All moms and dads know that the flu is very dangerous for the life and health of a child. However, not everyone knows how to distinguish the flu from the mass of viral diseases similar to it, and out of habit, any seasonal infectious disease associated with fever, cough and runny nose is often called flu. In this material, we will look at what the flu is, how to recognize it in a child and how to treat it.
What it is?
The disease has received a beautiful French name - "Grippe". At its core, influenza refers to acute infectious diseases, and is caused by a very specific virus - one of the representatives of a large group of influenza viruses. Influenza can be caused by one of the 2000 viruses that are currently known to science.
Every year, up to half a million people die from various variants of influenza viruses in the world, most of them are children and the elderly, because their immunity is much weaker than the immunity of a young or middle-aged adult.
You can often find the second name of the disease - "influenza". It comes from the Italian word for impact. This name stuck due to its extreme contagiousness. Very quickly, individual outbreaks of viral infection turn into an epidemic covering large areas, and then into a pandemic, into which entire countries and continents are drawn.
The virus is transmitted by airborne droplets, and medicine cannot keep up with its mutations. Every year, new strains appear that are resistant to certain drugs and differ in symptoms. Influenza is dangerous not so much in itself as in its complications. Often, after the flu, pneumonia begins, hearing loss, vision loss occurs, and the heart muscle is affected.
Doctors noticed a strange disease back in the 16th century, but for the first time the influenza virus was discovered, isolated and studied in 1930, since then research work has not stopped. Several types, subspecies, types and subtypes of influenza have been identified, many of them are dangerous to humans.
How to distinguish from ARVI?
Influenza belongs to the group of acute respiratory diseases (ARVI), but is only one of its representatives. In this group, there are about 200 types of respiratory diseases that are caused by adenoviruses, rhinoviruses and other viruses. They provoke diseases that are considered to be flu-like, that is, similar to the flu. But in fact, they are completely different ailments.
It is a mistake to call any viral infection influenza, but the flu can be considered ARVI, although rather conditionally. In view of the fact that the group is large, specification is required.
Let's say right away that it is almost impossible to distinguish flu from SARS at home. This can be done only with the use of laboratory research. A blood test will help determine whether it is SARS or flu with high accuracy, and laboratory analysis will also show which particular strain of influenza affected the patient.
The external differences of influenza from other viral acute respiratory ailments are somewhat erased, implicit. So, at ARVI temperature is slightly lower than with flu, and muscle pain and severe headache are most often found with flu.
Often, doctors do not bother themselves with the difference. If the child is sick, and the mother called the doctor at home, with a 99.9% probability, the doctor will diagnose ARVI. Formally, he will be right, because the flu, as we now know, is a full member of a large group of ARVI. Why doesn't the pediatrician get to the bottom of the truth? The answer is quite simple - the Ministry of Health of the region will not praise a zealous specialist who “spoils” the epidemiological picture of the region or the edge, who creates unnecessary work for laboratories, and also “dramatizes” from scratch.
That is why the entry "ARVI" appears in the child's card, and the appointment is distinguished by a banal and standard approach. Blood for analysis will be taken from the child only if he goes to the hospital. It will be important to establish the exact strain and type of virus, if only to avoid an epidemic. Unfortunately, parents often find out about the exact diagnosis after a posthumous examination is done on a deceased child.
If the mother has doubts about the diagnosis of ARVI, if the child feels very bad, his condition is serious, there is no need to be shy. Parents have the right to insist on a complete and comprehensive examination, to demand a laboratory blood test for the isolation of the influenza virus. This will help save the child's life.
Influenza types
Three types of influenza virus pose a danger to humans: A, B, C.
The safest of them is type C: diseases caused by viruses of this type do not cause epidemics and pandemics, everything is limited to only single outbreaks of the disease, which, in turn, proceeds quite easily - without coughing, but with a runny nose, without fever. The type C virus does not cause formidable complications.
The most common is influenza caused by viruses of the A. It includes the well-known strains H1N1, H1N2, H3N2. These are the most insidious viruses that change faster than scientists can describe and study new forms of it. It is influenza A that causes the largest and most severe epidemics. The likelihood of severe complications from such a viral disease is the highest.
