home Calculators Clinical forms of influenza. Flu is the most dangerous viral infection. Antihistamines for influenza

Clinical forms of influenza. Flu is the most dangerous viral infection. Antihistamines for influenza

Introduction

Almost everyone has experienced the flu at least once in their life. And this is not surprising, because flu is one of the most common infectious diseases that can lead to massive outbreaks and even epidemics almost every year. That’s why it’s so important to know the “enemy in person”: how dangerous it is, how to defend against it, and how it’s easiest to survive.

Why is it so widespread? Why do so many adults and children around the world each year suffer from this ubiquitous disease, which can lead to very serious complications?

Virus flu extremely changeable. Every year, new subtypes (strains) of the virus appear that our immune system has not yet encountered and, therefore, cannot easily cope with. This is why flu vaccines cannot provide 100% protection - there is always the possibility of a new mutation of the virus.

History of influenza

Flu was known to mankind many centuries ago. First documented epidemic flu happened in 1580. True, at that time nothing was known about the nature of this disease.

The pandemic of respiratory infection in 1918-1920, which swept the globe and was called the “Spanish flu,” most likely was nothing more than an epidemic of severe influenza. It is known that the Spanish flu had an incredible mortality rate - it quickly led to pneumonia and pulmonary edema, even in young patients.

The reliably viral nature of influenza was established in England only in 1933 by Smith, Andrews and Laidlaw, who isolated a specific virus affecting primarily the respiratory tract from the lungs of hamsters infected with nasopharyngeal swabs of influenza patients and designated them as influenza A virus. In 1940, Francis and Magill discovered the virus influenza B, and in 1947 Taylor isolated another new variant of the influenza virus type C.

Since 1940, it became possible to actively study the influenza virus and its properties - the virus began to be grown in chicken embryos. Since then, a big step forward has been made in the study of influenza - the ability to mutate was discovered, and all parts of the virus capable of variability were identified. An important discovery, of course, was the creation of a vaccine against influenza.

What is the flu

Flu is an acute viral disease that can affect the upper and lower respiratory tract, is accompanied by severe intoxication and can lead to serious complications and deaths - mainly in elderly patients and children.

Flu and ARVI are diseases close to each other - both in the method of infection and in the main manifestations, but they are not the same thing. The flu causes significantly more intoxication, is often severe and leads to various kinds of complications.

Influenza infection

The source of infection is a sick person. Viruses are released in saliva, sputum, and nasal discharge when coughing and sneezing. Viruses can enter the mucous membranes of the nose, eyes or upper respiratory tract directly from the air, through close contact with a sick person; and can settle on various surfaces and then get onto the mucous membranes through the hands or when using hygiene items shared with the patient.

Then the virus enters the mucous membrane of the upper respiratory tract (nose, pharynx, larynx or trachea), penetrates the cells and begins to actively multiply. In just a few hours, the virus infects almost the entire mucous membrane of the upper respiratory tract. The virus “loves” the mucous membrane of the respiratory tract very much, and is not able to infect other organs. This is why it is incorrect to use the term “intestinal flu” - the flu cannot affect the intestinal mucosa. Most often, what is called intestinal flu - fever, intoxication, accompanied by diarrhea - is a viral gastroenteritis.

It has not been established precisely due to what protective mechanisms the virus stops reproducing and recovery occurs. Usually after 2-5 days the virus stops being released into the environment, i.e. a sick person ceases to be dangerous.

Manifestations of influenza

The incubation period for influenza is very short - from infection to the first manifestations of the disease, an average of 48 ± 12 hours passes.

Flu always begins acutely - the patient can accurately indicate the time of onset of symptoms.

Based on severity, influenza is classified into mild, moderate and severe.

In all cases, to varying degrees, there are signs of intoxication and catarrhal phenomena. In addition, in 5-10% of cases there is also a hemorrhagic component.

Intoxication has the following manifestations:

first of all, high fever: with a mild course, the temperature does not rise above 38ºС; for moderate flu – 39-40ºС; in severe cases, it can rise above 40 ºС.
chills.
headache - especially in the forehead and eyes; severe pain when moving the eyeballs.
muscle pain - especially in the legs and lower back, joints.
weakness.
malaise.
loss of appetite.
There may be nausea and vomiting.

Signs of acute intoxication usually persist for up to 5 days. If the temperature lasts longer, some bacterial complications are more likely to occur.

Catarrhal symptoms persist for an average of 7-10 days:

Runny nose.
A sore throat.
Cough: when uncomplicated, it is usually a dry cough.
Hoarseness of voice.
Stinging in the eyes, lacrimation.

Hemorrhagic phenomena:

Minor hemorrhages or vasodilatation of the sclera
Hemorrhages into the mucous membranes: this can be noticeable on the mucous membranes of the mouth, eyes
Nosebleeds
A very characteristic sign of the flu is redness of the face with general pallor of the skin.
The appearance of hemorrhages on the skin is an extremely unfavorable sign in terms of prognosis.

