Influenza

Influenza is a highly contagious acute viral disease proceeding with lesions of the respiratory tract, fever and symptoms of General intoxication.
the influenza virus photoEtiology. The influenza virus, represented by serotypes a, b, C, belongs to a group of myxoviruses; sustainability of its external environment is small. High temperature, drying, solar light, many disinfectants quickly kill him. More resistant influenza virus to low temperatures.
Epidemiology. The source of infection with influenza is a sick man, especially in the acute period of the disease (1-5th days of the disease). Infection occurs more frequently airborne, rarely through household items (towels, handkerchiefs, utensils and other). Susceptibility to influenza a very high; it is almost absolute, it is not immune. We recover the immunity lasts from 1-2 up to 3-6 years, depending on the serotype. Influenza during the major epidemic is characterized by rapid spread with coverage of up to 30-70% of the population within 1-2 months. Possible escalation of the epidemic in the pandemic. After major epidemics recover that make up the majority of the population, become immune. In majapidamiste period registered sporadic disease with rises of their frequency in the cold season.
Pathogenesis and pathological anatomy. The influenza virus enters the body through the respiratory tracts, taking root here in the epithelial cells of the epithelium. Intracellular multiplication of the virus causes degenerative-necrotic changes. Skin cells while die, and the vacant virus penetrates into new cells, hitting them. Pathological process extends downward along the respiratory tract. The current blood penetrates the virus itself (wirusami), toxic substances associated with the virus and the cell collapse, causing common toxicities, the defeat of the cardiovascular system, Central nervous system. The degree of the damage to the vascular system determines the severity of circulatory disorders with influenza, which is expressed in sharp plethora of bodies, nasal bleeding, hemorrhage into the fabric of organs (lungs, brain, mucous membranes of the respiratory tract). Activated bacterial microflora of respiratory tract causes of secondary inflammatory processes in various organs, especially the lungs.
The clinical picture. The incubation period of 12 hours. up to 3 days 1-2 days. Clinical manifestations are similar and do not depend on the serotype of the virus that caused the disease. The main clinical symptoms of the disease are associated with toxemia, and with damage to the respiratory tract.
The illness usually begins suddenly. The temperature rises rapidly, reaching 38-40 degrees during the first 2 days of illness. Rapidly developing, and all the other symptoms. Patients complain of headaches, aches all over the body, weakness, fatigue, stuffy nose, chilling, dizziness, weakness, drowsiness. In some cases, possible insomnia, sometimes vomiting, fainting, delirium, convulsions, meningeal phenomenon. Characterized by redness and puffiness of the face, more or less pronounced cyanosis, hyperemia of the conjunctiva of the eye apples. In more severe patients have bleeding in the skin and mucous membranes nose bleeding, gematuria, heavy menstruation, etc. From the side of cardiovascular system celebrate hypotension, muted tones heart, relative, but unstable bradycardia.
Amazed and respiratory organs, develop nerezko expressed catarrhal phenomena upper respiratory tract. Almost all patients experience cough and catarrhal changes in the shed with cyanosis, hyperemia and swelling of the soft palate and handles, a tongue. Also typical of small grain soft palate, injection vessels, point bleeding. Amazed often the mucous membrane of the trachea, sometimes larynx. The phenomenon of tracheitis prevail, therefore, coughing flu painful, "scratching". With the development of laryngotracheitis appear, moreover, hoarseness, sore throat. Shortness of breath may be associated with symptoms of hypoxia in the circulatory disorders or with a common bronchitis, bronchiolitis or pneumonia.

changes in the mucous membrane of the soft palate with flu
Fig. 4 - 6. Changes in the mucous membrane of the soft palate with the flu: Fig. 4 - the first - second day of illness; Fig. 8 - the third or fourth day of illness; Fig. 6 - the seventh - eighth day of illness.


In the blood of the characteristic radiation with relative monocytosis. At the beginning of the disease may normal content of cells or leukocytosis with stab neutrophile shift. ROHE - normal or moderately accelerated. Complicated influenza accompanied by leukocytosis and significantly accelerated ROHE. From other internal organs and systems changes are not typical.
Complications. The most frequent and severe are the complications of respiratory: bronchitis, bronchiolitis and pneumonia. Pneumonia is usually mixed etiology, in their development involved the influenza virus and bacterial flora of the respiratory tract. Time of occurrence of pneumonia can be an early (first days of the disease) and late. Pneumonia is accompanied by increased toxicity and deterioration of the patient with increasing temperature, dyspnea, cyanosis. Often, pain in the chest, cough, which may be a mixture of blood. However wheezing may not listen. X-ray examination of the patient, especially radiography, helps to identify pneumonia (small, interstitial, rarely with capture segments or a lobe of the lung, unilateral or bilateral). The most difficult flow of pneumonia in elderly people with cardiovascular or pulmonary diseases, and infants. Frequent are the defeat of the sinuses, tonsils, otitis, evstakhiy, cystitis and other Flu often leads to aggravation of various chronic diseases such as rheumatism and other Possibly the collapse, myocardial infarction, cerebral haemorrhage.
The diagnosis. Detection of influenza during outbreaks usually is not difficult, and in majapidamises time can be very difficult due to the similarity of the clinical picture with other acute respiratory diseases (parainfluenza, adenovirus, enterovirus, rhinoviral and others). The hallmark of influenza is the rapid development of the disease with a full deployment in the first two days of symptoms, which are dominated by the signs of toxicosis in moderately expressed catarrhal symptoms.
For laboratory diagnosis of influenza include virological tests; 1-2-th day of illness (with the purpose of allocation of the virus through infected chicken embryos) sterile take swabs from the nasal or nasopharyngeal aspirates patients.
For retrospective diagnosis conduct serological studies: the reaction of haemagglutination inhibition and a reaction of binding complement with paired sera (see Virological tests) .
Method of rinocerose, which examined the prints from the mucous membranes of the nose, identifies specific for influenza a cytoplasmic inclusions. The most specific, early and rapid laboratory study is the method immunofluorescence. Through this method, under fluorescence microscopy detected flu-like antigen in the columnar epithelial cells in smears with mucous membrane chair, processed immune fluoreszierenden gamma globulin.
The forecast. For uncomplicated influenza forecast is favorable. Very serious forecast for complicated influenza, severe toxic forms, in cases of severe hemorrhagic manifestations, staphylococcal pneumonia, especially in children and the elderly.