increased bleeding, etc.). At the height of intoxication phenomena, functional disturbances in the activity of the heart are possible, sometimes the development of myocarditis. SARS in children of any age can occur with complications such as urinary tract infection, cholangitis, pancreatitis, septicopyemia, mesadenitis.

DIAGNOSTICS

The diagnosis of ARVI is made on the basis of the clinical picture of the disease. The severity and dynamics of the appearance of the main clinical symptoms (fever, intoxication, catarrhal phenomena from the mucous membranes of the respiratory tract, physical changes in the lungs) and epidemiological data are taken into account.

For laboratory confirmation of the diagnosis, rapid methods are widely used - RIF and PCR, which make it possible to determine the Ag of respiratory viruses in the cylindrical epithelium of the nasal passages (in "imprints" from the mucous membrane of the nasal cavity). Less commonly used is the method of determining viral neuraminidase activity in reactions with a specific substrate (to detect the influenza virus). Virological and serological [study of paired sera at the onset of the disease and during the period of convalescence using ELISA, complement fixation test (RCC), hemagglutination inhibition test (HITA)] methods have a retrospective value.

DIFFERENTIAL DIAGNOSIS

Distinctive clinical signs of these infections are presented in table. 19-1.

TREATMENT

Treatment of patients with SARS is usually carried out at home. Hospitalization is indicated only for severe or complicated course of the disease. The volume of therapeutic measures is determined by the severity of the condition and the nature of the pathology. During the period of fever, bed rest must be observed. Traditionally, in the treatment of acute respiratory viral infections, symptomatic (plentiful warm drinks, good nutrition), desensitizing (chloropyramine,

Table 19-1.Differential diagnosis of various acute respiratory viral infections

* According to Gasparyan M.O. et al., 1994.

clemastine, cyproheptadine) and antipyretics (paracetamol, ibuprofen) agents. Acetylsalicylic acid is contraindicated in children (risk of developing Reye's syndrome). They use expectorants (marshmallow medicinal extract, ambroxol, bromhexine, etc.), vitamins, complex preparations [paracetamol + chlorphenamine + ascorbic acid ("Antigrippin"), paracetamol + phenylephrine + chlorphenamine ("Lorain"), caffeine + paracetamol + phenylephrine + terpinhydrate + ascorbic acid (Coldrex), etc.]. With severe rhinitis, solutions of ephedrine, naphazoline, xylometazoline, etc. are used intranasally. In case of eye damage, ointments are prescribed (with bromnaphthoquinone ("Bonafton"), "Florenal"). Antibacterial drugs are indicated only in the presence of bacterial complications, the treatment of which is carried out according to the general rules.

Etiotropic therapy has an effect in the early stages of the disease. They use interferon alfa-2 (Grippferon) for intranasal administration, inducers of endogenous interferons α, β and γ (for example, Anaferon for children), amantadine, rimantadine (for influenza A), oseltamivir, oxolinic ointment, anti-influenza γ- globulin, ribavirin, etc.

Complex treatment of patients with severe forms of acute respiratory viral infections, in addition to etiotropic, includes mandatory detoxification pathogenetic therapy. During the period of convalescence, it is desirable to take adaptogens and vitamins that increase immune defense.

PREVENTION

Measures of specific prevention to date remain insufficiently effective. In the epidemic focus, it is recommended to use interferons prophylactically, for example, interferon alfa-2 (Grippferon, 1-2 drops in each nasal passage 3-4 times a day, 3-5 days), inducers of endogenous interferons α, β and γ (for example, "Anaferon for children" - 1 tablet 1 time per day for a course of 1 to 3 months), strictly observe the sanitary and hygienic regime (ventilation, UV radiation and wet cleaning of the room with a weak solution of chloramine, boiling dishes, etc.). Much attention is paid to the activities of the general plan:

The introduction of restrictive measures during the influenza epidemic to reduce crowding (cancellation of mass celebrations, lengthening school holidays, limiting visits to patients in hospitals, etc.);

Prevention of the spread of infection in children's institutions, families (early isolation of the patient is one of the most important measures aimed at stopping the spread of SARS in the team);

Increasing the child's resistance to diseases with the help of hardening procedures, non-specific immunomodulators [appointment of Echinacea purpurea, "Arbidol", bacterial lysates of the mixture ("IRS-19"), "Ribomunil"];

Preventive vaccinations:

For children under 10 years of age, the vaccine (for example, "Vaxigripp") is administered intramuscularly twice at a dose of 0.25 ml with an interval of 1 month, and over the age of 10 years - once at a dose of 0.5 ml; other specific vaccines are also used: foreign (Influvac, Begrivak, Fluarix) and domestic (Grippol);

SARS is an acute respiratory viral infection. ARVI viruses are the most common infectious diseases. They are united into one group by their inherent property to affect various parts of the respiratory tract, which is accompanied by intoxication, frequent addition of bacterial complications, as well as the speed and ease of transmission of pathogens (airborne droplets), their high contagiousness and variability.

SARS are caused by RNA and DNA-containing viruses.

Family Paramyxoviruses

Members of this family are RNA viruses. The genus Paramyxoviruses includes human parainfluenza virus, respiratory syncytial virus (RS-B), and others.

parainfluenza

The main point of application of this virus is the mucous membrane of the upper respiratory tract, in particular, the larynx and bronchi.