Flu symptoms

Temperature 40 ºС and above.
Maintaining a high temperature for more than 5 days.
Severe headache that does not go away when taking painkillers, especially when localized in the back of the head.
Shortness of breath, rapid or irregular breathing.
Impaired consciousness – delusions or hallucinations, forgetfulness.
Cramps.
The appearance of a hemorrhagic rash on the skin.

If you experience all of the above symptoms, as well as the appearance of other alarming symptoms that are not part of the picture of uncomplicated influenza, you should immediately seek medical help.

Who gets the flu more often?

People with weakened immune systems are most susceptible to the flu:

Children under 2 years of age because their immune systems are not fully developed
Persons suffering from various immunodeficiency conditions: congenital immunodeficiencies or HIV
Aged people

Who gets the flu more severely?

Persons suffering from chronic cardiovascular diseases: especially congenital and acquired heart defects (especially mitral stenosis).
Persons suffering from chronic lung diseases (including bronchial asthma).
Patients with diabetes mellitus.
Patients with chronic kidney and blood diseases.
Pregnant women.
Elderly people are over 65 years of age, since in most cases they have chronic diseases to one degree or another.
Children under 2 years of age and those who are immunocompromised are also at risk of developing complications from the flu.

Flu prevention

First of all, it is important to prevent viruses from entering the mucous membranes of the nose, eyes or mouth. To do this, it is necessary to limit contact with sick people. In addition, it must be remembered that viruses can linger for some time on the personal hygiene items of a sick person, as well as on various surfaces in the room where he is located. Therefore, it is important to wash your hands after touching objects that may harbor viruses. You should also not touch your nose, eyes, or mouth with dirty hands.

It should be noted that soap certainly does not kill influenza viruses. Washing your hands with soap and water causes mechanical removal of microorganisms from your hands, which is quite sufficient. As for various hand sanitizing lotions, there is no convincing evidence that the substances they contain have a detrimental effect on viruses. Therefore, the use of such lotions for the prevention of colds is completely unjustified.

In addition, the risk of catching ARVI directly depends on immunity, i.e. the body's resistance to infections. To maintain normal immunity it is necessary:

Eat properly and nutritiously: food should contain sufficient amounts of proteins, fats and carbohydrates, as well as vitamins. In the autumn-spring period, when the amount of vegetables and fruits in the diet decreases, additional intake of a complex of vitamins is possible.
Exercise regularly, preferably outdoors, including brisk walking.
Be sure to follow a rest regime. Adequate rest and good sleep are extremely important aspects for maintaining normal immunity.
Avoid stress
Quit smoking. Smoking is a powerful factor that reduces immunity, which has a negative impact on both the general resistance to infectious diseases and the local protective barrier - in the mucous membrane of the nose, trachea, and bronchi.

Vaccine prevention of influenza

Flu vaccines are updated annually. Vaccination is carried out with vaccines created against viruses that circulated in the previous winter, so its effectiveness depends on how close those viruses are to the present ones. However, it is known that with repeated vaccinations the effectiveness increases. This is due to the fact that the formation of antibodies - protective antiviral proteins - occurs faster in previously vaccinated people.

What vaccines exist?

Currently, 3 types of vaccines have been developed:

Whole-virion vaccines are vaccines that are a whole influenza virus, either live or inactivated. Now these vaccines are practically not used, since they have a number of side effects and often cause disease.
Split vaccines are split vaccines containing only part of the virus. They have significantly fewer side effects and are recommended for vaccination of adults.
Subunit vaccines are highly purified vaccines that cause virtually no side effects. Can be used in children.

When is the best time to get vaccinated?

It is best to vaccinate in advance, before the epidemic develops - from September to December. It is also possible to get vaccinated during an epidemic, but you must keep in mind that immunity is formed within 7-15 days, during which it is best to carry out additional prophylaxis with antiviral agents - for example, rimantadine.

Vaccine safety:

As already mentioned, for greater safety it is better to use the most purified subunit vaccines.

Adverse reactions:

Local reactions in the form of redness, disappear in 1-2 days
General reactions: fever, malaise, chills, muscle pain. They occur quite rarely and also disappear within 1-2 days

Allergy to vaccine components. It is important to remember that the vaccine should not be administered to people with chicken protein intolerance, since the viruses used in vaccines are grown using this protein, and the vaccines contain traces of it. If you are allergic to influenza vaccines, subsequent vaccinations cannot be performed.

Emergency prevention of influenza

In the event of an outbreak of the disease in a closed community or during a flu epidemic, the effectiveness of vaccination is significantly reduced, since it takes at least 1-2 weeks to form full immunity.

Therefore, if vaccination has not been carried out, especially in people at risk, prophylactic use of antiviral drugs is advisable.

Rimantadine is taken daily at the same time at a dose of 50 mg for no more than 30 days.

Oseltamivir (Tamiflu) is also effective at a dose of 75 mg 2 times a day for 6 weeks.

