Respiratory disease prevention. Prevention of acute respiratory infections

Keywords: acute respiratory infections, viruses, antiviral drugs, vaccination, immunomodulators

Keywords: acute respiratory infections, viruses, antiviral preparations, vaccination, immunomodulators

The issues of prevention, diagnosis and treatment of acute infectious respiratory diseases in children have always been and remain in the focus of pediatricians.

Vaccinations take the form of long campaigns, usually two weeks. The period of these campaigns should be before the period of the greatest spread of the virus in the population of different regions of the country. This immunogen is also available from state specific immunobiological reference centers.

The vaccine consists of three types of influenza virus strains grown on embryonic hen eggs and subsequently inactivated and purified. It also contains neomycin, gentamicin, and thimerosal as preservatives. To provide adequate protection, the vaccine must be administered every year, as its composition also changes annually, depending on the circulating strains. The vaccination schedule recommended by the Ministry of Health varies according to the age group of the person to be vaccinated, as shown in the following table.

Acute respiratory infections (ARI) are the most common infectious pathology in children, characterized by a seasonal fall-winter rise and the ability to cause disease outbreaks in organized groups. The term "acute respiratory infection" encompasses a wide variety of diseases caused by various respiratory pathogens. The predominant place of reproduction and pathogenic effects of respiratory pathogens is the mucous membrane of the upper respiratory tract, however, the infection covers the entire respiratory tract, from the nasal passages to the terminal bronchioles and alveoli, which ultimately determines the clinical manifestations of the disease. Depending on the topic of the lesion of the respiratory tract, it is customary to distinguish various variants of infection of the upper (rhinitis, nasopharyngitis, tonsillopharyngitis, etc.) and lower (laryngo-tracheitis, tracheitis, bronchitis, pneumonia) respiratory tract. In most (90%) cases in which it is possible to detect pathogens by cultural, serological or molecular genetic methods, respiratory viruses are the cause of the development of ARI, which justifies the use of the term "acute respiratory viral infection (ARVI)", in other cases, acute respiratory infections have bacterial or viral-bacterial nature (table).

After vaccination in healthy adults, the detection of protective antibodies occurs between 1 and 2 weeks, with a peak after 4-6 weeks. The immunity gained from vaccination can vary. In the elderly, as the formation of antibodies is modulated by experience gained through years of repeated stimulation of the immune system by the influenza virus.

In cancer patients, because antibody production is lower than in healthy controls. Seroconversion ranges from 24% to 71%, with anticancer therapy being the determining factor for the least response in this group. In transplanted patients, immunization should be given prior to the procedure. In renal transplantation, seroconversion occurs in about 50% of cases one month after vaccination.

Table. The main groups of pathogens of ARI in children

Group	Causative agents
Respiratory viruses	Influenza (A, B), parainfluenza, adenoviruses, respiratory syncytial virus (RS virus), rhinoviruses, coronaviruses
Intra- and extracellular pathogens	Chlamidophila pneumonia, Ch. trachomatis, Mycoplasma pneumoniae, M. hominis, Pneumocystis spp.
Herpesviruses	Herpes type 1, type 2, Epstein-Barr virus (EBV) type 4, cytomegalovirus (CMV) type 5, herpes type 6
Representatives of endogenous microflora	Staphylococci, streptococci, enterococci, etc.
Bacterial pathogens of ENT organs and the respiratory tract	Pneumococcus, Haemophilus influenzae, Moraxella, Staphylococcus aureus, Escherichia coli, Klebsiella
Other pathogens	Legionella, bocavirus, metapneumovirus

Causative agents of acute respiratory infections of viral etiology are representatives of different viral families, many viruses are heterogeneous in their antigenic structure and have several serotypes, which can greatly complicate clinical diagnosis, since this, in turn, determines the variety of clinical manifestations of the same infection. One of the most common are rhinoviruses (more than 100 strains of the pathogen are known), which cause disease in more than a third of ARVI cases. Along with rhinoviruses, the causes of acute respiratory infections are adenoviruses, parainfluenza viruses, respiratory syncytial virus (RS virus), enteroviruses, and during epidemic outbreaks - influenza viruses.

