Characteristic signs of acute respiratory disease. ORZ - what is it? Acute respiratory disease: symptoms of the disease, prevention and treatment. Causes of SARS in children

Good day, dear readers!

Today we will consider with you a disease such as SARS, as well as its symptoms, causes, treatment and prevention. In addition, we will analyze how ARVI differs from acute respiratory infections and colds. So…

What is SARS?

SARS (acute respiratory viral infection)- a disease of the respiratory tract, the cause of which is the ingestion of a viral infection into the body. Among the pathogens, the most common are viruses, parainfluenza, adenoviruses and rhinoviruses.

The SARS affected area includes the nose, paranasal sinuses, throat, larynx, trachea, bronchi, and lungs. Under the "sight" is also the conjunctiva (the mucous membrane of the eye).

SARS is one of the most common infectious diseases. Most of all, children attending kindergarten, school are sick with it - up to 10 times a year. This is due to not yet formed immunity, close contact with each other, lack of knowledge and / or unwillingness to follow preventive measures to avoid infection. Other groups at risk are students, teachers, office workers, health workers and others. However, adults usually suffer less from acute respiratory infections of viral etiology, which is associated with a mature immune system, as well as its resistance to these diseases due to other past diseases. However, even if an adult is not susceptible to the development of this infection in the body, and he does not have obvious signs of the disease, he may simply be a carrier of the infection, infecting everyone around him.

Acute respiratory viral infection is seasonal. So, most cases of morbidity were noted in the period from September-October to March-April, which is associated with, as well as cool and humid weather.

How is SARS transmitted?

ARVI is transmitted mainly by airborne droplets (when coughing, close conversation), however, infection is possible through direct contact with the pathogen (kissing, shaking hands and further contact of hands with the oral cavity) or contact with objects of the carrier of the infection (dishes, clothes). When a person catches an infection, he immediately becomes its carrier. At the first signs of SARS (general malaise, weakness, runny nose) - the patient begins to infect everyone around him. As a rule, the first blow is taken by relatives, the work team, people in transport. This is the reason for the recommendation - at the first signs of SARS, the patient should stay at home, and healthy people, if the media report an outbreak of this disease, avoid staying in crowded places (public transport, holiday gatherings on the street, etc.).

Incubation period and development of SARS

During a person's contact with an infection, the virus first settles on the mucous membrane of the upper respiratory tract (nose, nasopharynx, mouth), its potential victim. Further, the infection begins to release toxins that are absorbed into the circulatory system and carried by the blood throughout the body. When the patient's body temperature rises, this indicates that the infection has already entered the circulatory system and the protective functions of the body have turned on, because. elevated temperature actually destroys the virus and its derivative toxins.

Nasal warming. It helps well to relieve swelling of the nasal mucosa, improve blood circulation, discharge from the sinuses of the pathological secretion formed by the infection.

Washing the nose. As you remember, dear readers, that the nasal cavity is practically the first location that is attacked by the infection. That is why the nasal cavity must be washed, which not only minimizes the further development of the disease if it is just beginning to manifest itself, but is also an excellent preventive method if there are no signs of it at all. In addition, just from the nasal cavity, the infection is actively spreading into the body, therefore, with ARVI, it must be washed daily.

Weak saline solutions, as well as special pharmacy sprays, are well suited as a “wash” for the nose.

Gargling. The throat, like the nasal cavity, must be rinsed for the same reason, because. this is the first barrier between the infection and the body, so this "checkpoint" must be constantly rinsed. Gargling also helps to relieve coughs by moving them from dry to wet. This procedure will limit the possibility of exacerbation of the disease due to mucosal irritated from coughing.

Soda-salt solution, as well as decoctions of chamomile, calendula, and sage, are excellent for rinsing the mouth and throat.

Inhalations. This procedure is practically aimed at the same thing as gargling - to relieve coughing. From folk remedies, for inhalation, you can use steam from potatoes "in uniform", as well as decoctions from, and other medicinal herbs. From modern means, to facilitate inhalation, you can purchase a nebulizer.