Influenza caused by B viruses is less common. These viruses do not have strains, are not divided into subtypes, mutate less often, and almost do not cause epidemics. However, every case of B virus infection is not easy. The good news is that the likelihood of complications after it is small.
The history of epidemics clearly shows that influenza A is the most dangerous.... In the early 20th century, the Spanish flu (H1N1) claimed millions of lives. At the end of the 50s of the last century, humanity faced a severe pandemic of the Asian influenza (H2N2). In the late 60s of the last century, many people died from the Hong Kong flu (H3N2). At the beginning of the new millennium, people "got acquainted" with the bird flu (H5N1), and more recently, swine flu (A-H1N1) was isolated.
Types of flu in 2018
Every year, WHO scientists observe the incidence and closely monitor the structure of influenza viruses. This allows them to predict the incidence for the year ahead and create new vaccines. A new flu strain is projected for 2018. Virologists say that he will take all the "best" from three strains - "Brisbane", "Michigan" and "Hong Kong".
The epidemic, according to WHO representatives, most likely cannot be avoided. Spring 2018 is just the beginning, the bulk of diseases are predicted in autumn. Each of the components of the new strain has mutated, so there is nothing adequate for doctors to resist the new ailment, but work in this direction is carried out every day.
In addition, this year, doctors are planning to "meet" the already familiar bird and swine flu, as well as other varieties of A.
Why get vaccinated?
It is the ability of the virus to mutate at an unprecedented rate that necessitates annual vaccination. The strain that "walked" last year is likely to change by next year, so a completely different vaccine will be required and, possibly, a different treatment regimen.
Previously, the vaccine protected a person from two type A viruses and B viruses, now the composition of the vaccine has been expanded to 4 strains and this is not the limit: scientists annually assess mutations and make adjustments to the "recipe" of the next flu vaccine.
Vaccination is recommended for all children over 6 months. After vaccination, immunity does not begin to work immediately, but about 2 weeks after the introduction of the vaccine components. That is why it is important to ensure that the child is vaccinated in advance. If the epidemic has already covered a good half of the city, it is too late and pointless to get vaccinated.
How does the infection take place?
Anyone can get the flu, regardless of age, gender, health status. Everyone is susceptible to the virus. But the likelihood of severe complications is higher in those with weaker immune defenses. Pregnant women and children, as well as pensioners, are a special risk group.
On average, the flu lasts 7-10 days. Throughout this time, the virus will spread through the air, with particles of saliva and nasal mucus when sneezing and coughing.
Spring flu, according to experts, is less dangerous from the point of view of the development of a severe form and epidemic. But in the autumn-winter period, a viral disease is a real threat to children's health. Scientists have found that the flu virus spreads fastest in the environment at temperatures from +5 degrees to -5 degrees Celsius, with low air humidity. The drier the air, the faster and more aggressive the influenza virus will act, collecting more and more victims.
At the time of infection, the virus enters the child's body through the nose, less often through the eyes. The cells of the ciliated epithelium of the upper respiratory tract are affected first. The virus enters them, begins to multiply, rebuilds the structure of the cells of the nasopharynx, trachea, bronchi. The cells cannot resist a rough invasion for a long time and die, then the virus infects the cells adjacent to them, and so on, until the ciliated epithelium is partially detached.
When the ciliated epithelium is almost killed, the influenza virus enters the bloodstream. Together with it, it spreads throughout the body, causing intoxication, muscle and headaches, spasms, chills, "aches". The blood vessels are also affected by a foreign invader and become more permeable, which often leads to hemorrhages and stasis.
In patients with influenza, signs of severe exudative damage to the alveoli and other structural units of the respiratory system are often observed. Simultaneously with the attack on all fronts, the influenza virus has an overwhelming effect on the immune system - the only system of the human body capable of giving it an adequate response to aggression. If the immunity is already weak, the protection is significantly reduced, secondary infections join - bacterial, fungal, viral. The development of complications begins.
From the moment of infection until the first signs of the disease appear, it can take several hours, or maybe several days.
Most often in children, due to age-related weakness of immunity, the incubation period lasts 1-2 days.
The younger the child, the weaker his natural immune defenses, the shorter the incubation period. So, in a teenager, the flu can manifest itself only on the third day after infection, while in a child in 1-2 years, the disease develops faster, progresses more severely and often ends in complications.