For emergency prevention, specific anti-influenza immunoglobulin can also be used, especially in patients with immunodeficiency

Viral complications of influenza

Primary viral pneumonia is a rare but extremely serious complication of influenza. Caused by the spread of the virus from the upper respiratory tract further along the bronchial tree and damage to the lungs. The disease begins like the flu and progresses steadily. Intoxication is expressed to an extreme degree, shortness of breath is observed, sometimes with the development of respiratory failure. There is a cough with scanty sputum, sometimes mixed with blood. Heart defects, especially mitral stenosis, predispose to viral pneumonia.
Infectious-toxic shock – extreme degree of intoxication with impaired functioning of vital organs: in particular the cardiovascular system (a pronounced increase in heart rate and a critical drop in blood pressure is observed) and kidneys. The first manifestation of infectious-toxic shock.
Myocarditis and pericarditis – How complications of influenza occurred during the Spanish flu pandemic. Currently they are extremely rare.

Bacterial complications of influenza

At flu Natural resistance to other infections is significantly reduced. The body spends all reserves to fight the virus, so bacterial infections join the clinical picture very often. Especially in the presence of any chronic bacterial diseases - all of them tend to worsen after the flu.

Bacterial pneumonia. Usually, after 2-3 days of the acute course of the disease, after the condition improves, the temperature rises again. A cough with yellow or green sputum appears. It is important not to miss the onset of this complication and begin treatment with correctly selected antibiotics in a timely manner.
Otitis, sinusitis, frontal sinusitis. Bacterial inflammation of the sinuses and ears are perhaps the most common complications of the flu.
Glomerulonephritis is an inflammation of the renal tubules, which is accompanied by a decrease in kidney function.
Meningitis, encephalitis - inflammation of the membranes and/or tissue of the brain. It occurs most often in patients at risk, mainly those suffering from immunodeficiency.
Septic conditions are conditions accompanied by the entry and subsequent proliferation of bacteria in the blood. Extremely serious conditions, often ending in death.

Non-drug treatment of influenza

Calm, better bed rest for 5 days. During an acute period of illness (no matter how much you would like to) you should not read, watch TV, or work on the computer. This depletes the already weakened body, prolongs the time of illness and the risk of complications.
Drink plenty of warm drinks, at least 2 liters per day. Better rich in vitamin C - tea with lemon, rosehip infusion, fruit juice. By drinking a large amount of liquid daily, a sick person detoxifies – i.e. accelerated removal from the body of toxins that are formed as a result of the activity of viruses.

Antiviral therapy

Intranasal interferon: leukocyte 5 drops in the nose 5 times a day, influenza 2 - 3 drops 3 - 4 times a day for the first 3 - 4 days.
Anti-influenza γ-immunoglobulin is administered to patients suffering from immunodeficiency
Rimantadine is an antiviral agent. It is better to start treatment with rimantadine on the first day of illness, and at least not later than 3 days! The drug is not recommended for children under 12 years of age, pregnant women, or people suffering from chronic liver and kidney diseases. Treatment lasts 3 days.
Oseltamivir (Tamiflu). Treatment should begin on the first day of the disease. The advantage of oseltamivir is that it can be prescribed to children under 12 years of age. The course of treatment is 3-5 days.

Influenza is a viral disease familiar to everyone, which is characterized by severe intoxication of the body with damage to the upper respiratory tract and an acute onset. The disease is transmitted by airborne droplets. The outbreak of the disease occurs during the cold season. The disease is easily transmitted from person to person and is highly contagious. It affects men and women of all ages equally. The flu is most dangerous for children, the elderly, pregnant women and people suffering from severe chronic diseases. If you do not start treatment in a timely manner and ignore the symptoms of the disease, the flu can easily lead to severe complications that can cause death. Only with proper treatment can you expect that the disease will go away in the shortest possible time and without dangerous consequences. For the treatment of influenza, it is useful, in addition to the main treatment with medications, to use folk remedies, but they cannot fight the disease only with them.

How does the influenza virus affect the body?

In order for the disease to begin to develop, the influenza virus must enter the body of a person whose immune system is weakened. Infection most often occurs through the mucous membranes of the nose, although infection is also possible through the mucous membranes of the eyes. The mechanism of development of influenza is as follows:

entry of the virus into the mucous membrane;
penetration of the virus into mucosal cells and active reproduction;
penetration into the blood along with toxins after the destruction of the affected cell;
penetration of the influenza virus into various systems and organs. This process is fast, and therefore the disease begins with rapid and severe intoxication of the body.

As a rule, from the moment of infection to the appearance of the first symptoms of the disease, it takes from several hours to 2 days.

Flu forms and symptoms

Flu, depending on the state of the immune system, can occur in mild, moderate and severe forms. Their symptoms appear more or less clearly and differ somewhat.

Mild form of influenza

Seeking medical help in this case is not necessary if there is no need to receive sick leave. However, despite this, even a mild form of the flu should not be tolerated on your feet, since neglecting the home regime can lead to serious complications. The main symptoms of this flu are:

a sharp increase in body temperature to 38 degrees (the temperature is easily reduced with medications);
maintaining elevated temperature for 2-3 days;
slight runny nose;
slight dry cough;
slight deterioration in the general condition of the patient.