Diet for SARS. With ARVI, it is desirable to eat easily digestible food enriched with microelements. Particular emphasis should be placed on vitamin C. It is advisable to exclude fatty, spicy and fried foods, smoked meats.

symptomatic treatment. It is aimed at suppressing certain symptoms to alleviate the course of the disease.

Medicines for SARS

Antiviral drugs. Antiviral therapy is aimed at stopping the vital activity of a viral infection and spreading its toxins throughout the body. In addition, antiviral drugs speed up the healing process.

Among the antiviral drugs for ARVI, one can distinguish - "", "", "Remantadin", "Cycloferon".

Temperature in SARS. The temperature during ARVI is not brought down, because. it is a defense mechanism against viral infection within the body. The immune system raises the temperature, thereby “burning out” the infection, so it is very important not to interfere with it. An exception is cases when the body temperature lasts more than 5 days or exceeds 38 ° C in children, 39 ° C in adults.

To lower body temperature, antipyretics and analgesics are used: "", "".

For nasal congestion, to facilitate breathing, vasoconstrictors are used: Naphthyzin, Knoxprey.

With severe dry cough apply: "Codelac", "Sinekod". To remove sputum from the respiratory tract - syrup, Tussin. For liquefaction of sputum - "Ascoril", "ACC" (ACC).

For headache appoint: "Askofen", "Aspirin".

For insomnia prescribe sedatives: "Barbamil", "Luminal".

Antibiotics for SARS. It is not advisable to prescribe antibiotics for ARVI, because with the right supportive therapy, the body itself copes well with a viral infection. Moreover, as a rule, the course of antibiotic treatment is much longer than the duration of the course of the disease.

Antibiotics are prescribed only if the symptoms of SARS do not subside after 5 days of illness, and also if a secondary infection has joined SARS or complications have appeared, for example, pneumonia, otitis media, sinusitis,. Also, antibiotics may be prescribed if, after relief, the symptoms have increased again, which sometimes indicates a bacterial infection in the body. Antibiotics are prescribed only by a doctor on the basis of a personal examination of the patient.

Prevention of SARS includes the following recommendations:

• when announcing the epidemic in your area of ​​​​residence, wear masks;
• do not allow ;
• eat mostly healthy food enriched with vitamins and minerals, especially in autumn, winter and spring;
• try to eat natural antibiotics at the same time, such as - and onions;
• ventilate the living and working premises more often;
• if there is an ARVI patient in the house, then allocate tableware (forks, spoons, dishes), bedding, towels for separate use, and also disinfect daily doorknobs and other items that the patient comes into contact with;
• observe;
• get vaccinated, but not with free drugs, but with expensive and proven vaccines;
• temper your body;
• try to move more;
• stop smoking;
• if during an epidemic you often visit crowded places, upon arrival home, wash the nasal passages with a weak saline solution;

1. Instructions for the medical use of the drug AntiGrippin. There are contraindications. It is necessary to consult with a specialist.

Acute respiratory viral infection is a fairly common disease.

But few people understand that it can cause dangerous complications, so adequate treatment of ARVI is necessary in order to.

ARVI, or as we used to call it, a cold is not one, but a group of respiratory diseases that have similar symptoms.

Mostly due to the penetration of pathogenic viruses, the respiratory tract suffers. If it is not possible to accurately determine the type of virus, they write “ORZ” on the card.

How does a cold occur, what are the characteristic symptoms - the main questions that everyone should know the answers to.

Why do we get colds

Colds can be contracted or caught due to certain factors.

Our life without air would be impossible. But do not forget that the surrounding space is literally “teeming” with microorganisms, among which pathogenic bacteria occupy a strong place.

There are more than 200 types of viral pathogens.

Several times a year there are outbreaks of epidemics due to climatic and physical factors.

Approximately 20% of the adult population is forced to see a doctor at least 2-3 times a year and take a sick leave.

Particularly susceptible to colds small children, students. Babies do not yet have an immune system, they easily pick up the virus. The risk group also includes the elderly, people who have had serious illnesses. The danger of SARS, resulting in epidemics, and even influenza pandemics,

Source of disease

The main source of infection is a sick person, especially if the disease is in the initial stage.