A contraindication for this vaccine is the presence of an anaphylactic hypersensitivity reaction to the proteins of chicken eggs and people with a previous history of Guillain-Barré syndrome. The adverse events most commonly associated with the vaccine are localized and usually resolve within 48 hours: moderate pain at the site of application and erythema, which occurs in 10-64% of vaccines. Other systemic reactions may also be present, such as fever, asthenia, myalgia, and headachewhich usually occur 6-12 hours after application.

Currently, according to domestic and foreign studies, there are features of the epidemiology and etiological structure. acute infections respiratory tract. In recent years, especially in the last 5 years, a unique epidemiological situation with influenza has developed in the world. It is due to the fact that the world's population is simultaneously threatened by circulating strains of seasonal influenza A (H1N1), A (H3N2). Moreover, in recent years, a situation has emerged when two evolutionary lines of the influenza B virus are relevant, which, unfortunately, do not provide cross-uniform immunity and create a problem in terms of the possibility of mismatching the strain composition of seasonal vaccines. The pandemic influenza A (H1N1) pdm09 virus continues to be relevant, with a real threat of widespread spread bird flu A (H5N1), A (H7N9) and influenza virus reassortant A (H3N2) swl. In addition, in recent years, many studies have been devoted to the role of such "new" infections as coronavirus, bocavirus and metapneumovirus, which in the structure of respiratory viral morbidity, according to various sources, range from 10 to 20% (especially in combination with other respiratory viruses) ...

Since the vaccine consists of inactivated viruses, it cannot cause disease. The “flu cases” that are ultimately diagnosed in newly vaccinated people can be caused by infection with other strains not present in the vaccine, serological conversion failure, or infection with other respiratory viruses.

All rights reserved. Partial or complete reproduction of this work is permitted, provided that the source is cited and not sold or for any commercial purpose. This playback will remain open to unlimited subscribers. Coordinator of the pediatric medical treatment program at the same institution. Acute respiratory infections are an important cause of morbidity and mortality in children under 5 years of age worldwide. Two thirds of these deaths occur in children under 1 year of age and 90% in developing countries.

Today it is already known that not only influenza viruses and the RS virus, but also rhinoviruses, adenoviruses, human metapneumovirus, as well as herpes viruses and atypical ones, are important etiological agents in the development of infections of the upper respiratory tract, as well as bronchiolitis and pneumonia, croup and exacerbation of bronchial asthma. pathogens. For example, the causative agents of community-acquired pneumonia, along with the most significant pathogen for this pathology, Streptococcus pneumoniae, can be both the RS virus and rhinoviruses. Moreover, if for adults with community-acquired pneumonia of viral etiology, influenza viruses, coronaviruses and adenoviruses are most often relevant, then in children the spectrum of etiologically significant viral pathogens of pneumonia is much wider and viral and viral-bacterial associations are more often found.

The most common viral agents involved in acute respiratory infections are respiratory syncytial virus, influenza A and B virus, parainfluenza virus, adenovirus, and human metapneumovirus. It has a worldwide distribution and follows a characteristic seasonal pattern that circulates mainly during the winter months.

They are part of this risk group in children: premature babies, patients with cardiopulmonary disease, men attending kindergartens, children of parents of smokers, families with low income and absence or short breastfeeding... The virus survives well in places such as clothing and aprons, sprays, toys, items on the table, stethoscopes and cradle bars, surgical gloves, pajamas, fabrics, and leather.

Acute respiratory infections due to high risk the development of complications at any time from the onset of the disease is a serious health problem, and especially in children. But the most serious illness along the course and the risk of developing complications of all ARIs is influenza. Every year, even during seasonal outbreaks of influenza alone, up to 5 million people fall ill in the world, mortality from influenza during epidemics in different age groups ranges from tens to hundreds of cases, and during a pandemic the figure can reach 1000 cases per 100 thousand population. The results of an 8-year epidemiological study conducted by the Centers for Disease Control and Prevention (CDC) between October 2004 and September 2012 in the United States showed that the risk of death from influenza is high for both chronically ill and healthy children. ... According to the study, more than a third of children with influenza died before hospitalization, within 3 days from the onset of the first symptoms of the disease, the average age of the patients who died was 7 years (probable deviation: 1-12 years). Of the 794 influenza-related deaths, 43% of children were not at increased risk of illness. At the same time, these studies confirmed an increased risk of complications, including a high mortality rate among children with concomitant diseases: 33% of the children who died had neurological pathologies and 12% had genetic or chromosomal abnormalities. The authors emphasize that the timely administration of anti-influenza drugs could reduce the severity of the disease and complications, but only less than half of the children who died had information on the appointment of anti-influenza chemotherapy.