Quite often, a mild form of influenza is confused with ARVI. Recovery from this form usually occurs after 7 days, but in order for immunity to be fully restored after the illness, you should stay at home for at least 10 days.

Moderate form of influenza severity

With this form of the disease, the patient’s condition worsens significantly and medical monitoring of the progress of treatment is required. This is necessary because with insufficient quality therapy, the risk of complications is very high. Moderate flu symptoms include:

a sharp increase in body temperature up to 39 degrees (decreases when taking medications);
maintaining an elevated temperature for 4-5 days;
noticeable headache;
lethargy;
severe weakness;
muscle aches;
significant dry cough;
sore throat;
a sore throat;
severe nasal congestion;
scratching pain behind the sternum;
lacrimation;
photophobia.

Recovery usually occurs within 10 days, but full recovery requires 14 days.

Severe form of influenza

In this form, the patient’s condition becomes serious and seeking medical help should be done immediately. In some cases, such manifestations of influenza require hospitalization of the patient. Severe symptoms include:

a rapid increase in body temperature to 40 degrees and above (the temperature is difficult to bring down using traditional antipyretics);
particularly severe weakness;
Strong headache;
severe body aches;
sleep disorders;
severe dizziness;
fainting (does not always happen);
seizures (rare);
hallucinations (rare);
delirium (occurs rarely);
symptoms of brain inflammation (rare);
nausea;
painful dry cough;
severe sore throat;
complete nasal congestion;
strong flow from the nose.

Treatment is carried out under strict medical supervision at home or, if necessary, in a hospital. A person needs at least 14 days to recover, and full recovery can take up to 1 month.

Complications of influenza

In cases where therapy is absent or carried out incorrectly, or the patient refuses to take a number of medications and neglects bed rest, there is a high risk of complications. The most common complications of influenza include:

In addition, serious exacerbations of existing chronic diseases are also possible as consequences of the flu. For pregnant women, the flu is dangerous because it leads to fetal deformities or miscarriage.

Traditional medicines to fight influenza

Traditional medicines can only be used as additional therapy, and under no circumstances can they replace traditional treatment.

In order to improve the patient's condition and lower the temperature, you can take advantage of the medicinal properties of raspberries. Taking 1 tablespoon of dried berries, pour 240 milliliters of boiling water over them and leave covered for 20 minutes. After this, the medicine is drunk in full. In order to prevent a rise in temperature, you should drink this drink in the morning and evening during the first 5 days of illness.

At the first signs of the flu, treatment with garlic will also be effective. To carry it out, take a few cloves of garlic, chop them and squeeze out the juice. Next, a cotton swab is moistened in the resulting juice and placed in the nose. Leave this cotton wool for 15 minutes. It is quite difficult to use such therapy for children due to the severe burning sensation in the nose after inserting a garlic tampon.

Onions will also help in treatment. In order to fight the flu, you should take 1 large onion, chop it very finely and put it on a plate. Next, the patient should inhale the onion smell, holding the plate at a distance of 30 centimeters from the nose. This inhalation lasts 10 minutes. At least 4 procedures are performed per day. Therapy continues for at least 4 days.

Cranberry juice will also be useful for the flu, as it will speed up the cleansing of toxins from the body. To prepare the drink, take 1 glass of berries and fill it with one and a half liters of water and bring to a boil. After this, the berries must be crushed and the composition boiled for 5 minutes. After cooling the fruit drink, you can strain it if desired. Drink this drink throughout the day. The fruit drink is prepared anew every day. They drink it throughout the entire period of illness. If desired, you can add honey to the drink to taste.

Eucalyptus infusion is also suitable for treating flu. To prepare it, you need to take 20 grams of dried leaves of the plant and pour 1 glass of medical alcohol, then tightly close the lid and put it in the dark to infuse for 7 days. After this period, the composition is filtered and used internally. You should drink the medicine 25 drops diluted in 60 milliliters of boiled water 2 times a day.

A useful remedy for eliminating fever is the following drink: taking 100 grams of dried cherries, pouring 500 milliliters of boiling water over them and, putting on fire, simmer under the lid for 30 minutes. After this, after cooling and straining the medicine, take it 1 glass 4 times a day. If desired, you can add sugar or honey to the composition.

You can prepare an effective medicine against the flu from pistachios. To obtain the composition, take 3 tablespoons of crushed nut kernels and pour one and a half glasses of boiling water. After this, the composition is left to infuse for 30 minutes. At this time, it should be shaken once every 10 minutes. After the specified time, the drug is filtered and taken before meals, 3 large (tablespoons) spoons 3 times a day. The drug is used until the patient recovers completely.

Garlic is also an effective remedy for the flu. In order to speed up recovery, you should eat 1 large clove of garlic before eating, chewing it well. This needs to be repeated 5 times a day. This therapy is carried out for 7 days.

Flu prevention

Even though preventive measures do not protect against influenza 100%, they can still significantly reduce the risk of infection. In order to protect yourself as much as possible from the disease, you should take the following precautionary actions:

carry out systematic hardening of the body throughout the year;
take vitamin courses in spring and autumn;
use medications to maintain immunity during a seasonal outbreak of viral diseases;
observe the rules of personal hygiene;
avoid hypothermia;
promptly treat inflammatory processes in the body.

