How does the flu impact different age groups. What are the normal symptoms of influenza. When should you seek emergency medical care for flu complications. How can you differentiate between a common cold and the flu. What treatments are available for influenza.

The Impact of Influenza: More Than Just a Common Cold

Influenza, commonly known as the flu, is often underestimated in its severity. While many people recover without complications, the flu can lead to serious health issues and even hospitalization. In the United States alone, over 200,000 individuals are hospitalized annually due to flu-related complications, with tens of thousands succumbing to the illness. The severity of flu cases varies greatly, with certain demographics facing higher risks of complications.

The flu virus spreads through respiratory droplets when an infected person coughs, sneezes, or talks. Transmission can also occur by touching contaminated surfaces and then touching one’s face. Symptoms typically manifest 1 to 4 days after exposure, making early detection crucial for proper management and prevention of spread.

Distinguishing Flu from Other Illnesses

Differentiating between the flu and a common cold can be challenging due to overlapping symptoms. However, flu symptoms generally appear more suddenly and with greater intensity. It’s important to note that the “stomach flu” is a misnomer and is not caused by the influenza virus. Adult flu cases rarely present with gastrointestinal symptoms.

Recognizing Normal Flu Symptoms

Understanding the typical symptoms of influenza is crucial for early detection and appropriate care. Common flu symptoms include:

• High fever
• Severe headache
• Extreme fatigue
• Persistent cough
• Sore throat
• Nasal congestion or runny nose
• Body aches and muscle pain

These symptoms can vary in intensity from person to person, but they generally persist for about a week to ten days in uncomplicated cases.

Available Treatments for Influenza

While flu vaccines can prevent certain strains, treatment options for those already infected are limited. Antiviral medications such as oseltamivir (Tamiflu), peramivir (Rapivab), and zanamivir (Relenza) may alleviate symptoms if administered within 48 hours of symptom onset. These drugs work by inhibiting the virus’s ability to replicate, potentially shortening the duration of the illness.

For symptom management, several over-the-counter options are available:

• Pain relievers like ibuprofen or acetaminophen for body aches, headaches, and fever reduction
• Antihistamines and decongestants to alleviate congestion
• Plenty of fluids to prevent dehydration
• Adequate rest to support the body’s natural healing processes

It’s crucial to understand that antibiotics are ineffective against the flu virus. They are only prescribed if a secondary bacterial infection, such as pneumonia or bronchitis, develops as a complication of the flu.

High-Risk Groups for Flu Complications

While anyone can experience severe flu symptoms, certain groups are more susceptible to complications. These high-risk individuals include:

1. Newborns and children under 5 years old, especially those under 2
2. Adults aged 65 and older
3. Pregnant women
4. Residents of long-term care facilities
5. Caregivers and healthcare workers
6. Individuals with chronic conditions such as asthma, heart disease, or lung disease
7. People with compromised immune systems due to illness or medical treatments

These groups should be particularly vigilant about flu prevention and seek medical attention promptly if flu symptoms develop.

Serious Complications of Influenza

In some cases, the flu can lead to severe complications that require immediate medical intervention. These complications can include:

• Pneumonia: A potentially life-threatening lung infection
• Myositis: Inflammation of muscle tissue
• Central nervous system disorders
• Cardiac complications: Including heart attacks, myocarditis, and pericarditis
• Exacerbation of existing chronic conditions like congestive heart failure, asthma, or diabetes

Early recognition of these complications is crucial for timely treatment and prevention of further health deterioration.

When to Seek Emergency Medical Care

Certain symptoms indicate a potential flu emergency requiring immediate medical attention. These warning signs include:

• Coughing up blood
• Croup (a barking cough, especially in children)
• Wheezing or difficulty breathing
• Chest pain or pressure
• Confusion or altered mental state
• Bluish discoloration of lips or nails (cyanosis)
• Persistently high fever
• Seizures due to fever (particularly in children)
• Severe or persistent cough that doesn’t improve

If you or a family member experience any of these symptoms, seek emergency medical care immediately. Prompt intervention can be life-saving in cases of severe flu complications.

Understanding Reye’s Syndrome: A Rare but Serious Complication

Reye’s syndrome is a rare but potentially life-threatening condition that can occur as a complication of viral infections, including influenza. This syndrome primarily affects children and teenagers and has been associated with the use of aspirin during viral illnesses.

Symptoms of Reye’s Syndrome

Recognizing the symptoms of Reye’s syndrome is crucial for early intervention. These symptoms include:

• Severe nausea and vomiting
• Confusion and delirium
• Extreme listlessness
• Personality changes, including increased aggression
• Seizures
• Loss of consciousness

Due to the potential link between Reye’s syndrome and aspirin use, it’s essential to avoid giving aspirin to children or teenagers with viral illnesses unless specifically instructed by a healthcare provider.