Control measures in hospitals need to be in place to prevent the spread of the virus in hospitalized children, as more than 45% of contacts become infected. The guidelines are intended to isolate the patient in a separate room alone or in combination with other infected children, barrier methods, selection and separation of nurses, and restriction of visits. Versatile measures such as hand washing are fundamental.

In regions with subtropical climates, such as the city of São Paulo, outbreaks occur during the fall and winter months, with peak levels in May and June. Its incubation period is 2 to 8 days. At the onset of the disease, viral replication in the nasopharynx is intense.

An effective method of preventing infections is vaccination - active immunization, leading to the development of specific resistance to infectious agents. Currently, vaccination is carried out against such respiratory pathogens as influenza, pneumococcal and hemophilus influenza (Hib) infections. Due to persistent genetic and antigenic changes in influenza viruses, the World Health Organization (WHO) recommends annual vaccination before the start of the season.

The mechanism by which the virus spreads from the upper respiratory tract to the lower respiratory tract is not clear, it is assumed that it is spread by the respiratory epithelium, cells with a cell, or aspiration of contaminated secretions or infected macrophages migrate in the respiratory tract below.

The virus has a direct cytopathic effect on the respiratory epithelium and induces a set of adjacent cells, not infected with the formation of syncytium, with the destruction of ciliated epithelial cells with necrosis and bronchial proliferation of the epithelium, promoting the exposure of cholinergic nerve endings to stimuli, increased permeability to antigens and allergens and loss of epithelial factors that relax in the peribronchial muscles, such as nitric oxide.

Specific prophylaxis of influenza is carried out by vaccines, which are prepared from the actual strains of the virus recommended by WHO for the new epidemic season, the composition of the vaccines contains 3 strains: 2 - subtypes A / H1N1 /, A / H3N2 / and 1 - influenza B virus. In addition, in the season 2013-2014 in the USA, Canada and a number of European countries were approved for use, including in children, 4-component vaccines containing 4 strains: 2 of each subtype of influenza A and B.

After viral incubation, the presented symptoms are characterized by light-colored nasal secretion, moderate cough and low hyperthermia, and wheezing may occur in some cases. This type of infection can include anorexia, hearing complications such as otitis media and sinusitis.

The etiologic diagnosis of acute respiratory infections is based on the patient's symptoms, especially in infants with bronchiolitis. However, pinpointing viral etiology is important to guide antiviral therapy, prevent spread in the hospital, initiate surveillance, and in some cases reduce hospital costs and hospital stay days.

Today, an important point in the prevention of respiratory infections in children is the possibility of vaccination against hemophilic and pneumococcal infections, which are the cause of an acute infectious disease in children, mainly under the age of 5 years, as well as those associated with severe bacterial complications flu and SARS. The results of a recent study of the prevalence of community-acquired pneumonia and acute otitis media in children under 5 years of age in Russia, conducted within the framework of the PAPIRUS (Prospective Assessment of Pneumococcal Infection in Russia) program, confirmed the high incidence of these diseases and demonstrated the leading role of Streptococcus pneumoniae and Haemophilus influenzae in their development. Analysis of epidemiological studies on the prevalence of various serotypes of pneumococcal pathogen in Russia at present, identification of antibiotic-resistant strains in all age groups allowed the authors to conclude that the widespread use of modern conjugated pneumococcal vaccines within the immunization program will solve this serious problem of domestic health care and significantly reduce the incidence given nosological forms.

More quick methods diagnostics is the detection of viral antigens. It can be performed using direct and indirect immunofluorescence reactions, which have a sensitivity of 80% and a specificity of 90%. Polymerase chain reaction methods in a number of studies have proven to be more sensitive than immunofluorescence and culture for the etiological diagnosis of acute viral infections.

There is no evidence in the literature to support the use of corticosteroids in cases of acute viral bronchiolitis, although their use is routine. The supply of humidified oxygen, maintenance of hydration and fluidization of secretions remain the only effective methods treatment. Its use is limited by the high cost of each dose.