At the same time, he may not yet realize that the infection has begun its “work” in his body and has begun to affect healthy cells and internal organs.

The virus is transmitted by airborne droplets when communicating with an infected person, being in the same room with him, public transport.

The infection is transmitted through coughing, sneezing, and even the patient's breath.

The cause of infection is also poor hygiene. No matter how tired we are of hearing from doctors - “Wash your hands often”, but this is a very important point. Through dirty hands, we can become infected not only with SARS, but also with other diseases that are very dangerous for humans.

The physical cause of susceptibility to foreign bacteria is reduced immunity.

A weakened body loses its protective functions; this condition can be provoked by:

• malnutrition;
• avitaminosis;
• anemia;
• bad ecology;
• hypodynamia;
• stress, depression;
• chronic diseases.

Regular stress weakens the body, impairs immunity

Once in the body of a weak person, the virus does not "see" the barriers to reproduction and disperses throughout the body.

Types of viral infections include:

• rhinovirus;
• adenovirus;
• coronavirus;
• metapneumovirus.

The onset of SARS and symptoms

Whatever virus enters the body, it is necessary to determine the characteristic signs of the disease for adequate treatment.

Classic features include:

• heat;
• chills;
• lethargy, weakness;
• pallor of the skin;
• headache;
• myalgia - pain in the joints, muscles;
• swollen lymph nodes in the neck, behind the ears, on the back of the head.

The onset of ARVI is a lesion of the mucous membranes and respiratory tract by pathogenic microbes, patients have a runny nose, nasal congestion, cough, lacrimation, copious discharge from the nose, pain in the eyes.

The cough may be dry, barking, or sputum-producing.

If it is the flu, then these signs seem to be late and appear on the second, third day of infection.

First of all, there is a severe headache, pain in muscles and joints, dizziness, apathy, drowsiness. When infected with parainfluenza, the respiratory tract first of all suffers, laryngitis, pharyngitis occurs, with adenovirus, the mucous membrane of the eye is affected - conjunctivitis .

Symptoms of concern

As much as we would not like it, but for each person, even a banal cold passes according to its own “scenario”.

Otherwise, you would not have to go to the doctor and take new types of drugs, but be treated with the usual means.

But a complex human body reacts differently to viruses, because there are no absolutely identical microbes, each has its own forms and ways of distribution.

Treatment of SARS should be started already at the first symptoms, especially in children.

Even worse, viruses are constantly changing, acquiring more powerful abilities to infect the body, and take on atypical forms.

Even the usual nasal congestion with SARS, which we take lightly, can lead to very dangerous diseases, among which are -

• meningitis,
• pneumonia,
• heart failure,
• vasospasm,
• kidney failure,
• liver,
• genitourinary system, etc.

In order not to find yourself in such a difficult situation, self-diagnosis and self-treatment are completely unacceptable.

This is especially true for parents who have a sick child.

How does SARS proceed?

In addition to the classic signs, at an advanced stage, symptoms will appear that indicate a complicated form of the disease:

• heat - more than 40 degrees;
• severe headache, in which it is impossible to tilt the chin to the chest, turn the neck;
• rash, and it does not matter on which part of the body;
• chest tightness, pain, heavy breathing, cough with pink or brown sputum;
• feverish state more than 5 days;
• fainting, confused consciousness;
• secretions from the respiratory tract - nose, larynx, bronchi, etc. greenish, purulent hue interspersed with blood;
• swelling, pain behind the sternum.

The reason for visiting a doctor should also be the duration of the disease, if the symptoms do not improve or do not disappear after a week, qualified medical assistance is needed, a complete examination of the body and adequate treatment.

Diagnosis of SARS

It is not difficult to diagnose an acute respiratory disease if the course acquires typical signs.

But any self-respecting doctor who knows how to properly treat ARVI, suspecting complications, should send the patient for fluorography, to the laboratory for testing and their thorough examination.

Danger is a combination SARS and bacterial infection, and bacteria are cultured to rule out or take action. Severe forms of the disease require immunological studies to determine the type of virus.