The most severe flu is in children with chronic respiratory diseases, as well as in children from six months to 3 years. By the way, newborns rarely get the flu. Doctors tend to see this as a positive protective effect of maternal innate immunity on the infant's body, because some antibodies are passed on by the mother's immunity to the child even during the period of his intrauterine development, and most of the antibodies to common infections are obtained with the baby's breast milk.
Symptoms and Signs
Influenza is an insidious disease, it has no specific symptoms. Recognizing this ailment among other viral ailments is not as easy as it might seem at first glance. Only laboratory diagnostics can reliably determine the flu.
The virus can be isolated from swabs from the throat of a sick child, from the nasopharynx, as well as from the results of a serological test, which allows to determine the presence of anti-influenza antibodies in the blood.
A diagnosis of influenza can be made only on the basis of a comprehensive laboratory test. Serological indicators, ESR in the study of a general blood test (CBC), the number of leukocytes - all this matters, but the assessment "by eye" is not.
However, parents need to know how the disease manifests itself. Symptoms may be more severe and less noticeable. The form of the disease can be mild to hypertoxic.
The classic picture of influenza looks like this: first, the body temperature rises. This rise is abrupt, sudden and acute. The temperature does not rise gradually, it immediately "jumps" to 38-40 degrees. Symptoms of intoxication appear almost immediately: severe pain in the muscles, pressing pain in the eyeballs, breaking pain in the legs, severe chills, headache.
Intoxication can be manifested by vomiting, most often vomiting at high temperatures occurs in children aged 2-4 years, as well as in children after 5 years.
The thin, flowing snot, which is common with most viral respiratory infections, is usually not observed with influenza. On the contrary, the nose often remains dry. The child experiences heat and dryness in the mouth and nose. The first signs include dry, frequent cough.
An older child will be able to outline an additional sensation when coughing - pain in the chest region. Due to the fact that the influenza virus violates the integrity of the blood vessels, in children, especially in small children, nosebleeds may flow, a hemorrhagic rash, resembling small hemorrhages, may appear.
If the flu is mild, then such symptoms persist for 4-5 days, after which they begin to recede, the child retains for several days after this a feeling of fatigue, weakness, weakness, and increased fatigue.
In severe influenza, the improvement after 3-4 days is insignificant and short-lived in itself. After barely noticeable relief, the child becomes worse, he develops secondary complications: pneumonia, vascular collapse, cerebral edema, hemorrhagic syndrome.
How often complications develop is difficult to answer unequivocally. According to clinical practice, severe complications do not develop so often, but in all cases, without exception, they pose a serious danger to the health and life of the child. They are usually caused by moderate to severe, severe and toxic forms of influenza. The largest number of deaths was registered among children under 2 years of age.
The most common complications are:
bacterial pneumonia (one of the most severe forms);
hemorrhagic pneumonia;
lung abscess;
respiratory acute distress syndrome;
bacterial rhinitis;
sinusitis;
tracheitis;
encephalitis;
meningitis;
radiculoneuritis and other neuritis, including neuritis of the auditory nerve;
myocarditis;
toxic-allergic shock.
Whether it is possible to influence the likelihood of complications is the second difficult question. Many doctors are inclined to believe that there is no way to influence this, it is impossible to predict the behavior of the immune system. However, most doctors believe that treatment, which begins promptly, without delay, partially reduces the likelihood of developing dangerous and serious complications.
Treatment
Influenza treatment is a complex of measures, which in fact is always more complicated than the manufacturers of dubious "cold and flu" medicines that are widely advertised on Russian television, newspapers and radio, are presented.99% of the drugs advertised as effective flu drugs have nothing to do with influenza treatment and will have no effect.
First of all, when the first signs of an illness resembling the flu are detected, the child should be put to bed, and his physical activity should be limited. Since low air humidity is very important for the reproduction of the virus, the air must be actively humidified.
With high humidity, the causative agent of the disease will be less likely to infect large areas of the ciliated epithelium, the disease will spread more slowly, the chances of complications will decrease tenfold.
