SARS

Description:

The Acute Respiratory Viral Infections (ARVI)  are a group of the acute diseases of a virus etiology caused by RNA - and the DNA-containing viruses, with characteristic damages of airways at various levels, with the phenomena of intoxication and frequent bacterial complications.
The SARS is the most widespread disease, especially in the nursery age. The SARS gives rather high incidence at all seasons of the year, even in the absence of an epidemiological situation, and much more exceeds incidence of other diseases of the infectious nature. About 30% of the population in the world get sick in the conditions of a pandemic of an acute viral respiratory infection, at the same time about a half of the diseased – children. The type of a viral infection in many respects is defined by an age group of the children who got sick with OVRI. The highest incidence of a SARS is registered in an age group of children from 3 to 14 years. Most often bacterial complications – bronchitis, sinusitis, pneumonia join a SARS. Incidence of a SARS can aggravate the diseases which are already available chronic. After recovery from a respiratory viral infection usually there is no durable immunity left. The same child can have a SARS within a year many times that is connected with lack of a cross immunity and a variety of serotypes of viruses. Frequent recurrent diseases of a SARS promote decrease in the general body resistance, formation of secondary immunodeficience and allergization of an organism, and sometimes – and a delay of psychomotor development of the child. Besides, often ill children cannot be vaccinated according to a calendar of inoculations that leads to decrease in an immune layer of the population. So high incidence leads to economic expenses – treatment, rehabilitation of the child, and the expenses connected with disability of parents for this period. The listed facts create first-priority priority of health care of the country before a SARS problem.  

SARS reasons:

The SARS is a combined group of viral diseases. As etiological agents the viruses relating to various families and types, combining among themselves the general properties – the expressed tropism to epithelial cells of upper respiratory tracts act.
Flu, parainfluenza, rino-sintsitialnyy infection, adenoviral infection, reovirusny infection, etc. concerns to the SARS group. Practically all these viruses contain RNA in the structure, only adenovirus belongs to DNA-containing. All of them are obligate intracellular parasites. In external environment are unstable, perish under the influence of UF-radiation and dezsredstvo.
Source of a disease is the sick person or the carrier of a virus without SARS symptoms. The virus is transmitted in the airborne way, is more rare – a household way through ware and other objects of use, and also at handshake.
The peak of incidence of a SARS is necessary on very and spring.

Pathogeny:

At a SARS the upper part of respiratory tract is surprised first of all. Implementation of a virus in cells of a macroorganism is followed by emergence of a catarral syndrome, with cough inherent in it and cold. At the subsequent hit of a virus in blood of the patient intoxication phenomena – a headache, weakness, muscle, joints pain are shown. Intoxication begins to fall down at gradual development of antibodies to the available virus. By means of nonspecific methods of protection – cough and cold - the organism gets rid of the struck epithelial cells.
Each virus shows a tropnost to a certain site of respiratory tracts. For example, at a parainfluenza the throat and a trachea are surprised more, at flu – bronchial tubes and a trachea, and the nasal cavity is more injured at a rinovirusny infection.

SARS symptoms:

Clinical symptoms of a SARS are similar among themselves, despite various etiology. All viral respiratory infections begin sharply, after a short incubation interval.
Febrile temperature is characteristic of flu (till 39-40 C) which depending on immunity of the person, can stick to 3-5 days. Neurotoxicosis is possible. Dry cough, painful feelings behind a breast, the low-expressed cold is characteristic of flu. Lymph nodes usually are not involved in pathological process. Flu quite often is followed by accession of bacterial complications.
Substantial increase of temperature or expressiveness of intoxication is not characteristic of a parainfluenza, but this type of a SARS is followed by cold and a probable croup, resulting from narrowing of a throat.  Are injured as well bronchial tubes.
The Rino-syncytial infection is not followed by temperature reaction higher than 38C. Patients are disturbed by dry unproductive cough, an asthma. Intoksikatsionny syndrome маловыражен. The Rino-syncytial infection is also complicated by bacterial damages, first of all bronchial pneumonia.
Body temperature at an adenoviral infection can periodically decrease and increase to 39C, intoxication of average degree of manifestation. Cough with a phlegm otkhozhdeniye, and lymph nodes are strongly increased and painful.