Passive immunoprophylaxis of MS viral infection with immunoglobulin palivizumab (Sinagis) in our country has recently been carried out for children from high-risk groups for the development of severe lower respiratory tract infections. According to foreign publications, monthly administration of palivizumab during the period of circulation of the RS virus among the population leads to a 50% decrease in the number of severe infections in children of risk groups requiring hospitalization, compared with placebo.

Respiratory syncytial viral infection in children. The incidence of viruses associated with acute respiratory infections in children under five years of age in Mexico City. Geneva: Heli World Organization. Newly discovered human pneumovirus isolated from young children with respiratory problems.

Vaccine Research Initiative - Acute Respiratory Infections: Respiratory Syncytial Virus. Pharmacological treatment of bronchiolitis in infants and children: a systematic review. Environmental and demographic risk factors for lower respiratory syncytial virus disease.

For seasonal prevention of acute infectious diseases respiratory organs are also used methods of nonspecific activation of the immune system with the use of immunomodulatory pharmacological preparations, for example, bacterial vaccines and synthetic immunomodulators. Bacterial vaccines - immunomodulators of microbial origin: purified bacterial lysates (IRS19, Imudon, Bronchomunal, Bronchowaxom), combined immunocorrectors containing bacterial antigens and non-specific immunomodulators LPS and proteoglycan (Ribomunil, Immunovac VP-4) (have semi-synthetic analogs) : specific (vaccinating) and non-specific (immunostimulating). Of the synthetic immunomodulators, azoxymer bromide (Polyoxidonium), pidotimod (Imunorix), and interferon inducers tilorone (Amiksin) are used.

Improving Respiratory Syncytial Viral Infection Outcomes in High Priority Hospitalized Canadian Children. The Pediatric Infection Research Network in Canada. Advances in the prevention of respiratory syncytial viral infections.

Prevention of respiratory syncytial viral infections. Immune reactions and intensification of the disease in respiratory syncytial viral infection. Genetic and antigenic diversity of respiratory syncytial viruses. Association of a new type of cytopathogenic mixovirus with infantile croup.

In addition to vaccination as the main strategy for fighting influenza, WHO recommends the use of etiotropic chemotherapy drugs that block the functional activity of the virus at different stages of its replicative cycle. Drug prophylaxis of influenza and ARVI is prescribed as an addition to late vaccination for people at risk in the first 2 weeks after vaccination (during the period of antibody formation); children who are vaccinated for the first time (since the formation of antibodies ends by the 2nd week after the second vaccination); patients with chronic pathology, accompanied by immunodeficiency, in whom, as a result of vaccination, an insufficient immune response is formed; persons for whom influenza vaccination is contraindicated (for example, in case of an allergic reaction to previous vaccinations); unvaccinated persons after contact with a sick person. Drug prophylaxis of influenza and ARVI effectively complements vaccination and, when used during influenza epidemics, can significantly reduce morbidity and mortality from infection. The WHO recommendations are the same for seasonal and pandemic influenza, but require compliance with the conditions of frequency and duration of antiviral drug intake. It is not recommended to carry out chemoprophylaxis later than 48 hours from the moment of contact with the patient. Post-exposure chemoprophylaxis is effective only if taken daily in recommended dosages for at least 7 days after contact with the patient. For the newly vaccinated, the recommended duration of chemoprophylaxis is at least 2 weeks, that is, until the formation of specific immunity (for children, an increase in the period may be possible, depending on age and vaccination history).

Recovering from infants with respiratory diseases of a virus associated with a chimpanzee puncture agent. Respiratory syncytial viral infection. Respiratory syncytial virus and influenza A infections in hospitalized older adults. Relationships between respiratory syncytial bronchiolitis virus and asthma in children: clinical and research approaches.

Prevention and treatment of acute respiratory infections

Comparison of the three detection methods respiratory viruses in aspiration of nasophaging in children with more acute respiratory infections. Vitamin deficiency is already considered a public health problem that can threaten up to 90% of people in some populations. To prevent deterioration in respiratory function, pneumonia must be prevented, detected early, and treated quickly. Unlike in healthy people, long-term and sometimes continuous use of antibiotics is of paramount importance for patients with cystic fibrosis.

