Swine Influenza A (H1N1) - Causes , Symptoms and Treatment .MF .

August 12, 2017 17:52 | Infectious Diseases

«Swine Flu» - a sharp vysokokozaraznoe infectious disease caused by pandemic influenza A (H1N1), is transmitted from pig and human-to-human, having high sensitivity among the population with the development of a pandemic and is characterized by fever, respiratory syndrome and severe with the possibility of a lethaloutcome.

himself the swine flu virus was discovered in 1930 by Richard Shope (USA).Within 50-60 years, the virus met and circulated only among pigs in North America and Mexico.Then swine flu was detected sporadically in humans, mostly in workers pig farms, veterinarians.

We all remember the last sensational swine flu epidemic in 2009 (the so-called California / 2009), which is emotionally and persistently informed public media.The epidemic spread since March 2009.The first cases infected with an unknown virus strain have been reported in Mexico, followed by Canada and the United States.USA, Canada, Mexico, Chile, United Kingdom, France, Germany, Australia, Russia, China, Japan and many other

s - in the process of the epidemic, many countries were involved.As of the end of October, according to the World Health Organization (WHO) laboratory confirmed 537,248 cases of swine flu.The highest susceptibility was observed among a group of people from 5 to 24 years, followed by children under 5 years.In the course of the epidemic virus assigned 6 hazard class (ie registration of the swine flu pandemic, which is easily transmitted from person to person and the disease seizes many countries and continents).According to official information to WHO cases of death on the basis of a pandemic (California / 2009) reached 17, 4 thousand people.In Russia pandemic came in the fall of 2009, the peak was at the end of October - beginning of November.In total there were more than 2500 patients with a confirmed diagnosis.There have been deaths.

causative agent of swine flu

There are several subtypes of the influenza virus in swine (H1N1, H1N2, H3N2, H3N1), however, HIGHLY properties and the ability to spread from person to person has acquired only the subtype H1N1.The influenza virus A (H1N1) - a cross between a human influenza virus A (H1N1) and swine flu, as a result of virus has mutated and become the highly, as it is called - pandemic virus CA / 2009.As well as a regular human influenza viruses, pandemic virus has a hemagglutinin in a shell (facilitates the attachment of the virus to the cell) and neuraminidase (facilitates the penetration of the virus into the cell).

swine flu virus

reasons for the spread of swine flu

source of infection - the pig (patients or carriers of the virus), and the sick person.The sick person becomes infectious one day before the onset of symptoms and for another week of illness.Accordingly, a large epidemic have potential value in patients with end of the incubation period.Up to 15% of patients during treatment continue to shed virus for 10-14 days.

infection mechanisms:
- aerogenic (airborne path) - dangerous discharge of the patient when you sneeze, cough - a diameter of 1.5-2 meters;
- contact-household - dangerous discharge of the patient on the hands of others, as well as everyday objects (tables, surfaces, towels, cups) - the virus retains its properties for 2 hours or more (bring can be a virus from the hands to the mucous mouth and eyes).

universal susceptibility to infection.There are at risk of developing severe forms of swine flu:
- children under 5 years of age;
- adults over 65 years of age;
- pregnant women;
- persons with underlying chronic diseases (chronic lung disease, cancer, blood disorders, liver disease, urinary tract, heart, diabetes, and infectious immunodeficiencies such as HIV).

symptoms of swine flu

clinical symptoms of swine flu are similar to symptoms of regular seasonal flu with small features.The incubation period (from the time of infection until the first complaints) for swine flu lasts from days to 4 days on average, sometimes extended to a week.Patients concerned about symptoms of intoxication (high temperature to 38-39 °, marked weakness, muscle pain, nausea, vomiting of central origin, that is, against the background of a high temperature, body aches, lethargy).

Another group of complaints related to the development respiratory syndrome (dry cough, pronounced sore throat, feeling short of breath), as well as the likelihood of the rapid development of one of the complications - the development of pneumonia in the early stages (2-3y day of illness).

Sore throat refers to the activity of pathogenic microorganisms, which help destroy the mucous nasal irrigation procedure preparation with antibacterial activity.Such means may be Bioparox spray containing a naturally occurring antibiotic fusafungine reducing inflammation and accelerating the healing process.The drug stops the proliferation of harmful bacteria and not harm the normal flora.