These measures allow you to keep your immune system as active as possible, which helps get rid of the influenza virus, preventing its development, as soon as it enters the body. In addition, to prevent influenza, there is a vaccination, which has proven itself to be the best means of prevention.

In the Moscow region and throughout the country, there is a seasonal rise in the incidence of acute respiratory viral infections and influenza, and the so-called “pulmonary” form of acute respiratory diseases is now “raging” - which can lead to bronchitis and even severe pneumonia. True, the threshold of the epidemic has not yet been passed -

“Incidence rates are lower than the calculated epidemic threshold values in all age groups, including for the total population - by 1/6,” Rospotrebnadzor previously stated.

Also, according to specialists from the Center for Medical Prevention of the Moscow Health Department, “the peak incidence of influenza and ARVI in the metropolis will occur in January-February 2016.”

“Currently in Moscow, what is popularly called “pulmonary flu” or ARVI with a pulmonary component is “raging”. This is the same ARVI that is well known to Russians - when people become infected at work, in the subway, in transport, in shops, or through personal contact.” , - infectious disease doctor of the highest category Maria N. told the site.

“Many doctors note that its manifestations are mainly associated with the bronchopulmonary system - these are bronchitis, pneumonia (“pneumonia”). Alas, there are also complications in the heart. Therefore, you should not neglect the disease or self-medicate if you see or "If you feel the symptoms, there is no need to be a hero with work - urgently call a doctor, take sick leave, take pills and stay in bed. It is better not to play with such complications," she said.

"How to prevent influenza and ARVI? There is no universal recipe here; in any case, a doctor must decide - people may have allergies, contraindications, etc. There are some traditional methods. This is a flu vaccination. This is taking vitamins (just don’t need to eat handfuls of them), multivitamins. This is taking immunostimulating drugs, which you should definitely consult with your doctor about,” doctors share.

“I felt a rise in temperature - and it was above 37.5, a sore throat, a cough, weakness, headaches, runny nose began - if this is not a “cold”, then it means you have ARVI. Call a doctor,” says medical resources.

“The treatment is prescribed standard - the same immuno-strengthening, antiviral drugs - but in no case antibiotics (influenza and acute respiratory viral infections, acute respiratory infections are viruses, and antibiotics fight bacteria). But if “pneumonia” begins, then in accordance with Based on your health condition and contraindications, the doctor will prescribe an antibiotic,” doctors say.

“Once again, ARVI is now very dangerous, you cannot get over it “on your feet” - this is fraught with pneumonia or heart disease,” doctors warn

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

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

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

Typical course of influenza

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

Intoxication syndrome

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

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

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

Headache is the main sign of intoxication and one of the first symptoms of the disease. The pain is usually localized in the frontal region, especially in the area of the brow ridges, and sometimes has a retro-orbital nature. In elderly patients, the headache is often diffuse, its degree can vary, but in most cases it is moderate.

Severe headache combined with insomnia, delirium, and repeated vomiting is observed in patients with severe disease and may be accompanied by meningeal syndrome. Examination of the cerebrospinal fluid reveals no changes. In adults, unlike children, seizures rarely occur.

Catarrhal syndrome

It is one of the two leading syndromes and often fades into the background. In some cases, it is not expressed enough or is completely absent. It manifests itself as dryness and a sore throat, nasal congestion. But the most typical symptom of catarrhal syndrome is tracheobronchitis. It manifests itself as a feeling of tickling or pain in the chest, which is caused by the inflammatory process of the mucous membrane of the trachea and bronchi, a rough hacking cough, sometimes paroxysmal with a small amount of sputum. This can lead to increased pressure in the superior vena cava system and, in the case of increased fragility of blood vessels, can contribute to the manifestations of hemorrhagic syndrome (nosebleeds, small hemorrhages in the mucous membrane of the oropharynx, sometimes on the skin). During an uncontrollable dry cough, which is accompanied by vomiting, very severe pain occurs in the upper parts of the rectus abdominis muscles and intercostal muscles along the line where the diaphragm joins the chest. Subsequently, the cough becomes wet. Hoarseness of voice and a feeling of squeezing in the chest are often associated. Some experts believe that “scratching” pain in the chest is a pathognomonic sign of influenza. Catarrhal syndrome lasts about 7-10 days, the cough lasts the longest.

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

On the mucous membrane of the palate, arches, and posterior wall of the pharynx there is bright hyperemia, which in patients with severe disease has a cyanotic tint (due to circulatory disorders), the injection of the vessels of the soft palate is more pronounced. In some patients, granularity of the soft palate is detected, less often - of the uvula and arches. The posterior wall of the pharynx is dry in appearance and has enlarged lymphatic follicles. By the 3-4th day of the disease, hyperemia of the mucous membranes decreases and only vascular injection remains. Against this background, the granularity of the soft palate becomes more noticeable and pinpoint hemorrhages are often noticeable.