The vast domestic pharmaceutical market requires a clear understanding of the criteria for choosing an etiotropic drug. Antiviral chemotherapy drugs have a direct effect on viral reproduction and are aimed at a specific virus-specific target in the cycle of viral reproduction. The use of exclusion criteria - and this is the absence of a proven mechanism of action, the absence of a direct effect on one of the viral replication links, the impossibility of achieving a therapeutic concentration of the drug in the blood plasma - allows us to clearly limit the range of effective antiviral agents ... In pediatric practice, neuraminidase inhibitors - oseltamivir (Tamiflu) in children from 1 year old, zanamivir (Relenza) - from 5 years old and an inhibitor of virus-cell fusion umifenovir (Arbidol) - from 3 years old are used for chemoprophylaxis and therapy of influenza. Preparations of rimantadine, which blocks the M2 channels of the virion of the influenza A virus and is not active against the influenza B virus, are currently not recommended by WHO for use due to the high prevalence of drug-resistant virus strains. Unlike neuraminidase inhibitors, umifenovir is active not only against influenza A and B viruses, but also against a number of other pathogens of acute respiratory viral infections; it is used both as a means for seasonal prevention of acute respiratory viral infections, and as a means of emergency prevention of not only influenza, but also acute respiratory viral infections in children's groups, in family foci, including in pregnant women who have been in contact with patients, preventing the development of severe forms of the disease in them.

Respiratory physiotherapy: essential

Respiratory physiotherapy is the cornerstone of symptomatic management of cystic fibrosis. It should be done daily, once or twice a day, for life. Its purpose is to help the lungs evacuate secretions. During childhood, sessions are conducted by a specialized physical therapist or parents. Indeed, there are techniques that can be made by oneself. However, they do require training and should be monitored regularly by a physical therapist who corrects mistakes.

There are several methods, sometimes accompanied by tools. Several medications can be used to avoid bronchial obstruction with too viscous secretions. Fluidizers are designed to make the secretion more liquid bronchodilators, often indicated because they increase the effectiveness of physiotherapy and relieve asthmatic symptoms in some patients or as a result of certain medications, inhaled corticosteroids, bronchodilator inflammation, antibiotics are indicated to fight bacterial infections. These drugs can be administered in different ways.

Into the complex preventive measures, in addition to vaccination and pharmacoprophylaxis, includes general strengthening measures aimed at reducing the antigenic effect and increasing the resistance of the child's body as a whole - a rational daily regimen, optimal nutrition, hardening procedures, sanitation of local foci of chronic infection; the appointment of vitamin and mineral complexes. The use of a set of these measures can reduce the frequency of acute infectious respiratory diseases and exacerbations of foci of chronic infection.

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For most people, diseases from the ARVI group (ARI), or acute respiratory viral infections are known as colds. General malaise, fever and headache are found in the clinical picture of each ARVI, despite the variant of the pathogen - parainfluenza virus, adenovirus, rhinovirus. Influenza is also characterized by an acute course and damage to the respiratory system; it is caused by a virus, which is subdivided into types A, B and C. The disease is more difficult to carry than other acute respiratory viral infections, with dangerously numerous complications. Intoxication syndrome usually predominates over catarrhal, fever reaches febrile and pyretic values \u200b\u200b(38–41 ° C). Prevention of acute respiratory infections and influenza prevents both the case of the disease and the spread of the pathogen.

Influenza is called not only diseases caused by the pathogen of the same name, but also damage to the digestive tract, provoked by rotavirus.

Prevention includes adherence to the rules of personal hygiene, the use of purified water, and vaccination.

The influenza virus is transmitted from a sick person to healthy people. At the same time, age and gender do not matter, although the susceptibility to the pathogen and the tendency to a severe course of influenza is higher among patients belonging to risk groups:

persons over 65;
patients with chronic pathologies of the respiratory and cardiovascular systems;
patients with impaired renal function;
patients with immunodeficiency;
pregnant women;
young children.

Flu symptoms appear suddenly, among them are:

Weakness, headache.
Pain in muscles and joints.
Fever.
Dry cough.
Sore throat and sore throat.