There are many ways to humidify the air. If the house has a humidifier, you need to turn it on and set the scale of the desired humidity to 50-70%. If there is no such miracle device in the family, you need to hang wet towels on the heating radiators on a rope stretched across the room for such an occasion and make sure that they do not dry out completely, wetting them again from time to time.
In a hot room, humidity is harder to raise. Therefore, it is worth making sure that the air temperature in the room where the sick child is located does not exceed 21 degrees Celsius. This may seem too cruel to parents, since, according to subjective feelings, 21 degrees is pretty cool. If this temperature makes household members uncomfortable, let them dress warmly. For the patient, it is this temperature that will be the most optimal, contributing to a speedy recovery.
The second prerequisite for proper treatment is sufficient fluid. The child must be constantly given warm water, warm tea or homemade fruit drink, but not milk. Drinking plenty of fluids will make it possible to additionally moisturize the mucous membranes, and also prevent the onset of dehydration, which threatens the child with high heat and a toxic form of influenza that occurs with diarrhea or vomiting.
If the child categorically refuses to drink, you need to be more persistent, if the sick person is just a baby, you can use a disposable syringe without a needle in order to drip warm liquid into his mouth in small portions.
To protect the mucous membranes from drying out and the destructive effects of the influenza virus, instillation of saline, saline, and special preparations based on sea water will help. Irrigate the nasal mucous membranes as often as possible, there will be no harm from this. By and large, this is all that parents can do in the first stage. Of course, after the pediatrician has been called home.
With the flu or suspicion of it, the child does not need to be taken to the clinic to see a doctor. The disease is highly contagious. You should stay at home and wait for the doctor. The healthcare professional will be able to prescribe drugs that he considers the most effective and appropriate in this situation.
Medication
In Russia, they love to self-medicate. For some reason, parents think that they can give their child Kagocel or some kind of antibiotic against the flu and calm down. In fact, the use of medications for influenza infections is a rather dubious question.
Experts tend to believe that mild forms of flu do not need medications. Why is that? But because mild forms of flu rarely cause complications. By itself, the flu in a mild form is a kind of training for the child's immunity. He must cope with the virus himself, without outside support. And the child's body is capable of this, if the parents do not interfere with it.
With a mild form of flu, plenty of warm drinks, humidified air, and irrigation of the mucous membranes of the nose and throat are enough. In addition, you can give your child large doses of vitamin C.
You should not insist on eating. On an empty stomach, it is easier for the body to mobilize its defenses. When there is no need to spend energy digesting food, recovery is faster. That is why nature has arranged so that a sick child refuses to eat.
It is useful to remind you that you should not give a child any medication without the knowledge of a doctor, even if mom and dad are sure that “last time this syrup helped”. There is a special group of medicines for influenza - anti-influenza drugs. There are few of them, they are all used exclusively as directed by a doctor. Let's look at what means can be cured in a child, and what cannot.
Antibiotics
Antibiotics are effective against germs and bacteria.
They are really used for the flu, but only if if bacterial complications have begun, for example, bacterial pneumonia or rhinitis caused by disease-causing bacteria. If there is no such complication, antibiotics are inappropriate. They cannot affect the virus, facilitate the course of influenza infection.
However, taking antibiotics for influenza significantly increases the likelihood of complications themselves.
The bacteria adapt to the drug that the patient receives "just in case", and then it will be very difficult to cure such an infection.
Parents may object, because local pediatricians called to their homes often prescribe an antibiotic even before the development of complications with the wording "for prevention." The pediatrician seeks to protect himself, because in case of complications, claims will arise against him, and if complications arise while taking antibiotics, no one dares to reproach the specialist for not prescribing treatment on time.
Antibiotics are not used to prevent complications, they are created solely to treat bacterial diseases, to fight bacteria when they show pathological activity. Therefore, an experienced and thinking parent will categorically refuse such an appointment, asking to prescribe the correct treatment, and not therapy "just in case."
If complications have already begun, then antibiotics are needed. For children, drugs of a wide spectrum of action are most often used, for example, "Flemoxin", "Amoxiclav" or "Amoxicillin". They are prescribed as a course admission, the duration of the course is determined by the doctor, and in no case should the course be interrupted.