Even an experienced doctor can confuse a cold with a hemophilic infection, it can only be distinguished by the exact signs that the patient must inform the doctor without fail.

The onset of ARVI - how to treat?

Each of us is familiar with the saying — « If you treat a cold, then it will pass in 7 days, if not, then in a week».

Joking aside, but it's not really true.

After all, it does not matter in what time frame you can cope with the disease, it is important that there are no serious consequences for the body.

The main thing is that the course of SARS should be under the control of a qualified specialist. Only in this way the human body can easily transfer the infection, and all internal organs will remain safe and sound.

Problems arise at advanced stages, when the defenses are no longer able to cope with pathogenic bacteria.

Antivirals help fight viral infections

The course of treatment for ARVI

With a cold, it is necessary to act on the cause and alleviate the symptoms.

Means have a powerful effect, but the effect is not immediately observed, and after 5-6 hours.

The initial stage of SARS: treatment of symptoms

The modern pharmaceutical industry produces the latest drugs that affect not only the cause, but also the elimination of severe symptoms.

Thanks to this, the body maintains immunity and quickly recovers.

What do specialists prescribe for ARVI?

1. aimed at maintaining thermoregulation, but the degrees are not worth it. The body with the help of hyperthermia fights pathogenic microbes. Medication should be prescribed by a doctor and only when the temperature rises.
2. Non-steroidal anti-inflammatory drugs increase blood circulation in the affected airways, larynx, trachea, and bronchi. They reduce fever, reduce pain. Hot drinks "Coldrex", etc. have high efficiency.
3. Nasal congestion in SARS. What is the treatment for this? - dilating blood vessels and removing puffiness - the best way out. Thanks to the medicinal liquid, stagnation in the nasal sinuses is eliminated, which prevents sinusitis, sinusitis, sinusitis. But it is worth remembering that long-term use of such drugs can lead to chronic runny nose - rhinitis, thickening of the nasal mucosa and dependence on nasal drops.
4. What to use for SARS, if the throat hurts? A more effective remedy than rinsing with solutions has not yet been invented. More on this I detail. Yes, there are drugs that relieve spasm, eliminate pain, but rinsing with a soda solution, furacilin is safe for the body. Disinfectants help a lot - "Bioparox", "Geksoral", etc.
5. Cough with SARS. What is the treatment in this case? It is important to stimulate the release of sputum from the respiratory tract, to make it liquid. In addition to warm drinks, milk with soda, honey, cocoa butter, expectorant drugs are used: ACC, Bronholitin, Mukaltin. Appointments should only be made by a qualified professional.

For those who do not know how to relieve the symptoms of SARS, you need to pay attention to the usual list of drugs:

• Analgesics - relieve headache, ear pain, eliminate spasms.
• Antihistamines - Claritin, Diazolin, etc. will help to expand the bronchi, relieve itching, swelling, expand blood vessels.

Important! SARS should not be treated with antibiotics . Only antiviral agents are shown, and the antibiotic series can cause an aggravation of the disease. Moreover, such drugs can in themselves cause serious damage to a weakened body.

The onset of ARVI: how to treat at home

The common cold, like any other infectious disease, can have dangerous complications.

An adult still has a protective reaction if there are no chronic diseases, hypothermia, and other factors that affect immunity.

Young children are at risk, as they are most prone to SARS

Breastfeeding babies receive with mother's milk all the useful components that protect against diseases and viral infections.

The risk group, as we have already noticed, includes the elderly and small children, infants on artificial feeding. It is unacceptable to treat them without consulting a doctor, only a professional approach and adequate prescriptions.

You can fight a viral infection with a cold with your own methods, but only when combined with traditional treatment.

