Flu

Description:

Flu is a viral disease of a respiratory path, with the characteristic acute beginning, damage of upper airways and the expressed intoxication.

Annually, in the period of epidemic and all it, millions of inhabitants of the planet get sick with flu. The largest frequency of cases is the share of children up to 5 years.
Flu concerns to group of acute respiratory viral diseases (SARS).

Flu reasons:

The influenza virus concerns to family of orthomyxoviruses which includes all 3 types of an influenzal virus – And, In, S.  Eto the spherical parts of 80-120 nanometers in size having in structure a genome in the form of RNA. On a surface of a virus there are "spinules" - viral antigens. In total 2 types of antigens – hemagglutinin N and a neuraminidase of N are revealed. Each type of antigens has types, at their hemagglutinin 12, and at a neuraminidase – 9.
The influenzal virus is unstable in the environment, it perishes for several hours at the room temperature. Under the influence of dezsredstvo viruses quickly perish. When heating to 50-60C virus it is inactivated within several minutes.
Infection source – the sick person or the carrier of a virus. The most infectious period is the acute period of a disease. Influenza viruses of the person of type A and B allocate at healthy seagulls, herons, sparrows.
Annual seasonal increase in incidence, each 2-3 years - epidemic flashes,  each 10-30 years – flu pandemics which result from a shift of antigens is characteristic of an influenza virus And. Serovars of flu B cause epidemics each 4-6 years. Flu epidemics usually fall on January-February and November-December. The transfer mechanism – airborne. Risk groups on a disease of flu are pregnant women, children, elderly people, people with a serious, chronic, dekompensirovanny illness.
The influenza virus constantly changes that is possible by means of such phenomena as шифт and antigen drift. Drift of antigen of an influenza virus are the its minor changes connected with small mutations. Antigenic шифт provokes emergence of a new antigenic structure. шифт antigen is "responsible" to emergence of pandemics since completely levels the immunity created in 20-30 years.
The disease is known since the 16th century. More than 10 heavy epidemics and pandemics are during this time registered. So, in 1918-1919 the "Spaniard" who caused a heavy pandemic raged and it was called by H1N1 influenza virus. The pandemic of Asian flu was observed in 1957-1958, the Hong Kong flu – in 1968-1969. Rather recent pandemic of swine flu in 2009-2010 was caused by the H1N1 virus.

Pathogeny:

Flu pathogeny phases:
1. The influenza virus gets and begins to breed in penetration in cells of an epithelium of respiratory tracts. Slime droplets with the virus parts which are contained in them get into airways with an air flow. An influenza virus tropny to a cylindrical ciliate epithelium. For a further course of a disease the virus needs to overcome factors of nonspecific resistance of respiratory tracts.
2. A virus exit, destruction of the struck cells.
3. Development of a catarral syndrome, virusemia and toxaemia.
4. Reconvalescence and formation of immunity.

Flu symptoms:

The incubation interval short also makes 1-2 days. The clinical picture of flu is followed by two main syndromes – intoksikatsionny and catarral. The disease is shown by a headache, fever, cough and pain behind a breast, cold, nasal bleedings, bleeding of gums. Arterial pressure is unstable, tachycardia, bradycardia is possible. Integuments of the face, mucous membranes are hyperemic, patients complain of morbidity in muscles, bones, joints. Conjunctivitis and a sclerite are shown first of all by an injection of vessels of scleras. Painful unproductive cough demonstrates accession of tracheitis.
Development of a croup is shown by a voice osiplost, the barking cough, breath disturbance.
The Neyrotropnost of an influenza virus causes existence of a cerebral syndrome. This syndrome includes the meningeal, entsefalichesky and convulsive phenomena.
Spasms arise as toniko-clonic attacks. They are called febrile as arise against the background of rise in temperature and disappear at its normalization. Existence of febrile spasms speaks about the increased convulsive readiness of a brain.
The meningism phenomena at flu are followed by vomiting, a headache, tension of occipital muscles. Quite often there are positive meningeal signs.
The clinical picture can be supplemented with an abdominal syndrome. The abdominal pain, dyspepsia can disturb.
At children some features of a course of flu take place: the possible stertost of a clinical picture of flu, the child refuses food, shows concern. Aged up to 6 months of grain occurs at children infrequently. Tendency to rough bacterial complications is noted.