Antiviral drugs
Unlike other SARS, the influenza virus is sensitive to antiviral drugs, but only to certain drugs. They are used for both treatment and prevention. An important condition is that you need to treat the flu as early as possible. The effectiveness of the remedy will be shown only when the treatment has begun even before the onset of clinical symptoms. At later stages, the effectiveness of antiviral treatment is significantly reduced. It is unlikely that any of the parents would think of treating a child for a disease that has not yet manifested itself. It follows from this that special hopes cannot be pinned on antiviral agents.
Against the influenza virus in laboratory conditions, two groups of antiviral agents show a definite effect:
- inhibitors of neuraminidase;
- derivatives of adamantane.
The drugs that are derivatives of interferon, which have not only antiviral, but also anti-inflammatory effects, stand apart.
Neuraminidase inhibitors reduce the activity of the virus, acting on it in a direct pattern. These drugs include Tamiflu. It is very effective against most strains of influenza, including bird flu, but medical science today has overwhelming evidence of multiple side effects from such drugs.
For example, in Japan, where Tamiflu is the main drug for influenza for children, adolescent suicide is very common. Experts tend to believe that mental disorders that lead to suicide and other unpleasant behavioral pathologies are the result of exposure to neuraminidase inhibitors.
Side effects of this group of drugs also include diarrhea, intestinal disorders, abdominal pain, vomiting, and convulsions. According to indications, Tamiflu is given to children in a hospital setting; this drug cannot be purchased in ordinary pharmacies without a doctor's prescription. "Teraflu" and other "-flu", which are so often advertised on TV, have nothing to do with anti-influenza drugsdespite the fact that manufacturers say otherwise. They only partially relieve the symptoms of the disease, but in no case do they affect the virus itself.
M2 inhibitors (adamant derivatives) - "Amantadine" and "Rimantadine". These drugs prevent the virus from entering cells. They have fewer side effects, but the main effect is not too pronounced. In addition, doctors are increasingly talking about the emergence of influenza strains that are resistant to these drugs.
Among interferons against influenza, drugs are quite effective, which are donor serum and anti-influenza gamma globulin. These funds are injected intramuscularly, with severe toxic forms of the disease, 0.15-0.2 ml per kilogram of the baby's weight.
Experts warn that large doses of interferon can adversely affect the health of the child. Often, children are prescribed to bury "Interferon" in the nose. In this drug, the dosages of interferon are small, they will not cause harm, but experts also question the effectiveness of such treatment and prevention.
Thus, if the doctor sees the expediency of using antiviral agents, he must prescribe treatment, which will proceed in a hospital under the supervision of doctors.
The independent choice of a remedy, the name of which contains the word "antiviral", does not make sense and, at best, simply will not harm, but it will not have any effect on the course of the disease.
Dr. Komarovsky talks about antiviral drugs in the next video.
Homeopathic remedies
For the treatment of their children, many parents choose drugs that have no relation to medication, they are homeopathic. And no one warns parents about this. Most of the widely advertised drugs for the flu and colds are homeopathy, which means that the doses of the active substance in them are so small that they are counted in molecules, not milligrams. The child is not actually getting a flu pill, but sugar, starch and water.
Homeopathic medicines include the well-known "Anaferon" and "Anaferon for children", "Otsillococcinum", "Ergoferon", "Viferon". It is these drugs that are the favorite and most prescribed in modern pediatrics. Doctors know for sure that this is homeopathy, but they tactfully keep silent about it. This is because the flu will go away on its own in 3-5 days. However, it will be safer for parents if a doctor with an authoritative air prescribes at least something for them.
Homeopathic remedies cannot harm the baby, doctors are well aware of this. But the benefit of them has not yet been experimentally proven.
Whether to spend the family budget on such drugs is up to mothers and fathers to decide. The truth is that such "drugs" are very useful for those who produce them, each cold season, they bring their creators billions of dollars in profits.
For more information on homeopathic medicines, see the program of Dr. Komarovsky.
Vitamins
Vitamins for a child with flu are useful and necessary. They have a tonic effect, but in no way cure the flu itself. Therefore, there is no point in making the unfortunate child choke on sour lemon if he has all the signs of the flu. Doctors have been arguing for a long time about how vitamin C affects viral ailments. However, an end to this dispute was put by scientists who were able to prove that no doses of ascorbic acid can cure a person from influenza, but this substance can somewhat alleviate the course of the disease.