Preventive Measures and Flu Management Strategies

While the flu can be severe, there are several strategies to reduce the risk of infection and manage symptoms effectively:

Vaccination

Annual flu vaccinations are the most effective way to prevent influenza infection. They are especially important for high-risk groups and those in close contact with them.

Hygiene Practices

Proper hand hygiene, including frequent handwashing with soap and water or using alcohol-based hand sanitizers, can significantly reduce the spread of the flu virus.

Social Distancing

During flu season, maintaining distance from individuals who are sick and staying home when you’re ill can help prevent transmission.

Healthy Lifestyle

A balanced diet, regular exercise, and adequate sleep can boost your immune system, making you more resilient to infections.

Prompt Treatment

If you develop flu symptoms, especially if you’re in a high-risk group, consult with a healthcare provider promptly. Early intervention with antiviral medications can reduce the severity and duration of the illness.

The Role of Antiviral Medications in Flu Management

Antiviral drugs play a crucial role in managing influenza infections, especially for high-risk individuals. These medications work by inhibiting the replication of the virus within the body, potentially reducing the severity and duration of the illness.

Types of Antiviral Medications

Several antiviral medications are approved for treating influenza:

• Oseltamivir (Tamiflu): Available as a pill or liquid
• Zanamivir (Relenza): Inhaled medication
• Peramivir (Rapivab): Administered intravenously
• Baloxavir marboxil (Xofluza): A newer, single-dose oral medication

These medications are most effective when started within 48 hours of symptom onset. They can shorten the duration of the illness by about one day and may reduce the risk of complications in high-risk individuals.

Who Should Receive Antiviral Treatment?

Antiviral medications are particularly recommended for:

• People at high risk of flu complications
• Individuals with severe flu symptoms
• Those hospitalized with confirmed or suspected influenza

Healthcare providers may also prescribe antivirals to people with mild illness who are not at high risk, especially if they seek treatment early in the course of their illness.

The Impact of Influenza on Chronic Health Conditions

For individuals with pre-existing health conditions, influenza can pose significant risks. The flu can exacerbate chronic illnesses and lead to severe complications. Understanding these risks is crucial for proper management and prevention.

Asthma and Respiratory Conditions

People with asthma or other respiratory conditions are at increased risk of flu-related complications. The flu can trigger asthma attacks, worsen symptoms, and lead to pneumonia. Proper management of both the chronic condition and the flu is essential.

Heart Disease

Influenza can put additional stress on the heart, potentially leading to heart attacks or worsening of heart failure. Individuals with heart disease should be particularly vigilant about flu prevention and seek prompt treatment if infected.

Diabetes

The flu can make it harder to control blood sugar levels in people with diabetes. This can lead to serious complications and increase the risk of hospitalization.

Immunocompromised Individuals

Those with weakened immune systems, whether due to illness or medical treatments, are at higher risk of severe flu complications. They may also have a prolonged illness and increased risk of secondary infections.

For individuals with chronic health conditions, preventive measures such as annual flu vaccinations and early treatment with antiviral medications are particularly important.

The Global Impact of Influenza: Beyond Individual Health

While we often focus on the individual health impacts of influenza, it’s important to recognize its broader societal and economic effects. The flu has far-reaching consequences that extend beyond personal illness.

Economic Impact

The annual flu season has significant economic implications:

• Lost productivity due to sick days
• Increased healthcare costs
• Strain on healthcare systems during peak flu seasons

Studies estimate that the annual economic burden of influenza in the United States alone ranges from $11.2 billion to $25.5 billion.

Public Health Challenges

Influenza poses ongoing challenges for public health systems:

• The need for annual vaccine development and distribution
• Managing potential pandemics
• Educating the public about prevention and treatment

Public health initiatives aimed at flu prevention and control play a crucial role in mitigating these challenges.

Global Surveillance and Research

The ever-changing nature of influenza viruses necessitates ongoing global surveillance and research efforts. These initiatives are crucial for:

• Identifying new strains for vaccine development
• Monitoring antiviral resistance
• Preparing for potential pandemics

International cooperation in influenza research and surveillance is essential for global health security.

Emerging Technologies in Flu Prevention and Treatment

As our understanding of influenza evolves, so do the technologies and strategies for prevention and treatment. Several innovative approaches are being developed or refined to combat the flu more effectively.

Universal Flu Vaccines

Researchers are working on developing universal flu vaccines that could provide broad protection against multiple strains of influenza, potentially eliminating the need for annual vaccinations. These vaccines target conserved parts of the virus that don’t change from year to year.

Rapid Diagnostic Tests

Advancements in diagnostic technology are leading to more accurate and faster flu tests. These rapid tests can help healthcare providers make quicker treatment decisions, potentially improving outcomes for patients.

Gene-based Therapies

Emerging gene-based therapies aim to boost the body’s innate immune response to influenza. These therapies could potentially provide immediate protection against the flu and reduce the severity of symptoms.