What to do with SARS at home:

1. Do not break bed rest . The body needs to conserve strength, less physical exertion. We need peace, quiet, a pleasant atmosphere.
2. When the disease occurs, a powerful intoxication of the body due to the decay products of healthy and disease-causing cells. The liver, blood vessels, kidneys, and genitourinary system suffer. In order not to disrupt metabolism, metabolic processes, you need constant consumption of warm water, mineral water, juices, compotes, jelly, fruit drinks. It is useful to drink tea with lemon, honey, rose hips, raspberries.
3. Healthy diet. If the disease is accompanied by enteral symptoms - diarrhea, cramps, colic, it is necessary to abandon dairy products. Otherwise, sour-milk products, cereals, fruits, vegetables, greens are shown. To facilitate the work of the liver, fried, smoked, spicy, sour foods should be limited.
4. Walks in the open air . Despite the condition, if the temperature allows - up to 38 degrees, it is necessary to breathe fresh air, walk, which improves blood flow and metabolic processes.
5. room in which the patient is needs to be ventilated several times a day to eliminate the accumulation of germs in the air. Wet cleaning with disinfectants is also useful, since viruses have a “habit” to settle on furniture and household items.

Folk remedies for colds

It is worth considering that even folk remedies should be taken only after consulting a doctor..

Recommendations like “start hardening by dousing with ice water”, “enemas”, “fasting and others”, very dubious advice, must be discarded . Old recipes are rather intended for the prevention of viral diseases, strengthening the immune system - the use of garlic, onions, herbal teas, rose hips, linden, mint, chamomile, eucalyptus.

Signs of recovery from SARS

In the acute stage of the disease, a person has a fever, a serious condition, apathy, loss of appetite, pain in the joints, muscles, etc.

As soon as the virus begins to "lose", the temperature balance normalizes - perspiration occurs, the pallor of the skin turns into a blush, the patient wants to eat, is drawn to sweets.

Improvement in well-being may indicate recovery

All this points to the restoration of the body.

But this does not mean that you can immediately go out into the street, visit public places, clubs, discos, school.

Rehabilitation will take more time, a healthy diet, a course of vitamin therapy. You need to restore strength, make sure that the disease has receded and boldly go out into the world!

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 SARS, 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. By using 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 determine 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. In an electron microscopic examination of the epithelium of the bronchi, in addition to viral particles, ultrastructures associated with the cell membrane can be detected, 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) 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.

SARS (acute respiratory viral infection) diagnosed at least once in almost every person. This condition, popularly referred to as the "cold", is caused by airborne viruses.
There is the so-called “cold season”, this is spring and autumn - a time when immunity is at zero, and a weakened body becomes more susceptible to viruses and bacteria.
ARVI (acute respiratory viral infection) is a fairly large group of viral diseases that have almost the same type of features, as well as a similar picture of the course of the disease. These respiratory viral infections can be provoked by viruses, and with inadequate treatment, the bacterial flora joins.

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Spread of disease

In terms of incidence, it is in the top three. SARS is spread all over the world. For a year, on average, an adult can get sick three to six times. Whole epidemics can occur in the spring and winter periods, since the method of transmission "through the air" involves infecting the body even with minimal contact.
Viruses are localized, as a rule, in the upper respiratory tract, which allows them to be attributed to a single group of diseases.
If ARVI is not treated in time, the infection will spread further along the respiratory tract and complications such as:

• - inflammation of the nasal mucosa;
• - inflammation of the pharynx;
• - inflammation of the larynx;
• - inflammation of the trachea, etc.

At the moment, scientists have recorded more than 140 types of viruses that cause SARS.

In adults, the number of cases of acute respiratory viral infections is significantly lower than in children and adolescents, however, if the patient has chronic diseases, cardiac disorders or allergies, then the frequency of diseases increases.
Once in the human body, the virus settles in the nose or throat, in the absence of adequate treatment, descends lower, aggravating the course of the disease.

The reasons

Since the viruses that cause SARS are quite resistant to the external environment and are transmitted by airborne droplets, it becomes clear that it is very easy to get infected, it is enough to be in a crowded place: a store, public transport, at work or a cafe.

The main reason for the entry of a virus or bacteria into the body of an adult is a decrease in immunity.

Weak immunity is not a barrier to infection, as it is simply unable not only to resist them, but even to identify "offenders". Therefore, an adult often suffers SARS "on his feet", without fever, complaining of weakness, headaches and muscle pain.

The source of infection is always a human carrier of the virus.

Sometimes the picture of the disease is erased, but the infection, entering the body of another person, can manifest itself with all the ensuing consequences.