Unlike seasonal flu is the fact that 30-45% of patients with dyspeptic syndrome - patients receive constant nausea, repeated vomiting, a violation of the chair.

Manifestations of severe swine flu

In the first days of illness intense headaches, pain in eyeballs, photophobia, which increases with the eye movement.Perhaps the development of serous meningitis, encephalitis.Muscle pain is an expression of disease symptoms.

One of the dangerous complications of swine flu is to develop pneumonia.Lung inflammation can result from an influenza virus exposure (primary, may be associated with secondary bacterial flora (secondary) can be a consequence of the action and of the virus and associated layers of bacterial flora (mixed)

Primary pneumonia develops in the second or third day.from the onset of the disease and is characterized by the development of symptoms of acute respiratory failure: the patient often breathing (40 breaths per minute at a rate of - 16), in the act of breathing is actively involved support muscles (diaphragm, abdominal muscles), pronounced dry or unproductive cough (discharge mucous and transparent), severe shortness of breath, bluish skin (cyanosis) when listening to lungs.. crackles in the lower regions of the lungs mainly at the height of inspiration, dullness at rapping light

often primary pneumonia lead to the formation of respiratory distress syndrome (pulmonary edema) with possible fatal outcome.

secondary pneumonia occurs 6-10 days after the onset of the disease.Most often there is a pneumococcal contamination (45% patients), at least Staphylococcus aureus (not more than 18%), and Haemophilus influenzae.A feature of this pneumonia is increased cough: it becomes painful, almost constant, amid increasing cough patient a second wave of fever and intoxication, the patient takes a little food.Increasing pain in the chest when coughing or even breathing.Discharge lungs (sputum) is not transparent, and has a putrid shade.When X-ray - inflammation of lesions in the lungs.The flow of secondary pneumonia prolonged, patients can not recover a month and a half.Often, staphylococcal pneumonia lead to the formation of lung abscess.

Pneumonia in swine flu

Mixed pneumonia have clinical symptoms and one, and second pneumonia is prolonged (progradiently), are difficult to treat.

Other complications of swine flu include:

pericarditis, infectious-allergic myocarditis, hemorrhagic syndrome.

Under what is disturbing in terms of "swine flu" symptoms should see a doctor?

For children:
- Rapid breathing, difficulty breathing movements;
- bluish skin of the limbs and trunk;
- Waiver of eating and drinking;
- Repeated vomiting (vomiting "fountain", as well as frequent regurgitation in infants - the equivalent of vomiting at that age);
- lethargy and drowsiness of the child;
- contrary agitation resistance, even when taking the child in his arms;
- The emergence of a second wave of symptoms with increased cough and shortness of breath.

For adults:
- Shortness of breath and increased it during the day;
- Pains in the chest when breathing or coughing;
- Severe dizziness, appearing suddenly;
- Periodically confusion (forgetfulness, loss of memory of certain events);
- Repeated vomiting and profuse;
- The second wave of fever, cough, shortness of breath.

Immunity after suffering flu type-specific and short (1 year).

diagnosis of swine flu

Preliminary diagnostics difficult because of the similarity of symptoms with normal seasonal influenza.To help the doctor will have the following features:

- contact with the flu, as well as the arrival of swine flu endemic areas (countries of North America);
- complaints of the patient on the gastrointestinal disorder in the background temperature and respiratory syndrome;
- unexpressed or absence of pain in the throat on the background of a strong cough mainly dry;
- development of 2-3 hours with typical pneumonia symptoms (described above).
Final diagnosis possible after laboratory confirmation of the disease:
- PCR diagnosis of nasopharyngeal mucus samples for the detection of RNA of influenza virus A (H1N1) CA / 2009;
- Virologic method of sowing nasopharyngeal mucus, sputum certain environment.

swine flu treatment

main goal of treatment - to reduce the number of patients with severe and complicated course of the swine flu.