AI and Big Data in Flu Forecasting

Artificial intelligence and big data analytics are being employed to improve flu forecasting. These technologies can help predict flu outbreaks more accurately, allowing for better preparation and resource allocation in healthcare systems.

While these technologies are promising, it’s important to note that they are still in various stages of development and testing. Current prevention methods, including annual vaccinations and good hygiene practices, remain crucial in the fight against influenza.

The Importance of Community Awareness and Education

Combating the spread of influenza and reducing its impact requires more than just medical interventions. Community awareness and education play a vital role in effective flu prevention and management.

Public Health Campaigns

Effective public health campaigns can:

• Increase vaccination rates
• Promote good hygiene practices
• Educate people about flu symptoms and when to seek medical care

These campaigns are crucial for reaching vulnerable populations and dispelling myths about the flu and flu vaccines.

Workplace and School Policies

Implementing supportive policies in workplaces and schools can significantly reduce flu transmission:

• Encouraging sick individuals to stay home
• Providing hand sanitizers and promoting regular handwashing
• Offering flu vaccinations on-site

These measures not only protect individuals but also contribute to community-wide flu prevention.

Healthcare Provider Education

Ongoing education for healthcare providers is essential for:

• Staying updated on the latest flu treatment guidelines
• Recognizing atypical flu presentations
• Effectively communicating with patients about flu prevention and treatment

Well-informed healthcare providers are key to managing flu cases effectively and preventing complications.

By fostering a well-informed community and healthcare system, we can collectively reduce the impact of influenza and protect vulnerable populations. Continued efforts in education and awareness are crucial components of a comprehensive strategy to combat this persistent public health challenge.

Chest Pain, Breathing, High Fever, and More

Written by WebMD Editorial Contributors

• Normal Flu Symptoms
• Flu Treatments
• Who’s at Risk?
• What Are Some Serious Complications?
• When to Call the Doctor
• Reye’s Syndrome
• What to Do in a Flu Emergency
• More

You may think of the flu as pretty harmless. Most of the time, it is. People typically recover after about a week or two without any lasting problems. But sometimes this illness can lead to serious complications that require emergency care.

Every year more than 200,000 people in the U.S. wind up in the hospital because of the flu. Tens of thousands die. Infants, the elderly, and people with certain diseases or weakened immune systems are the most at risk. But a flu emergency can happen to anyone. So it’s important to know the signs of trouble.

Different strains of the influenza virus cause the flu. You get it when you inhale the germ or pick it up on your hands and then touch your eyes, nose, or mouth. Symptoms usually show up 1 to 4 days later.

The flu can be hard to tell from a cold. But it usually comes on faster and is more severe. The so-called “stomach flu” isn’t the same as influenza. The flu very rarely causes tummy trouble in adults.

Normal flu symptoms include:

• High fever
• Headache
• Tiredness (can be extreme)
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches

Although flu vaccines can prevent certain strains, there’s not much you can do after you get sick. If you take them within 48 hours after symptoms start, drugs like oseltamivir (Tamiflu), peramivir (Rapivab), and zanamivir (Relenza) may ease some symptoms. You can also:

• Take over-the-counter painkillers like ibuprofen or acetaminophen, to relieve body aches, headache, and fever.
• Take over-the-counter antihistamines and decongestants to help with congestion.
• Drink lots of fluids.
• Get plenty of rest.

Antibiotics don’t treat the flu. They only work against bacteria, and the flu is caused by a virus. You might need antibiotics if you get a secondary infection in your ear, sinuses, or lungs (like pneumonia or bronchitis).

Usually, you don’t need to see the doctor if you get the flu. Your body will fight off the virus on its own if you get enough rest. But sometimes you — or a family member — may have serious problems as a result of the flu. Those more likely to get them include:

• Newborns and children up to age 5 (especially kids under age 2)
• People over age 65
• Pregnant women
• People who live in long-term care facilities
• Caregivers
• People with chronic diseases like asthma, neuromuscular disease, heart problems, or lung disease
• People with a weakened immune system, either from a disease or its treatment

• Pneumonia, an infection of the lungs. If untreated, it can be life-threatening.
• Muscle inflammation (myositis)
• Central nervous system diseases
• Heart problems like heart attacks, inflammation of the heart muscle (myocarditis), and inflammation of the sac around the heart (pericarditis)
• Worsening of chronic medical conditions like congestive heart failure, asthma, or diabetes

If you or your child get any of the following symptoms, get medical care at once. You may have a serious complication that requires treatment.

• Coughing up blood
• Croup, which causes a loud barking cough
• Wheezing
• Trouble breathing, shortness of breath, or rapid breathing
• Pain or pressure in the chest
• Confusion
• Bluish-colored lips or nails
• High fever
• Convulsions from fever (this usually affects children)
• Fever or cough that becomes severe or won’t go away

This serious illness occurs most often in children. It may follow infection with the flu or other viral diseases like chickenpox. It often happens after the child takes aspirin. Reye’s syndrome affects the liver and brain. It’s rare, but it can be life-threatening.

