Acute viral respiratory infections (AVRI) and influenza

1. TASHKENT MEDICAL ACADEMYDepartment of infectious and pediatric infectious diseases Acute viral respiratory infections and influenza Reader: Candidate of Medical Science, associate professor, Niyazova T.A.

2. Counsel:1. Introduction – 5 min. 2. Historical data – 5 min.3. Etiology and epidemiology – 10 min.4. Pathogenesis and pathological anatomy – 10 min.5. Clinical findings – 30 min.6. Diagnosis – 8 min.7. Treatment measures – 10 min.8. Preventive measures – 7 min.9. Conclusion – 5 min.

3. Acute viral respiratory infections (AVRI) and influenza AVRI – эта группа болезней различной этиологии, имеющих однородные клинические проявления. К ним относятся грипп, парагрипп, аденовирусные, респираторно-синцитиальные, риновирусные, энтеровирусные, коронавирусные заболевания.

4. INFLUENZA • Influenza, commonly referred to as the fluor grippe, is an acute, highly contagious infection of the respiratory tract, results from three different types of Myxovirusinfluenzae.

5. ETIOLOGY • Pathogenic organism (agent) - RNA virus of the family Orthomyxoviridae,size of virus – 80-120 nm; • In virus classification influenza viruses are RNA viruses that make up three of the five genera of the family Orthomyxoviridae: Influenzavirus A, B, C; • The type A viruses are the most virulent human pathogens and genetic changeable among the three influenza types; • Changeability of virus is showed by changingofsuperficial antigens: -hemagglutinin (Н); - neuraminidase (N).

6. Viruses of influenza

7. Этиология

8. Epidemiology • Large epidemics of influenza A arise in the range from 2 to 3 years, pandemics arise in the range from 10 to 15 years; • Type B also strikes annually but causes epidemics only every 4 to 6 years; • Type C is endemic and causes only sporadic cases; • Source of infection is sick person, particularly at the height of the disease (4-7 days of illness); • Transmission of influenza occurs through of a respiratory droplet from an infected person or by indirect contact, such as the use of a contaminated drinking glass; • Although influenza affects all age-groups, its incidence is highest in schoolchildren.

9. Known flu pandemics

10. Epidemiology

11. Epidemiology

12. Pathogenesis(byKethiladzeЕ.S.) : • Reproduction of viruses in epithelial cells of mucous membrane of respiratory tract; • Virusemia, toxic and toxic-allergic reaction of organism; • Causing inflammation and desquamation; • Bacterial complications of respiratory tract and other organs; • Decrease of pathological process and change-over to recovery.

13. Pathogenesis

14. Classification of influenza(S.D.Nosov,1972) Typical: 1. with complications: 1) easy form 2) средней тяжести 3) тяжелой 2. without complications: 1) легкой 2) средней тяжести 3) тяжелой Atypical: 1. Afebrile influenza (без осложнением, с осложнением) 2. Acatarrhal influenza (без осложнением, с осложнением ) 3. Flash-like influenza: а) протекающие с геморрагичеким пневмонией. б) протекающие без геморрагичеким пневмонией.

15. Symptoms of influenza Symptoms of influenza can start quite suddenly one to two days after infection; Usually the first symptoms are chills or a chilly sensation, but fever is also common early in the infection, with body temperatures ranging from 38-39 °C; Many people are so ill that they are confined to bed for several days, with aches and pains throughout their bodies, which are worse in their backs and legs.

16. Symptoms of influenza may include: Fever and extreme coldness (chills shivering, shaking (rigor)); Cough, nasal congestion; Body aches, especially joints and throat; Fatigue, headache; Irritated, watering eyes; Reddened eyes, skin (especially face), mouth, throat and nose; In children, gastrointestinal symptoms such as diarrhea and abdominal pain.

18. Clinical findings

19. Clinical findings

20. Clinical findings. Conjunctivitis.

21. Injections of vessels and enanthemas

22. Hemorrhagic pneumonia

23. Fibrinogenous- necrotic laryngotracheo-bronchitis

24. Segmental inflammation

25. COMPLICATIONS • Pneumonia; • Rhinitis, pharyngitis, laryngitis, tracheobronchitis, locular and ваfollicularquinsy, antritis, frontal sinusitis, ethmoiditis, otitis and others; • Meningitides, meningo-encephalitis, arachnoiditis, polyneuritis, radiculitis.

26. DIAGNOSTICS • Clinical findings; • Viral investigations; • Serologic investigations (RTGA, Reiter's complement fixation test, (R)CFT,RNGA); • Immune-enzyme analysis.

27. DIFFERENTIAL DIAGNOSTICS • Epidemic spotted fever, Brill's [Brill-Zinsser] disease; • Typhoid (enteric) fever andparatyphoid А , В; • Meningococcal infectious; • Tuberculosis meningitis; • Aseptic [serous] meningitis; • Tick-borne [vernal] encephalitis; • Poliomyelitis; • Infectious mononucleosis; • Hepatitis А; • Brucellosis; • Q-fever; • Ornithosis; • Measles; • Scarlet fever; • Malaria.

28. TREATMENT • Regimen; • Diet; • Etiological treatment; • Pathogenetic treatment; • Symptomatic treatment.

29. ETIOLOGICAL TREATMENT • The two classes of antiviral drugs used against influenza are neuraminidase inhibitors and M2 protein inhibitors: • Neuraminidase inhibitors – oseltamivir (trade name Tamiflu) and zanamivir (trade name Relenza); • M2 inhibitors (adamantanes) - amantadine and rimantadine.

30. PROPHYLAXIS • Isolation of sick (patient); • Separate all plates and dishes used by sick (patient); • Во время эпидемии гриппа запретить частое собрание многих людейв помещение; • All people must wear gauze mask; • Specific preventive measures (vaccination) should be carry out at the beginning of epidemic.

31. PROPHYLAXISType of influenza vaccine

32. Thank you for your attention!