Additional manifestations are considered a runny nose (nasal congestion, the presence of mucous discharge), nausea, vomiting, epistaxis. Complications of influenza can be pneumonia (both viral and bacterial etiology), myocarditis, pericarditis, meningitis, otitis media, sinusitis, hemorrhagic pulmonary edema and the development of acute respiratory failure. The severe course of the infectious process leads to dysfunction of organs and systems, decompensation of chronic diseases. Despite the existence of several groups antiviral drugs, some strains of the virus have acquired resistance to them, which negates all treatment efforts. Therefore, prevention and adults remains the most preferred option for dealing with the disease.

What you need to know about prevention

Prevention of influenza is a combination of measures that can reduce the likelihood of transmission of infection and / or prevent the onset of illness and is divided as:

non-specific;
specific.

The regulations and the list of necessary measures in relation to the source of infection and contact persons are specified in the SanPiN "Prevention of influenza". The document contains basic information on the organization of anti-epidemic measures, requirements for monitoring the accounting and analysis of morbidity; based on the information provided in it, sanitary bulletins are being prepared on the prevention of influenza, as well as memos for the population “Prevention of influenza and ARVI”. The main anti-epidemic measures include:

Collecting analytical information on the spread of viral infection.
Hospitalization, isolation of patients with influenza.
Identification of persons in contact with patients with influenza.
Restriction or prohibition of mass events.
Introduction of early holidays or their extension for school students.
Prohibition of admission or transfer of children between groups in kindergartens.
Conducting sanitary and educational work regarding the prevention of ARVI and influenza among the population.

In medical institutions, hospitals are being created for the treatment of patients with influenza, special admission departments in polyclinics (a separate entrance, offices delimited from the main corridor, a procedure room). In the pre-epidemic period, thematic classes are held for medical professionals, during which the main symptoms, innovations in the diagnosis and treatment of influenza infection are described, the need for vigilance in relation to the influenza virus is emphasized. In kindergarten, flu prevention includes daily thermometry and medical examination of children, and information about it can be obtained from the antenatal clinic or from a general practitioner.

Non-specific prophylaxis

Influenza infection occurs through contact with a patient - more precisely, with his secretions (sputum, saliva) containing the virus. They can be sprayed into the air during sneezing and coughing, applied with hands to objects, the hands of another person. Non-specific prevention of influenza is aimed primarily at limiting contact with the pathogen or increasing the reactivity of the immune system. It is divided into the following types:

emergency;
seasonal;
sanitary and hygienic measures.

Emergency prevention of influenza consists in the use of drugs with antiviral effects (oxolinic ointment, arbidol, immunal, influenza, leukocyte interferon).

It is carried out during an epidemic or during a stay in the focus of infection if it is impossible to avoid contact with patients with influenza. Emergency prophylaxis is expected to have a quick effect on preventing infection.

Seasonal prophylaxis of influenza is based on taking drugs-immunocorrectors in tablets or other dosage forms. The main direction is to increase resistance and reduce susceptibility to infection; this prevention option is shown:

Persons belonging to risk groups for disease and severe ARVI, influenza.

Knowledge of hygiene practices helps to prevent influenza in newborns, children of all age groups and adults. The list includes:

avoiding contact with patients with influenza and SARS;
refusal to visit crowded places;
wearing masks when forced to stay near patients;
frequent hand washing with soap;
systematic wet cleaning and airing of premises.

It is necessary to teach yourself and the child not to touch the nose, eyes, mouth until your hands are washed. It is recommended to take vitamins (C, A, group B) in age doses. It is important to observe the regime of work and rest, good sleep, a balanced diet, and if possible, hardening. All these measures contribute to the successful prevention of infection with swine, bird flu and other strains of influenza infection.

Patients with flu symptoms should avoid covering their mouths with a hand when sneezing or coughing using a handkerchief. It should be changed as often as possible or disposable nasal wipes should be purchased. Isolation is the best way to prevent transmission of influenza and SARS; the pictures in the memos clearly demonstrate information about the radius of the spread of the virus - it is 3 meters or even more, so it is unsafe to be present near a sneezing patient.

In infants, the prevention of influenza consists primarily in reducing the frequency of contact with others (family friends and relatives, people in line to see a doctor or visitors to the supermarket, the parents of the child themselves if any of them have influenza).

To prevent influenza in older children, it is necessary to explain the danger of infection and attend public events, talk about the rules for washing hands, behavior on the street and in transport. Annual vaccination is of great importance, as it is a specific preventive measure.