Symptoms include:

• Nausea and vomiting
• Confusion and delirium
• Listlessness
• Personality changes such as aggressiveness
• Convulsions
• Unconsciousness

Because of its link to Reye’s syndrome, never give aspirin to children or teenagers unless your doctor says it’s OK.

If you or a family member has any signs or symptoms of a flu emergency, call 911 right away or go to the emergency room. Don’t wait.

Top Picks

Chest Pain, Breathing, High Fever, and More

Written by WebMD Editorial Contributors

• Normal Flu Symptoms
• Flu Treatments
• Who’s at Risk?
• What Are Some Serious Complications?
• When to Call the Doctor
• Reye’s Syndrome
• What to Do in a Flu Emergency
• More

You may think of the flu as pretty harmless. Most of the time, it is. People typically recover after about a week or two without any lasting problems. But sometimes this illness can lead to serious complications that require emergency care.

Every year more than 200,000 people in the U.S. wind up in the hospital because of the flu. Tens of thousands die. Infants, the elderly, and people with certain diseases or weakened immune systems are the most at risk. But a flu emergency can happen to anyone. So it’s important to know the signs of trouble.

Different strains of the influenza virus cause the flu. You get it when you inhale the germ or pick it up on your hands and then touch your eyes, nose, or mouth. Symptoms usually show up 1 to 4 days later.

The flu can be hard to tell from a cold. But it usually comes on faster and is more severe. The so-called “stomach flu” isn’t the same as influenza. The flu very rarely causes tummy trouble in adults.

Normal flu symptoms include:

• High fever
• Headache
• Tiredness (can be extreme)
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches

Although flu vaccines can prevent certain strains, there’s not much you can do after you get sick. If you take them within 48 hours after symptoms start, drugs like oseltamivir (Tamiflu), peramivir (Rapivab), and zanamivir (Relenza) may ease some symptoms. You can also:

• Take over-the-counter painkillers like ibuprofen or acetaminophen, to relieve body aches, headache, and fever.
• Take over-the-counter antihistamines and decongestants to help with congestion.
• Drink lots of fluids.
• Get plenty of rest.

Antibiotics don’t treat the flu. They only work against bacteria, and the flu is caused by a virus. You might need antibiotics if you get a secondary infection in your ear, sinuses, or lungs (like pneumonia or bronchitis).

Usually, you don’t need to see the doctor if you get the flu. Your body will fight off the virus on its own if you get enough rest. But sometimes you — or a family member — may have serious problems as a result of the flu. Those more likely to get them include:

• Newborns and children up to age 5 (especially kids under age 2)
• People over age 65
• Pregnant women
• People who live in long-term care facilities
• Caregivers
• People with chronic diseases like asthma, neuromuscular disease, heart problems, or lung disease
• People with a weakened immune system, either from a disease or its treatment

• Pneumonia, an infection of the lungs. If untreated, it can be life-threatening.
• Muscle inflammation (myositis)
• Central nervous system diseases
• Heart problems like heart attacks, inflammation of the heart muscle (myocarditis), and inflammation of the sac around the heart (pericarditis)
• Worsening of chronic medical conditions like congestive heart failure, asthma, or diabetes

If you or your child get any of the following symptoms, get medical care at once. You may have a serious complication that requires treatment.

• Coughing up blood
• Croup, which causes a loud barking cough
• Wheezing
• Trouble breathing, shortness of breath, or rapid breathing
• Pain or pressure in the chest
• Confusion
• Bluish-colored lips or nails
• High fever
• Convulsions from fever (this usually affects children)
• Fever or cough that becomes severe or won’t go away

This serious illness occurs most often in children. It may follow infection with the flu or other viral diseases like chickenpox. It often happens after the child takes aspirin. Reye’s syndrome affects the liver and brain. It’s rare, but it can be life-threatening.

Symptoms include:

• Nausea and vomiting
• Confusion and delirium
• Listlessness
• Personality changes such as aggressiveness
• Convulsions
• Unconsciousness

Because of its link to Reye’s syndrome, never give aspirin to children or teenagers unless your doctor says it’s OK.

If you or a family member has any signs or symptoms of a flu emergency, call 911 right away or go to the emergency room. Don’t wait.

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Information on influenza – Belovskaya ambulance station

INFORMATION FOR EMERGENCY STAFF.

Clinical management of patients infected with pandemic influenza (h2N1) virus.

Influenza is an acute viral disease characterized by a short incubation period, severe general intoxication, catarrhal changes in the respiratory tract and a tendency to bacterial superinfections.

The 2009 pandemic (h2N1) influenza virus differs in its pathogenicity from seasonal influenza in two key respects: the infection affects a wider age range, especially children and young people, the virus can infect the lower respiratory tract and cause rapidly progressive pneumonia.