Therefore, there is nothing wrong with the fact that the mother will cook her sick baby juice from black currant, give tea with lemon, if he is not allergic to citrus fruits, or buy tasty and pleasant vitamins - "ascorbic" in the pharmacy. This, of course, will not affect the likelihood of developing complications, but it certainly will not harm.
How to treat correctly?
The correct treatment of influenza is symptomatic treatment, which does not imply the use of either antibiotics or antiviral drugs without the need.
Systemic drugs, as can be understood from all of the above, are relevant only for severe and toxic forms of the disease. In all other cases, parents should follow general recommendations - humidify the air, rinse the nose, monitor compliance with bed rest and generously water their child.
Symptomatic treatment includes remedies that will help the child survive several days of influenza infection with minimal loss. If the baby has a runny nose, it is allowed to bury him with vasoconstrictor drops, for example, "Nazivin" or "Nazol" in its children's forms.
It should be remembered that such drugs should not be used for more than 5 days; persistent drug addiction develops to them.
Paracetamol-based antipyretics will help reduce fever. If they are ineffective, the temperature does not drop, you can give the child a non-steroidal anti-inflammatory "Ibuprofen" or other drugs based on it, ibuprofen also perfectly relieves high fever.
It should be remembered that high fever with flu is a protective mechanism of children's immunity.
It is during the heat in the body that the production of natural interferons is stimulated, which enter into a merciless war with the penetrated virus. This is the best medicine for the flu. Therefore, it is recommended to be selective in reducing the heat. Give antipyretics only when it is really necessary.
If the age of the child allows you to tolerate the temperature a little, it is better to do this.
With a strong dry cough, you can give the child mucolytic agents, which facilitate the process of formation and expectoration of sputum, in case of vomiting or diarrhea, sorbents should be used and a drinking regime should be observed to prevent dehydration.
It is possible to protect the child from complications by observing rest, reducing the load on all organs and systems of his body.
Immunomodulators, which are often recommended by manufacturers as a remedy for influenza, should not be given unless the child has an immune system disorder. Isoprinosine and other drugs should only be taken as directed by a physician and not on the advice of a pharmacist from a nearby pharmacy.
A normal, somatically healthy child does not need stimulation of the immune defense, it will “work” without pills and pills.
Treatment with folk remedies
The effectiveness of folk remedies for influenza is about the same as that of most of the advertised drugs. At best, there will be no harm. If you really want to treat a child like this, then it is advisable to first talk to a doctor and understand that not all folk remedies are equally useful.
The main thing is to learn that there are several prohibitions that it is better not to discuss. Such actions of mom and dad can harm a child with flu.
Rubbing with vinegar, vodka, or ice wraps in high heat. This can cause a sharp drop in thermoregulation, vasospasm.
Wrapping the child in warm clothes, smearing it with badger fat, and pouring dry mustard into his socks. This can cause a violation of heat transfer, overheating of the body.
Instilling onion or garlic juice into the nose. These are aggressive substances that “burn” and damage mucous membranes.
Prevention
The flu vaccine will help protect your child. It is included in the mandatory vaccination schedule.You should not refuse it. Sure, vaccination does not guarantee that the child will not get infected, but it will provide an easier progression of the disease and minimize the likelihood of developing dangerous complications... This is the only specific preventive measure. All others are considered non-specific.
These include a more attentive attitude to precautionary measures during a dangerous period in terms of the likelihood of infection. In spring and autumn, you should not visit crowded places with your child, especially if these congestions take place indoors.
You should not violate the quarantine requirements if it is introduced in an educational institution or kindergarten. If it was not possible to save the baby, it is important to take only the drugs prescribed by the doctor, not to self-medicate. Influenza with proper treatment goes away quickly.
For prevention, a balanced, vitamin-rich diet will be beneficial. If a child has a diet prescribed by a doctor for a particular disease, it is imperative to take multivitamins. You shouldn't be afraid of walking. Walking in the winter is useful and necessary, the flu virus quickly loses activity in the cold in the air.
Systematic sports activities, an active and healthy lifestyle will help strengthen the immune system and make the baby healthier.
What is the peculiarity of the influenza virus and how to treat it, Dr. Komarovsky will tell in the next video.