The nasal mucosa is usually hyperemic with a cyanotic tint, edematous, so from the first day of the disease, nasal breathing is difficult, but the amount of nasal discharge is small. There may be congestion and swelling of the lower nasal concha, dryness, and sometimes bleeding of the mucous membrane. Later, as noted, light serous or mucous discharge appears. Profuse rhinorrhea is not typical for influenza. The tongue is moist, evenly coated with a thin white coating. Sometimes there may be a slight enlargement of the cervical lymph nodes, but usually lymphadenopathy is not typical.

Damage to the respiratory system with influenza is natural. During the febrile period there may be shortness of breath. When percussing the lungs, a box sound is often detected. When auscultating the lungs (in the absence of complications), breathing is vesicular, with a hard tint, and occasional dry rales are heard. Rg-grams visualize an increase in the vascular pattern and expansion of the roots of the lungs, which can be mistakenly diagnosed as pneumonia.

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

The use of echocardiography in the dynamics of influenza disease expands existing views on the nature of myocardial changes during this infection. Echocardiography allows you to identify changes in the myocardium in cases where it is not possible to diagnose changes in the myocardium clinically and through ECG. Echocardiographic changes are manifested by the following signs: moderately pronounced expansion of the ventricular cavities (mainly the right one), the appearance of local disturbances in the contractile function of the myocardium, changes in central hemodynamics with a tendency to the hyperkinetic type. These processes are based on deterioration of blood circulation in the pulmonary circulation, increased pressure in a. pulmonalis as a result of an increase in peripheral resistance in the vessels of the lungs, an increase in the load on the right side of the heart.

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

Damages to the central nervous system in severe cases of the disease are manifested by dizziness, sleep disturbances, vomiting, and manifestations of meningism. When the peripheral nervous system is damaged, local hyperesthesia and paresthesia of the skin, trigeminal neuralgia, intercostal and other nerves occur. Functional disorders of the autonomic nervous system are especially often observed in the form of facial hyperemia, sweating, and pulse lability.

There are no clinical signs of damage to the urinary system in uncomplicated influenza.

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

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

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

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

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

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

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

Severe form Influenza is manifested by rapid development and significant severity of intoxication, fever and catarrhal symptoms. Characteristic:

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

Complicated forms of influenza

Fulminant (hypertoxic) form.

An extreme manifestation of a severe form of influenza, which is characterized by severe neurotoxicosis with the development of cerebral edema; cardiovascular, respiratory failure (acute hemorrhagic pulmonary edema, bronchiolitis, laryngeal stenosis, etc.); progressive DWI syndrome; characterized by a rapidly progressive deterioration of the patient's condition, tachypnea, tachycardia, stabbing chest pain, “rusty” sputum, increased shortness of breath, bluish skin with a gray tint. Extreme severity and rapid progression of the disease are noted.

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

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

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

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

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

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

III degree. Coma sets in with clonic and tonic convulsions, wide pupils, significant cyanosis, breathing is shallow, frequent (more than 40 per minute), and only before cardiac arrest does breathing become rare. Blood pressure is sharply reduced. Pa02 less than 50 mm Hg. Art., PaC02 above 70 mm Hg. Art.

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

The ITS clinic is divided into 3 stages.

1st stage:

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

2nd stage:

“warm hypertension” stage, which is characterized by low peripheral resistance and high cardiac output;
symptoms: tachycardia, tachypnea, hypotension, pallor of the extremities with acrocyanosis, oliguria and cerebral disorders. Mortality of patients reaches 40%.

3rd stage:

“cold hypotension” - shock with high peripheral resistance and low cardiac output;
a soporous state that progresses to a coma. The skin is pale, cold; There may be a petechial rash. Tachycardia, tachypnea, oligoanuria. Violation of thermoregulation - hypothermia. Profound metabolic acidosis. Mortality of patients reaches 60%.

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

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

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

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

Toxic hemorrhagic pulmonary edema can appear already in the first days of illness and be the cause of death in severe and fulminant forms of influenza. Against the background of severe intoxication, shortness of breath appears and cyanosis increases; breathing disturbance is accompanied by agitation. An admixture of blood appears in the sputum, although this admixture does not cause the development of hemorrhagic pulmonary edema. When auscultating the lungs, a significant number of moist rales of various sizes are heard; shortness of breath and tachycardia increase. In such cases, death occurs very quickly due to severe respiratory failure.

Swelling of the vocal cords and reflex spasm of the laryngeal muscles can lead to the development of false croup. This condition occurs in children and young people and is characterized by the sudden onset of an attack of suffocation. The attack usually occurs at night and is accompanied by anxiety and tachycardia. If immediate assistance is not provided, the disease can result in death.

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

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

Clinically, pneumonia manifests itself as a cough, and a dry flu-like cough is often replaced by a cough with sputum (mucopurulent, purulent). Patients often complain of chest pain and shortness of breath. Objectively, a change in the percussion sound is determined above the source of inflammation; crepitus or fine rales are heard against the background of weakened breathing. The right lung is most often affected.