SARS at children:

Children are very susceptible to viral infections. The long course of a disease at children is caused by insufficient formation of immune system. Quite often one viral infection accumulates on another, it is possible even a bacterial infection. Newborns and children till 1 year of life are more often subject to the attack from adenoviral and rino-sintsitialnovirusny  to infections. During pregnancy infection of a SARS exerts adverse impact on a fruit and the course of pregnancy, increases risk of development of toxicosis, complications in labor. If the pregnant woman had a SARS in the first trimester of pregnancy, manifestation of teratogenic impact on a fruit is possible, in the second or third trimester the delay of intellectual and physical development, anomaly of development can be observed.

Treatment of a SARS:

For treatment of a SARS carry out pathogenetic (antiviral) and symptomatic therapy. In the period of intoxication the patient has to observe a bed rest, adhere to a milk and vegetable diet. The use of liquid is prevented to drying of the affected mucous membranes of respiratory tract, promotes decrease in viscosity of a phlegm and promotes the fastest removal of toxins.
As the most effective drugs are recognized амиксин, arbidol and амизон.
Amizon stimulates products of interferon, has febrifugal effect, removes inflammatory manifestations. Purpose of an amizon is possible from 6-year age. Possesses a wide range of antiviral action амиксин, stimulating development of interferon of all types, promotes immunity activation. Arbidol which it is possible to appoint since 2 years possesses direct antiviral action.
So-called drugs of group of immunomodulators promote immunity activation. For the purpose of increase in level of a lysozyme and interferon appoint nasal drops of human interferon or a reaferon. To children of preschool age appoint rectal suppositories of a viferon who is issued in 4 dosages. Viferon 1 and 2 use for children, suppositories with a bigger dosage (виферон 3 and 4) – at adults. The lysozyme which is a protection factor to a nard with interferon contains in drug лисобакт which use is possible already from 6-timesyachny age.
The hyper thermal syndrome at a SARS demands stopping at achievement of a mark higher than 38,5C. However, if in the anamnesis febrile spasms were noted, it is necessary to reduce even subfibrilny temperature.
Febrifugal drugs should be used very carefully. Uncontrolled self-treatment by drugs NPVS is fraught with development of complications. For example, purpose of aspirin at children is not recommended because of risk of development of a syndrome of Ray, dangerous by high death rate at all. Drugs of analginum can oppress the hemopoietic sprouts up to development of an agranulocytosis. Therefore it is better to use Nimesulide derivatives – найз, nimesit also others. It is possible to use drugs of paracetamol from 3-hmesyachny age, a single dose to 15 mg/kg, and daily – to 60 mg/kg. The overdose by paracetamol is fraught with damage of a liver therefore it is necessary to watch a daily dose of paracetamol in all the used drugs.
Development of cold complicates nasal breath. The drugs improving nasal breath by vasoconstriction are called decongestants. Forms of reception of decongestants it is various - it is sprays, aerosols or drugs for oral administration. Nasal decongestants do not recommend to accept more than 5 days as at longer reception they can strengthen cold. Wide uses naphazoline, oxymetazones, Phenylephrinum, etc. found drugs. Essential oils can be a part of nasal sprays (drugs пиносол, эквазолин and others).
For children and adults use moistening of a mucous membrane of a nose is shown by sea water. Produce already ready sterile solutions - akva-moris, a hyumer. The microelements which are its part promote improvement of nasal breath.
Dry or productive cough at a SARS is the indication to use of mucolytic drugs. For this purpose use as phytodrugs (any, a glycyrrhiza, a thyme, an ivy, a mallow, a marjoram, etc.), and synthetic Mucolyticums (AZZ, Ambroxol, Bromhexine, etc.).
At morbidity in a throat rinsing by Furacilin solution in cultivation 1 is necessary often: 5000.