A wide clinical spectrum has been described ranging from non-febrile, mild upper respiratory illness, febrile influenza-like illness (ILI) to severe or even fatal complications, including rapidly progressive pneumonia. The most commonly reported symptoms include cough, fever, sore throat, muscle pain, malaise and headache. Some patients had gastrointestinal symptoms (nausea, vomiting and/or diarrhea).

Approximately 10-30% of hospitalized patients required treatment in intensive care units. Critically ill patients were defined as those with rapidly progressive lower respiratory disease, respiratory failure, and acute respiratory distress syndrome (ARDS) with persistent hypoxemia.

Risk groups include the following:

* Infants and young children, especially children under 3 years of age 9

* Pregnant women with asthma, COPD)

* Persons of any age with chronic heart disease (eg, congestive heart failure)

* Persons 65 years of age and older

Uncomplicated influenza

• ​ILI symptoms include: high fever, cough, sore throat, rhinorrhea, headache, muscle pain and malaise without shortness of breath or difficulty breathing. Patients may have some or all of these symptoms.
• Gastrointestinal disease may also be present, such as diarrhea and/or vomiting, especially in children, but without signs of dehydration.

Complicated or severe influenza

Clinical (eg, dyspnea/difficulty breathing, rapid breathing, hypoxia) and/or radiological evidence of lower respiratory disease (eg, pneumonia), central nervous system (CNS) damage (eg, encephalopathy, encephalitis), severe dehydration, or the presence of secondary complications such as renal failure, multiple organ failure, and septic shock. Other complications may include acute skeletal muscle necrosis and myocarditis.

Exacerbation of existing chronic disease, including asthma, COPD, chronic liver or kidney failure, diabetes, or other cardiovascular disease.

Presence of any other disease or clinical manifestation requiring hospitalization for clinical treatment.

Presence of any of the signs of disease progression mentioned below.

Signs and symptoms of progressive disease

In patients who initially show symptoms of uncomplicated influenza, the disease may progress to a more severe form. Progression can be rapid (i.e., within 24 hours). The following are some of the indicators of progressive disease that will require an urgent review of patient management:

• Signs and symptoms that may indicate poor oxygen supply or cardiopulmonary failure:

– Shortness of breath (when moving or at rest), shortness of breath, cyanosis, bloody or colored sputum, chest pain and low blood pressure;

– In children: frequent or labored breathing;

– Hypoxia, determined by the readings of a pulse oximeter.

• Signs and symptoms that may indicate CNS complications:

– Altered mental state, unconsciousness, drowsiness or difficulty waking up and periodic or persistent convulsions (convulsions), confusion, severe weakness or paralysis.

Pregnant women, especially those with comorbidities, are at increased risk of complications from influenza virus infection. Influenza during pregnancy is associated with an increased risk of adverse pregnancy outcomes such as miscarriage, preterm birth, and fetal distress. Therefore, pregnant women require closer monitoring and early initiation of antiviral treatment. Paracetamol is recommended to reduce high fever and pain in pregnant women, as non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin ⁷ are associated with fetal risks and maternal bleeding and are therefore contraindicated in pregnancy.

Infants and young children (especially children under 2 years of age) have the highest rates of hospitalization, especially among children with pre-existing chronic conditions. Neonates and young children often present with less typical symptoms of ILI, such as shortness of breath, low grade fever, rapid breathing, blueness, excessive sleep, lethargy, poor appetite, and dehydration. Such symptoms are nonspecific and the diagnosis cannot be made on the basis of these features alone.

Antiviral therapy

The 2009 pandemic influenza (h2N1) virus is currently susceptible to the effects of the neuraminidase inhibitors (NAIs) oseltamivir (TAMIFLU) and zanamivir (RELENZA).

The following is a summary of treatment recommendations:

• Patients with severe or progressive clinical disease should be treated with oseltamivir. Treatment should begin as early as possible.

This recommendation applies to all patient groups, including pregnant women and children under 2 years of age, including neonates.

In patients with severe or progressive disease who do not respond to normal treatment regimens, higher doses of oseltamivir (TAMIFLU) and longer treatment may be appropriate. In some situations for adults, a dose of 150 mg twice a day is used.

In cases where (1) oseltamivir is not available or cannot be used, or (2) if the virus is resistant to oseltamivir, patients who have severe or progressive clinical disease should be treated with zanamivir (RELENZA).

* Patients who are at increased risk of severe or complicated illness but who have uncomplicated illness due to influenza virus infection should be treated with oseltamivir or zanamivir. Treatment should begin as soon as possible after the onset of the disease.

If antiviral therapy is used, it should ideally be started early after the onset of symptoms, but it can be used at any stage of active disease.

Mothers who are breastfeeding may continue to breastfeed while sick and receiving treatment with oseltamivir or zanamivir.

Pneumonia is the most common severe complication of influenza.

There are three forms of pneumonia complicating influenza: primary viral pneumonia, viral-bacterial (secondary) pneumonia, bacterial (tertiary) pneumonia.