The severe course of such a complication is more often observed with pneumonia, which occurs in the first days of influenza infection, in contrast to pneumonia, which develops at a later date. Pneumonia caused by staphylococcus, which is known to have a tendency to form abscesses in weakened patients, is especially severe. The etiological factor of pneumonia can also be other flora (enterobacteria, streptococci, pneumococci, Haemophilus influenzae).

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

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

The clinical picture of RDSD is divided into 4 periods.

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

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

III period - expanded, or the period of pronounced clinical manifestations, which is characterized by severe symptoms of acute respiratory failure. Severe shortness of breath appears, auxiliary muscles take part in the act of breathing, swelling of the wings of the nose and retraction of the intercostal spaces are clearly visible, and pronounced diffuse cyanosis is observed. When auscultating the heart, tachycardia and muffled heart sounds are noted, and blood pressure decreases significantly.

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

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

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

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

The main clinical symptoms of this period are:

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

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

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

Severe influenza, especially in persons with a complicated medical history (hypertension, atherosclerosis), may be accompanied by hemorrhage in the brain tissue with subsequent development of paralysis.

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

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

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

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

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

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

The results of clinical tests of urine and blood fluctuate within normal limits, and serological examination often makes it possible to diagnose a previous viral infection. Assessment of immune status indicates changes in the function of lymphocytes, changes in the complement system, as well as suppressor cells. The flu causes inhibition of the activity of macrophages and neutrophils, resulting in the formation of phagocytosis dysfunction syndrome. Against this background, unmotivated fatigue and increased emotional lability cause misunderstanding among the doctor, who regards them as aggravation.

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

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

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

Separately, it should be noted the possibility of complications of influenza in pregnant women, which in the second and third trimesters of pregnancy can lead to miscarriages, stillbirth and congenital defects. They can develop 9-14 days after the flu. If a woman has had the flu in the first half of pregnancy, then the child’s risk of developing schizophrenia significantly increases in the future.

Flu in different age groups

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

U young children symptoms of neurotoxicosis with repeated vomiting, symptoms of meningism, convulsions against the background of low-grade or normal body temperature may come to the fore. Sometimes such patients develop bronchiolitis, laryngitis, and croup. The cough during croup is rough, barking, breathing is noisy, and there is tension in the accessory respiratory muscles. In contrast to diphtheria croup, the symptoms of laryngeal stenosis are weakly expressed.

For elderly and senile people Influenza is dangerous primarily because it worsens chronic cardiovascular and respiratory diseases and activates other chronic foci. Clinically, these patients exhibit a state of hyperactivity. Influenza in patients in this group often occurs with a low body temperature, but with severe symptoms of intoxication, complicated by severe pneumonia. Susceptibility to other diseases also increases.

Convalescence

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

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

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

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

The outcome of the disease in relation to virus carriage has not been sufficiently studied. It is known that the formation of persistence of the influenza virus is facilitated by an immunodeficiency state of the body. It is still necessary to establish whether immunodeficiency is the main and necessary condition for such an outcome of the disease.

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

Flu- a respiratory disease of viral etiology, as a rule, has an acute course, provokes a number of complications, and the recovery period is much longer, unlike ARVI. Influenza is an epidemiological disease that occurs at least once a year. The outbreak of the virus can be judged by the sudden increase in the number of patients visiting a medical facility complaining of cold symptoms.

First of all, the disease spreads among children, in schools, kindergartens, etc. After a short time, the virus also affects the adult population. Infectious disease spreads quickly by airborne droplets, so it’s quite easy to get infected. The latent (incubation) period of the pathology is on average 5-6 days, after which an acute course of the disease and corresponding symptoms are observed. Treatment for influenza will depend on the severity of the disease and its form.

Flu symptoms: first signs

In most cases, the main symptom of the virus is headache. There is an increase in body temperature, general weakness, and a feeling of nausea. Against the background of all the symptoms, a decrease in blood pressure and the development of tachycardia are possible. A sharp development of nasal congestion, swelling of the mucous membrane, dry cough and sore throat is possible.

Some patients report disruptions in the gastrointestinal tract and the development of diarrhea. But, as a rule, this symptom is not a sign of influenza and most likely occurs as a side effect when treating influenza with drugs or as a result of an intestinal infection.

Main signs of the virus

Unlike the symptoms of acute respiratory viral infections or acute respiratory infections, the signs of influenza are characterized by rapid and sudden development. The virus begins with an acute course and a pronounced febrile state.

The main signs of pathology are the following:

central body temperature 39-40 degrees;
muscle and joint pain;
body aches, general malaise, weakness;
the initial symptom of conjunctivitis, hyperemia of certain areas of the skin;
dry cough that turns into a “barking” cough;
swelling of the nasal mucosa, clear discharge;
acute pain in the throat, especially pronounced when swallowing.

The most important thing is to recognize the symptoms of flu in time and begin treatment. It should be taken into account that antiviral drugs such as Amizon or Aflubin exhibit a therapeutic effect within 2 days; their use after a longer period of time is not entirely advisable.

The drug Amizon is effective as a prophylactic agent.