It is transmitted by airborne droplets. The duration of the incubation period is 2-7 days. The disease most often begins acutely: the patient is concerned about scanty mucous discharge from the nose, sore throat, hoarseness, loss of voice, rough, dry, tearing cough. Intoxication is not very pronounced, the temperature rarely exceeds subfebrile figures (37.2-37.4). The danger of the parainfluenza virus is for young children, in view of the anatomical features of the structure of the larynx and the reactivity of the body. Manifested by a rough "barking" cough, shortness of breath, sometimes stenosis of the larynx. It can also be complicated by bronchiolitis and pneumonia. With an uncomplicated course, the parainfluenza virus disappears within a week. The immune system is not strong.

respiratory syncytial virus

Another member of the paramyxovirus family is respiratory syncytial virus.

The main point of application of PC-B is the lower respiratory tract. The route of transmission is airborne. The incubation period is 2-7 days.

RS-viral infection is characterized by a gradual onset, a rise in temperature, abundant discharge of clear mucus from the nasal cavity, pain, sore throat, the development of bronchitis, bronchiolitis (in children), and pneumonia. Against this background, the formation of an asthmatic syndrome is possible. Adults are usually well tolerated, it stops with an uncomplicated course in a week. It is especially dangerous for children of the first years of life due to the high risk of developing broncho-obstructive syndrome.

The immune system is not strong.

Family Coronaviruses

A feature of this family of viruses is the ability to cause both acute respiratory and intestinal diseases in humans.

The family includes 13 types of viruses: respiratory and enteric coronaviruses of humans and animals. With a coronavirus infection, acute, abundant, watery rhinitis most often develops, without fever. Sometimes - headache, cough, pain, sore throat. In children (especially at an early age) it may be more pronounced. The defeat of the epithelium of the gastrointestinal tract, is manifested by the clinic of gastroenteritis.

coronavirus infections are seasonal in nature and are common mainly in the autumn-winter period.

Family Picornaviruses

Includes rhinoviruses and enteroviruses.

Rhinovirus infection

The main point of application is the mucous membrane of the nose and paranasal sinuses. One of the most frequent viral infections in the autumn-winter period.

The incubation period is 1-6 days. The route of transmission is airborne. The disease most often begins with severe itching in the nasal cavity, sneezing, abundant, continuous mucous discharge from the nose. Often this leads to the formation of macerations of the skin around the entrance to the nasal cavity, above the upper lip. The duration of the disease is usually no more than 7 days. Intoxication, low-grade fever develops rarely. Fever is possible in children; fever is rare in adults.

Enteroviruses (Coxsackie B and ECHO viruses)

A feature of these viruses is the defeat of epithelial cells and lymphoid formations of the respiratory tract and intestines.

It has many clinical manifestations due to the tropism of viruses to many human organs and tissues.

The incubation period is 2-10 days. The route of transmission is airborne and fecal-oral.

One of the many clinical forms is Coxsackie fever and ECHO fever. The disease begins acutely. The temperature can rise to febrile numbers (38-39 C). Intoxication is pronounced. Worries about headache, body aches, pain in the arms, legs, often - vomiting, pain in the abdomen. This is accompanied by not abundant mucous discharge from the nasal cavity, pain, discomfort in the throat, pain in the eyes, redness of the sclera, enlargement of regional lymph nodes, liver, spleen.

Family Adenoviruses

A feature of adenoviruses is the defeat of the mucous cavity of the oropharynx and sclera, with the development of rhinopharyngotonsillitis, conjunctivitis, mesadenitis.

Unlike the previous groups of ARVI pathogens, adenoviruses are DNA-containing.

The incubation period is 2-12 days. The main route of transmission is airborne, fecal-oral.

The disease begins acutely. Intoxication is quite pronounced, fever can reach febrile figures. The patient is concerned about mucous discharge from the nose, severe sore throat, swelling, redness of the tonsils, the presence of plaque on the tonsils. Cutting, pain in the eyes, redness of the sclera, cough, hoarseness. Abdominal pain, dysfunction of the gastrointestinal tract may also disturb.

The duration of the infectious period is up to two weeks.

An aggravating circumstance is the long-term persistence of the virus in the epithelium of the tonsils, which can lead to reactivation of the infection and a chronic sluggish course.

Diagnosis and treatment of SARS

If symptoms of SARS appear, you should consult a doctor to clarify the diagnosis and determine the correct treatment.

Often there is a delay in the start of treatment by patients, irrational self-administration of drugs, including antibacterial ones, which leads to complications.

Patients should pay attention to common self-treatment mistakes:

Antibacterial drugs (antibiotics) do not affect the vital activity of viruses, and the irrational intake of such drugs causes the resistance of the pathogenic flora;
Taking antipyretics (means that reduce the temperature) is not a treatment for infection, the apparent improvement in well-being is deceptive and dangerous for the development of complications;
Irrational, long-term use of vasoconstrictor drugs can lead to drug-induced rhinitis;
Before taking any medications, it is advisable to consult with your doctor;
With ARVI, bed rest, a sparing, fortified diet, plenty of fluids, and limitation of physical and emotional stress are recommended.