Primary viral pneumonia develops on 1st day from the onset of the disease. A significant proportion of lethal pneumonias may be associated not with a concomitant bacterial infection, but directly with the invasion and reproduction of the virus in the lungs. The initial symptoms of the disease are typical of influenza, but already within 12-36 hours, patients notice an increase in shortness of breath, which is often accompanied by a cough with a meager amount of sputum and streaks of blood. In rare cases, massive hemoptysis is possible. Pleural pain is rare. At the time of hospitalization most often manifest the phenomena of respiratory failure. Expressed tachypnea, tachycardia, cyanosis.

Viral-bacterial (secondary) pneumonia develops by the end of the first week from the onset of influenza. With this type of pneumonia, the interval between the onset of the first respiratory symptoms and signs and involvement in the process of the lung parenchyma can be up to 4 days, during this period even some improvement in the patient’s condition is possible. In most cases, the cough is productive with purulent or bloody sputum, accompanied by tremendous chills and pleural pain. As a rule, by the time of hospitalization, there are signs of severe respiratory failure: severe dyspnea, tachypnea, cyanosis.

Tertiary bacterial pneumonia develops in the second week from the onset of influenza. This is the most common complication that occurs due to damage to the ciliary epithelium by the virus, slowing down the mobilization of leukocytes, and impaired neutralization of bacteria by polymorphonuclear phagocytes. In most patients, the diagnosis of secondary bacterial pneumonia can be made based on the history. Usually the patient suffers a typical flu, followed by a period of apparent improvement, some patients even have time to get to work. However, 3-14 days after the first flu symptoms, the patient’s condition deteriorates rapidly: a second wave of fever with chills, pleural chest pain, cough with purulent sputum, and possibly hemoptysis. In about 2/3 of cases, the disease does not have a two-phase character, and the symptoms of pneumonia “superimpose” on the symptoms of influenza.

CONCLUSIONS:

– when working with patients with fever, a medical worker must wear a mask pulmonology departments of medical organizations

– early start of antiviral therapy is necessary, drugs with proven efficacy are TAMIFLU and RELENZA

– Paracetamol is recommended as an antipyretic for fever in pregnant women, while other drugs increase the risk of obstetric bleeding

– Mandatory hospitalization of children under 3 years of age with signs of acute respiratory disease

– obligatory pulse oximetry for patients (if a pulse oximeter is available) for early detection of respiratory disorders

Appendix

The degree of intoxication in children.

I degree. Decreased emotional tone, decreased appetite, liver enlargement by 1.0-2.0 cm, decreased muscle tone, subfebrile condition.

II degree. The child is restless or very lethargic, loses interest in others, refuses to eat, is pale, muscle hypotension, muffled heart sounds, temperature 38-39C, the liver is enlarged by 2.0-3.0 cm, there may be vomiting, regurgitation.

III degree. Sopor.

Degrees of respiratory failure in children (RD).

DN I degree. Respiratory distress with moderate exercise, breathing quickens by 10-2%. Tachycardia is moderate. HR:RR = 3:1 (normally 3.5:1). The gas composition of the blood is almost not disturbed.

DN II degree. Dyspnea and cyanosis at rest. Breathing speeded up by 20-30%. The pulse is frequent. HR:HR=2:1. Participation of auxiliary muscles in the act of breathing. In the blood, persistent hypoxia and hypercapnia. The child is restless.

DN III degree. Shortness of breath and cyanosis are pronounced. Breathing speeded up by 40-70%, superficial. Tachycardia. HR: RR = 1.5: 1. The skin is gray-cyanotic. Hypoxemia and hypercapnia in the blood. The child is retarded.

signs and symptoms, what types are there, how to avoid them and what happens if the disease is not treated

Influenza is a highly contagious infection of the upper respiratory tract, which is transmitted mainly by airborne droplets. Its causative agent is an RNA virus Influenza virus . Influenza differs from other acute respiratory viral infections (ARVI) in a more severe course, a high risk of complications.

The most commonly complicated infection is caused by the type A virus – that is, in 5-38% of cases ¹ . In this article, you will learn what complications occur with the flu, how they are diagnosed, and who is most susceptible to them. We give general recommendations for prevention.

Who is at risk of flu complications

Influenza is especially dangerous for people suffering from the following chronic pathologies ¹ :

• bronchopulmonary – bronchial asthma, chronic obstructive pulmonary disease;

• cardiovascular – ischemic heart disease, atherosclerosis, thrombophlebitis;

• endocrine-metabolic – diabetes mellitus, diseases of the thyroid gland and adrenal glands;

• kidney failure;

• obesity and other metabolic disorders.

There are three categories of patients at risk:

• Elderly – 80-90% of influenza complications occur in patients over 65 years of age. This is due to age-related weakening of the immune response and the presence of at least one of the chronic diseases listed above.

• Babies – the flu is especially likely to cause complications
  in children up to 3-5 months of age due to the immaturity of their immune system.