It actively stimulates the immune system, helps it cope with infectious agents, and triggers the process of interferon production. After taking the drug over the next 6-8 hours, the level of interferon in the body increases almost 3 times, and after 10-12 - 4 times. If you start taking Amizon on the first day after detecting signs of influenza, the symptoms of the disease can be eliminated 2 times faster. The drug also protects the body from the development of complications during the disease.

The influenza virus is highly contagious and is easily transmitted even by the slightest contact with a sick person. The ability of an already sick patient to infect others is 8-9 days; the most dangerous period for others is the first 2 days. In large cities and metropolitan areas, influenza spreads as quickly as possible, causing outbreaks and epidemics.

At the moment of coughing, sneezing, talking and even just breathing, a certain number of particles - RNA-containing viruses - are released from the mucous membranes of the respiratory tract of an infected patient. During the release period, an infected zone forms around the sick person, where the maximum number of pathogenic agents is formed. It is at this moment that a healthy person becomes infected.

Symptoms of different forms

How exactly the disease will progress, the severity of symptoms and the risk of future complications depends on many factors, however, the state of the immune system and the body’s ability to fight viruses are fundamental. Influenza can occur in four forms, each with its own symptoms: mild, moderate, severe and with increased intoxication (hypertoxic). Treatment for influenza involves eliminating the underlying virus and eliminating symptoms.

Mild form of flu

A mild form of influenza is characterized by mild symptoms. As a rule, body temperature remains within 38 degrees, there are no symptoms of intoxication. There may be minor pain in the joints and muscles, which can be easily relieved with painkillers. How to treat mild flu? In this case, the standard intake of antiviral drugs and, if necessary, antipyretic drugs is taken.

It should be noted that influenza in adults with a mild form should be treated with bed rest; one should not turn a blind eye to the disease, because at any moment it can worsen.

Moderate form of the virus

The core body temperature rises and can be more than 39 degrees. The symptoms are pronounced - headache, general weakness, increased sweating, swelling of the nasal mucosa, sore throat. The patient may also complain of epigastric pain and signs of diarrhea. A dry cough turns into a “barking” cough with the development of chest pain. The mucous membrane of the larynx and trachea is affected. How to treat influenza in this form? It is mandatory to prescribe medications aimed at eliminating the RNA virus, symptomatic treatment of influenza, as well as means to restore the functioning of the immune system.

Severe form of influenza condition

With this form of influenza, an increase in body temperature to 40-41 degrees is observed. Signs of intoxication are severe; the above-described symptoms of moderate severity are accompanied by nausea, vomiting, bleeding in the nasal cavity, convulsions, delirium and even hallucinations. Hospitalization of the patient is required, therapy is prescribed by the attending physician.

The recovery period after the flu is quite long. Recovery of the body is observed within 3 weeks, during which the patient complains of headache, weakness, and loss of appetite. In some cases, complications may develop, but, as a rule, in patients with chronic pathologies of the lungs and cardiovascular system. It is worth noting that during the flu period, chronic diseases have the ability to worsen. For this reason, flu symptoms may be more severe and recovery may take a longer period. Therefore, it is important that treatment of influenza is accompanied by monitoring the functioning of diseased organs. In case of exacerbations, hospitalization and additional examinations may be required.

How to distinguish signs of influenza from ARVI

In order to correctly adjust the treatment of influenza, it is necessary to be able to clearly identify and understand the difference between the signs of a cold and the flu. Superficially, the symptoms of both diseases are similar, so patients often confuse them, but the flu cannot be cured quickly.

Flu:

The virus is characterized by a rapid progression. After 2-3 hours, you can observe the first symptoms of the flu.
A febrile condition in which the body temperature can reach 40 degrees.
Body aches, sore eyes, feeling of twisting of joints.
Swelling of the nasal mucosa, however minor (this applies to patients without a diagnosis of sinusitis).
Redness of the mucous membrane of the throat, the presence of plaque on its walls.
The nodes of the lymphatic system do not enlarge.
Digestive disorders: nausea, vomiting, diarrhea in children.
The duration of the disease is about 10 days, but the patient may feel weak for several weeks. For this reason, it is not always possible to quickly cure the flu.

ARVI (ARI):

Signs of the disease appear slowly, the first symptoms can be noticed 2-3 days after infection.
The central body temperature does not exceed 38 degrees and most often lasts no more than two days.
There is a feeling of weakness and aches in the body, but not significant.
Nasal congestion, swelling of the mucous membrane, frequent sneezing, runny nose with copious discharge of clear secretion.
The mucous membrane of the throat is loose, with a reddish tint.
Possible enlargement of the nodes of the lymphatic system.
As a rule, there is no digestive disorder.
The disease lasts no more than a week, the recovery process is quick, there is no rehabilitation as such.

At the first symptoms of the flu, it is advisable to limit communication with other people, take sick leave if possible, and begin therapy with antiviral drugs as soon as possible.

Typical symptoms and treatment selected by a doctor allow you to cope with the disease at its first manifestations without harm to health. Before treating influenza in adults, additional diagnostics should be carried out to exclude damage to internal organs.