In the event of outbreaks and epidemics of swine, bird flu, it is necessary to refuse or limit contact not only with sick people, but also with animal carriers. If it is necessary to come into contact with them (work on a pig farm, maintaining a household, participating in an agricultural fair), personal protective equipment (masks) should be used, hands should be washed in time, and the contact time should be shortened.

If there is a patient with the flu in the house who is receiving treatment, you should never forget about prevention and following the rules of hygiene. In the absence of indications for hospitalization, isolation, the allocation of separate dishes, towels, bed linen, as well as a sufficient number of napkins and disposable masks are necessary. After visiting the patient's room, you need to thoroughly wash your hands, while staying next to him, put on a mask, which you need to change at least every 4 hours. Information on the prevention of influenza and ARVI is presented in numerous presentations; it is prohibited to allow children or pregnant women to care for patients with influenza.

Prevention of influenza folk remedies consists in the use of garlic, onions, as well as honey, which is known for its general tonic effect. These products are useful in the absence of allergies, diseases of the gastrointestinal tract.

Specific prevention

Specific and non-specific prevention of influenza is extremely important; when combining them, you can achieve good results in relation to not only one patient, but also the team. The fewer flu patients, the fewer healthy people they will transmit the virus. Specific prophylaxis means vaccination against influenza, that is, the creation of immunity against the virus and the formation of the body's immunity to influenza infection.

Vaccination is required:

Persons over 60 years old, including those staying in nursing homes and other social security institutions.
Children over 6 months old, including those in baby homes.
Persons suffering from chronic diseases.
Frequent and long-term ill patients.
Workers in trade, transport, educational institutions.
Medical staff.
Persons in military service.
Pregnant women.

Anyone who wants to protect themselves from the flu can get vaccinated if they have no contraindications:

acute infectious and non-infectious diseases accompanied by fever;
allergy to chicken protein and other components of the vaccine;
a history of allergic reaction associated with vaccination;
exacerbation of chronic diseases;
diffuse connective tissue diseases;
lesions of the adrenal glands and nervous system.

For immunization, both live and inactivated vaccines are used. Chronic lung diseases, bronchial asthma and chronic rhinitis are contraindications for vaccination with live vaccines.

Prevention of influenza in pregnant women is carried out only with inactivated vaccines.

Due to the constant antigenic variability, the influenza virus differs from previous strains - almost every year a new variant of the pathogen appears, the danger of which is the lack of any immunity to it. The vaccine contains several types of the virus or its components at once, which makes it possible to cover the entire suspected range of infectious agents and achieve the creation of immunity against those pathogens that are expected to circulate in the upcoming “influenza season”. In order for the immune system to form a defense, specific flu prophylaxis is carried out in the fall (from October to November). Antibodies appear after 2 weeks and persist for 6 to 12 months.

Vaccination only protects against influenza strains that have antibodies. The composition of vaccines is determined by the prognostic data of the WHO, which does not exclude the likelihood of infection with an "unfamiliar" variant of the causative agent of influenza or other infectious agents from the ARVI group.

The vaccine against influenza infection creates immunity exclusively against influenza - it is necessary not only so that the vaccinated patient does not get sick. Influenza causes severe complications that are not typical for most acute respiratory viral infections. Vaccination is a way to protect against the consequences of a viral infection. Also, vaccination does not provide an unconditional guarantee of the absence of disease. But if the virus infects the vaccinated person, the infectious process proceeds easily and is not accompanied by the development of complications.

Antiviral drugs

Drugs exhibiting antiviral activity have been used not only for the purpose of treatment, but also for the prevention of influenza not so long ago. These include ion channel inhibitors, or adamantanes (amantadine, rimantadine), neuraminidase inhibitors (oseltamivir, zanamivir). They are appointed:

unvaccinated patients belonging to risk groups;
patients included in risk groups and who received the vaccine immediately before the start of the epidemic;
upon detection of antigenic differences between the vaccine and the circulating strain (in case of a prediction error);
health care workers who have not been vaccinated and provide care for patients with the flu.

All drugs have contraindications (impaired renal function, liver function, chronic diseases respiratory system, pregnancy), in the presence of which a dose adjustment or refusal to take is required. Incorrect use of antiviral prophylactic therapy becomes the cause of resistance, therefore, careful monitoring of dosages is necessary, informing about the consequences of self-reduction in the minimum course of admission.