• Pregnant women – a natural decrease in immunity and the restructuring of the work of all organs and systems, allowing you to successfully bear a fetus, increase
  the risk of infection and complications in the mother and fetus. Their likelihood increases in late pregnancy.

In adults of young and mature age without chronic diseases, complications of influenza develop less frequently and are accompanied by mild symptoms.

Complications of influenza most often occur against the background of a weakened immune response – after a previous serious illness, against the background of psycho-emotional stress, as a result of long-term treatment with corticosteroids.

Symptoms of complications

The severity of the clinical signs of influenza does not always indicate an increased risk of complications. There are frequent cases of their sudden development and against the background of mild symptoms. This is especially true for infants and the elderly, in whom the manifestations of infection are usually erased. The development of complications may be indicated by an increase in symptoms or their resumption, the appearance of new symptoms after several days and even weeks from the moment of improvement.

Symptoms of flu complications in adults usually increase gradually, in young children they can occur suddenly.

Signs of a complicated course
influenza:

• debilitating weakness, which is expressed in the feeling that there is literally no strength to move;

• temperature rise to 40˚C or more;

• shortness of breath, a feeling of lack of air, palpitations with little physical exertion;

• cyanosis – cyanosis of the skin and mucous membranes;

• chest pain;

• change of dry cough productive – with sputum (often – with an admixture of blood).

• rare urination with the release of small portions of urine;

• dizziness and repeated vomiting;

• convulsions, fainting;

• drowsiness, confusion;

• acute encephalitis.

If you notice these warning signs, urgently call a local therapist or an ambulance team, depending on the severity of the manifestations.

Main types

The influenza virus can cause direct and indirect complications. The latter are associated with the addition of a secondary infection caused by other pathogens. Both species often pose a danger to health and life.

Influenza-related complications directly related to the virus

Uncomplicated influenza affects the upper respiratory tract. The spread of the virus to other organs and systems, their inflammation caused by viral intoxication, are considered complications.

The most common influenza complications from the respiratory tract – viral laryngitis, tracheitis, bronchitis. Primary pneumonia is especially dangerous – a viral inflammation of the lungs. Against the background of the inflammatory process, acute respiratory distress syndrome quickly develops – a life-threatening condition, accompanied by severe respiratory failure, shock.

Less commonly, the influenza virus causes infectious-toxic damage to other organs. Its manifestations:

• Viral myocarditis is an inflammation of the heart muscle. This disease, as a rule, proceeds relatively easily and ends in complete recovery, but, at times, leads to severe heart failure and death.

• Neurotoxic syndrome is a brain lesion. The destruction of respiratory epithelial cells by the influenza virus is accompanied by the release of toxins into the bloodstream, a violation of water-electrolyte and acid-base metabolism. Nerve fibers are the first to be affected. In uncomplicated influenza, the damage to the central nervous system is small and is manifested by a headache. With severe intoxication, cerebral edema may develop.

• Reye’s syndrome is a type of neurotoxic syndrome with simultaneous liver damage (fatty degeneration). It develops in children and adolescents.

In pregnant women, influenza often leads to thrombosis, preeclampsia, intrauterine death, and fetal loss. With a complicated course of the disease, the frequency of spontaneous miscarriages reaches 25%, preterm birth – 16%. An infection carried by the mother in the II and III trimesters of pregnancy can lead to congenital anomalies of the cardiovascular system, brain defects, and a cleft face in a child.

Due to secondary infection

Against the background of a viral infection, conditionally pathogenic bacteria are activated, which normally inhabit the mucous membranes of the body and do not harm it – streptococci, staphylococci, Haemophilus influenzae. Weakened immunity leads to the growth of their colonies, they attack the affected tissues. This is how a secondary (secondary) infection develops. Sometimes infection occurs from the outside – for example, by inhaling spores of aspergillus mold fungi, which are safe for a healthy person.

secondary infection
occurs more often than complications directly related to the virus. It can affect any organs and systems – urinary (nephritis, pyelocystitis), nervous (encephalitis, meningitis), heart (myocarditis, pericarditis).

With influenza, bacterial lesions of the ENT organs (otitis media, sinusitis) most often develop, the most dangerous of them is secondary pneumonia. Bacterial pneumonia can lead to septic shock with clotting disorders and multiple organ failure. Frequent outcomes of this condition are death or disability.

Nobasit ^® Forte is an antiviral drug against influenza and SARS containing enisamia iodide. ²
During a clinical study in 2018-2019. on the basis of the Research Institute of Influenza. A.A. Smorodintsev, it was found that while taking enisamium iodide, the number of complications requiring antibiotics was 4 times lower compared to the symptomatic therapy group. ³ Early treatment of enisamia with iodide will help to avoid complications and spread of infection to the lower respiratory tract ³ .

Diagnosis and treatment

In the diagnosis of influenza complications, instrumental and laboratory studies are used:

• CT (computed tomography) of the lungs is the most accurate method for detecting viral pneumonia.