Complications:

Refer development of a toxic hemorrhagic fluid lungs, a false croup, wet brain to complications of flu. Flu can be complicated by bronchial asthma, an arachnoiditis, hemorrhages, paralyzes, a syndrome the Hyena Barra, polyneurites, Ray's syndrome, a syndrome of sudden death.

Diagnosis:

Diagnosis of an influenzal infection is carried out serological, virusoskopichesky and вирусологическм in the way. As material for a research serve smears and washouts from a nasopharynx, and also the patient's blood.
Identification of an influenza virus is made by infection of 10-day chicken embryos on which the subtle cytopathic effect, decides on a characteristic phenomenon of hemadsorption. Determine by reaction of binding of a compliment standard accessory of a virus, and a hemagglutinin subtype – in reaction of TGA. Important value in diagnosis of flu has an enzyme immunoassay. Growth of an antiserum capacity in serums by 4 times taken at an interval of 2 weeks confirms the diagnosis.

Express diagnosis of flu assumes use reaction the REEF and IFA.

Treatment of Flu:

Sick flu recommended a bed rest and rest. It is necessary to fill a water balance with plentiful drink constantly. It is not necessary to smoke and take alcohol.
The pharmacotherapy of flu should be begun immediately, at the first displays of a disease.
From the very beginning of a disease to the patient febrifugal, expectorant, antibechic drugs are appointed, vitamin therapy is carried out, also antihistaminic drugs are shown.
Pathogenetic treatment of flu assumes reception of anti-virus drugs. There are 3 classes of these medicines: neuraminidase inhibitors, drugs of interferon and derivatives of an amantidin.
Derivatives of an amantadin are Sq.m inhibitors. The mechanism of their action consists in blockade of proton pumps and prevention of penetration of virus particles in cells. The most widespread drug of this group is Remantadinum which dosage directly depends on disease severity and age of the patient.
Carry drugs to group of inhibitors of a neuraminidase занамивир and озельтимивир (active ingredient of drug of Tamiflu). Blockade of a viral antigen of a neuraminidase leads to disturbance of spread of a virus, reduction of symptoms of a disease and prevention of development of complications of flu.
Drugs of group of interferon are used both at treatment, and for prevention of flu. The most widespread drugs are реаферон, виферон, гриппферон, амиксин. Drugs of interferon possess the immunostimulating and antiviral action. Human leukocytic interferon is appointed regardless of disease severity on 5 drops 4 times a day intranazalno.  Intratracheal administration of interferon is reasonable to use an oxygen tent or an inhaler.
A variety of clinical displays of flu causes need of carrying out a symptomatic treatment. At inefficiency of a paratsetalom and NPVS administration of "lytic mix" (mix of analginum, Dimedrol and novocaine) is shown. For the purpose of physical cooling of the patient rub off alcohol, open, put cold on area of the main vessels. The vasospasm provides emergence of a so-called "white hyperthermia" for which elimination spasmolysants – Nospanum are shown, параверин, foot baths.
Maintenance of action of the heart is made by administration of solutions of cardiac glycosides, a phenylephine hydrochloride or noradrenaline.
The convulsive syndrome is removed injection tranquilizers. At brain edematization immediately enter glucocorticoids and diuretic drugs. Bronkhoobstruktion is the indication to use of an alupent or Euphyllinum.  
In parallel carry out desintoxication of an organism for the purpose of which carry out intravenous infusions of solution of glucose, Haemodesum, neohaemodesum, etc. When involving in pathological process of kidneys, with development of an anury or oliguria, it is forbidden to carry out massive drop infusions. For maintenance of function of kidneys glyukozo-insulin mix, an Euphyllinum, calcium drugs is shown.