1. Organizational-regime activities - at the time of the preliminary diagnosis hospitalization performed as clinically indicated (severe and moderate in children, older people and those with chronic underlying medical conditions).In a laboratory confirmed diagnosis of swine flu is a compulsory hospitalization with the purpose of a specific therapy.For the entire febrile period and 5-7 days of normal temperature is assigned to bed rest for the purpose of prevention of complications.

your actions in cases of suspected swine flu:

- When a swine flu symptoms to stay at home, do not go to crowded places.
- Houses shield surrounding your loved ones from infection - wear a mask and change it every 4 hours.
- Call your doctor at home.If you come from endemic countries (Mexico, USA), tell your doctor.

To enhance the body's resistance shown is physiologically complete diet with plenty of protein and a high content of vitamins A, C and Group B. In order to reduce fever is shown receiving a sufficient amount of liquid (best fruit drinks of black currants, rose hips, black chokeberry, lemon).All products are assigned in the form of heat, avoid spicy, fatty, fried, salty, pickled dishes.

2. Drug therapy includes:

Antiviral agents - oseltamivir (Tamiflu) and zanamivir (Relenza), which substantially affect the release of new virus particles from the cells, which leads to the cessation of virus propagation.Admission Tamiflu and Relenza is recommended in the following cases:

1) If a patient has one of these symptoms (fever, stuffy nose, cough, shortness of breath);
2) Dedicated laboratory influenza virus A / 2009 (H1N1);
3) age group under 5 years;
4) Persons of advanced age - 65 years;
5) pregnant women;
6) people with severe concomitant diseases and immunodeficiency;

Usually treatment is 5 days, sometimes longer depending on the severity.

mild and moderate forms of swine flu allow the appointment of these antiviral drugs - Arbidol, interferon alfa-2b (Grippferon, viferon), interferon alfa-2a (IFN lipind) and gamma interferon (ingaron) Ingavirin, Kagocel, tsikloferon.

If you have bacterial pneumonia nature appointed antibiotics (cephalosporins III-IV generations, carbapenems, fluoroquinolones Generation IV vancomycin).

pathogenetic therapy involves the infusion detoxication therapy, corticosteroids, sympathomimetics to reduce manifestations of intoxication, facilitate breathing (carried out in the hospital).At home in the mild form of swine flu shows abundant drink (fruit drinks, tea, honey water).

Symptomatic means: antipyretics (paracetamol, ibuprofen), a vasoconstrictor nose (Nazol, tizin, nazivin, Otrivin, etc.), to facilitate cough (Tussin, stoptussin, ambroxol, ACC and others), antihistamines (Claritin, zodak).

Particular attention is given to children and pregnant women. children - welcome aspirinsoderzhaschih drugs is prohibited due to the risk of Reye syndrome (encephalopathy with cerebral edema, and hepatic failure), so the group of antipyretic paracetamol is preferred, nurofenu.Because antiviral agents show - Tamiflu, Relenza, viferon 1 Grippferon, IFN lipind, Kagocel to 3 years, anaferon.

Pregnant - drinking plenty of fluids in the absence of edema;
- with milder forms - from antiviral agents - viferon in candlelight Grippferon, Arbidol, if you can not take tablets (vomiting) - intramuscular administration panavir;in severe forms of Tamiflu, Relenza, viferon;
- to reduce the severity of fever - paracetamol, Ascorutinum;
- with the development of bacterial pneumonia - cephalosporins III-IV generation macrolides, carbapenems;
- during the epidemic is a mandatory hospitalization of all pregnant women with severe intoxication.

Prevention swine flu

Activities for Health (WHO recommendations):
• Wash your hands often with soap and water, alcohol-containing solutions can be.
• Avoid close contact with sick people.
• Avoid hugs, kisses and handshakes.
• If you get sick, stay home and limit contact with others.
• When flu symptoms seek immediate medical attention.If you are sick, stay home for 7 days after your symptoms in order to prevent infection of others.

these drugs are used for medical nonspecific prevention: Kagocel, Arbidol, anaferon, Grippferon, viferon for pregnant women, Tamiflu.

For specific prevention today created a vaccine against highly pathogenic virus of swine influenza (H1N1).This vaccine protects against influenza B, and strains A / H1N1 (swine) and H3N2 influenza A (Grippol plus), that is, and the swine flu and seasonal flu.Sick after immunization is not possible, since it does not contain any whole virus, and includes only the surface antigens of viruses, which themselves can not cause disease.The vaccine is given annually.

infectious disease doctor Bykov NI