• EchoCG (echocardiography, or ultrasound of the heart) – to detect inflammatory changes in the myocardium, the pericardial sac.

• PCR and bacteriological examination of sputum, bronchial lavage – for the diagnosis of secondary pneumonia and the selection of an antibiotic.

• Blood tests – general, biochemical, acid-base status, coagulogram. Their results may indicate damage to internal organs, the development of shock.

• Urinalysis – clinical, biochemical (to assess the state of the urinary system).

• Spinal puncture with cerebrospinal fluid examination – to detect lesions of the central nervous system.

Treatment of influenza complications depends on the location of the lesion. Pathologies of vital organs and systems are treated in the relevant specialized department of the hospital – resuscitation and intensive care, pulmonology, neurology and others. Secondary infections of the ENT and upper respiratory tract can be treated at home.

How to avoid complications

Influenza and its complications are diseases that are easier to prevent than to treat. There are proven primary and secondary prevention measures for this. The fight against influenza is carried out at all stages – it begins long before the onset of a seasonal outbreak and continues when symptoms have already appeared.

Primary prevention

Primary prevention measures significantly reduce the risk of developing the disease. No flu, no complications. The main general rule is to limit your visits to crowded places. As much as possible to exclude contacts with strangers should be representatives of risk groups, in which the disease is most often severe.

Prevents the spread of infection and wearing a medical mask. An important nuance should be taken into account here: the tissue barrier prevents the infected secretions of virus carriers (often asymptomatic or asymptomatic) from entering the environment, but does not protect healthy people when the virus-infected suspension is already in the air.

If you have clinical symptoms of SARS, and you wear a mask, this will protect others. If you are healthy and wearing a mask, it is unlikely to prevent infection by contact with a “maskless” virus carrier.

Common specific influenza prevention measures:

• Vaccination – promotes the production of anti-influenza antibodies before the probable infection with influenza. This is the most effective way to prevent illness. Get vaccinated in the summer, long before the start of the seasonal epidemic. During an outbreak, vaccination is not recommended.

• Chemoprophylaxis – prevents the penetration of the virus into the cells of the body and its reproduction, if the meeting with the causative agent of influenza took place. For this, drugs of the same groups are used as for anti-influenza treatment. They should be taken during an influenza epidemic before symptoms begin, especially if there have been suspicious contacts. For example, after attending crowded events, communicating with people who show signs of a respiratory infection.

Specific measures of primary prevention are closely related to secondary ones. Even if the disease cannot be prevented, most people who are vaccinated and who take influenza drugs have a much milder infection and less likely to develop complications.

Secondary prevention

Secondary prevention measures are aimed at accurate diagnosis, prevention of serious consequences when the signs of influenza have already appeared. Do not ignore the well-known general recommendations that help to overcome respiratory infections without complications:

• Limit physical and mental stress. If you get sick, do not go out, take sick leave, ask loved ones to temporarily take over your household duties. Rest more, move less.

• Drink more liquid. Especially useful are tea with raspberries, fruit drinks from sour berries – cranberries, lingonberries. Drink only moderately warm drinks – cold and hot drinks injure the mucous membranes, which contributes to the spread of the virus, the addition of a secondary infection.

• Ventilate the room more often. Do it carefully, avoid drafts, hypothermia in the room. Ventilation will provide a sufficient amount of oxygen in it, reduce the concentration of the virus in the room.

Compliance with these rules during the flu will help the immune system defeat the virus on its own . If you neglect the recommendations, the body’s own defenses are weakened.

Follow the doctor’s instructions exactly, do not self-medicate. Some drugs can provoke the development of complications (for example, the use of acetylsalicylic acid – Aspirin in children with influenza) and may be contraindicated in a number of concomitant diseases.

Why an accurate diagnosis is important

The symptoms can make it difficult to distinguish the flu from other SARS. To accurately determine what a person is sick with, a laboratory analysis is needed. Verification of the causative agent of a viral infection helps the doctor predict the course of the disease, assess the risks of using drugs, and make a decision on preventive hospitalization of the patient. The most accurate method for detecting the virus is PCR analysis. The study is useful for representatives of the risk group.

Accurately diagnosing influenza in every person with symptoms of an acute respiratory infection is technically difficult. Performing laboratory tests is expensive and takes a lot of time. Therefore, mass laboratory verification of influenza in Russia is not carried out ¹ . But you can take the analysis privately, for a fee. Many commercial clinics offer this service.

Briefly about the main

➢ Influenza is an acute viral infection from the ARVI group, which is most often accompanied by the development of complications.

➢ At risk for complicated influenza are people with chronic diseases, the elderly, infants, pregnant women.

➢ Most often, the disease is complicated by pneumonia, less often by infectious-toxic inflammation of other organs and systems.

➢ Complications are not always caused by the direct influence of the virus – a secondary (bacterial, fungal) often joins the influenza infection.