SARS symptoms in adults

Often in the initial stages of ARVI in adults, they are confused with fatigue or just a headache.

However, if you carefully listen to yourself, then the presence of several symptoms will reveal a picture of the disease:

• Malaise - weakness in the muscles and aching joints, I want to lie down all the time;
• drowsiness - constantly sleepy, no matter how long a person sleeps;
• runny nose - at first not strong, just like a clear liquid from the nose. Most attribute this to a sharp change in temperature (I went from the cold into a warm room, and condensation appeared in my nose);
• chills - discomfort when touching the skin;
• sore throat - it can be expressed as a tickle, and a tingling sensation or even pain in the neck.

Since ARVI develops very quickly, within 4-6 hours the following are added to these symptoms:

• An increase in temperature - this is how the body turns on a protective reaction in the fight against infection;
• headache - feeling as if the head is splitting;
• nasal congestion.

Types of SARS

There are several types of this disease, which, although they have many similar features, still differ from each other.

Adenovirus infection is characterized by:

• , which lasts from five to ten days;
• strong wet cough, aggravated in a horizontal position and with increased physical activity;
• enlarged lymph nodes;
• runny nose;
• sore throat when swallowing.

Influenza has a sharp course of the disease. When a virus, the causative agent of influenza, enters, it immediately begins:

• Very high temperature;
• causing pain in the chest;
• sore throat;
• runny nose;
• dizziness and sometimes loss of consciousness.

Parainfluenza is milder than flu, but this fact does not make it any more pleasant:

• The main danger of this infection is croup (suffocation), which occurs due to a strong narrowing of the larynx;
• the temperature is not high, fluctuates around 37-38 degrees;
• dry cough;
• severe runny nose.

RS infection. Its symptoms, in general, are similar to parainfluenza, but its danger is that, as a result of untimely treatment, it can.
ARVI is diagnosed quite easily, and the specific type of this disease is specified, taking into account the epidemiological situation in the region and individual symptoms in a particular patient.
It will not be difficult for an experienced doctor to determine the presence of the disease, however, for a more accurate diagnosis, it is necessary to pass a general blood and urine test. The source of infection is determined by the number of red blood cells, platelets, as well as urinalysis.

Methods for the treatment of SARS

In the case of a virus, no special medication is required for treatment. Treatment is symptomatic in most cases. And be sure to drink plenty of water.

If a bacterium is found in the blood, then this is an occasion to use antibiotics to prevent the aggravation of the course of the disease.
In the acute course of ARVI, the patient is prescribed drugs based on interferon, as well as complex drugs (such as Rinza, Teraflu). Vasoconstrictor drugs can be dripped into the nose. To reduce the volume of sputum, it is advisable to take antihistamines (Zodak, Zirtek).

You should always remember that self-medication is dangerous for health, and if the symptoms of SARS do not disappear or even increase, it is better to consult a specialist.

If a blood test shows a significant increase in leukocytes plus a decrease in the content of lymphocytes in the blood, and all this against the background of a high ESR, this is an indicator of a bacterial infection in the body.

This type of infection is treated with antibiotics.
In addition, there are a number of cases in which even a viral infection is stopped with antibacterial drugs:

• The presence of a purulent infection;
• inflammation of the middle ear;
• concomitant chronic diseases;
• weakened immunity (for example, after surgery or against the background of certain diseases).

During the height of SARS, namely, the autumn-winter period, leaving the house, you should treat the nasal mucosa with oxolinic ointment.

In case of infection with SARS, it is necessary to withstand at least two weeks of quarantine to eliminate the risk of re-infection.


In the initial stages, self-medication is permissible, which consists in taking antiviral and antipyretic drugs, as well as in consuming large amounts of fluid. But it should be remembered that a prolonged "cold" is an occasion to contact a therapist to obtain a competent treatment regimen.

In contact with

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

Moderately expressed symptoms of general intoxication, a predominant lesion of the upper respiratory tract and a benign course are characteristic. 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; adults and children of the older age group are characterized by a mild course of the type of catarrh or acute bronchitis. 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, 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:

1. 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.