Measures to prevent influenza, acute respiratory viral infections (ARDS), colds. Prevention of acute respiratory diseases in children

The manual for doctors was created on the basis of the scientific and practical program of the Union of Pediatricians of Russia and International Fund protection of maternal and child health "Acute respiratory diseases in children: treatment and prevention", developed with the participation of the companies Pierre Fabre, GlaxoSmithKline, Servier [show] .

SCIENTIFIC AND PRACTICAL PROGRAM
"ACUTE RESPIRATORY DISEASES IN CHILDREN: TREATMENT AND PREVENTION"

PROGRAM MANAGER

Baranov A.A.	Academician of the Russian Academy of Medical Sciences, Professor, Chairman of the Executive Committee of the Union of Pediatricians of Russia, Director of the Scientific Center for Children's Health of the Russian Academy of Medical Sciences
COORDINATORS
Gorelov A.V.	professor, Moscow medical Academy them. I.M. Sechenova, Central Research Institute of Epidemiology, Ministry of Health of the Russian Federation, Moscow
Kaganov B.S.
Korovina N.A.	Professor, Russian Medical Academy postgraduate education Ministry of Health of the Russian Federation, Moscow
Tatochenko V.K.	Professor, Science Center children's health RAMS, Moscow
Uchaikin V.F.	Academician of the Russian Academy of Medical Sciences,
EXPERT ADVICE
Balabolkin I.I.	Corresponding Member of the Russian Academy of Medical Sciences, Professor, Scientific Center for Children's Health of the Russian Academy of Medical Sciences, Moscow
Baleva L.S.	Professor, Federal Center for Radiation Protection at the Research Institute of Pediatrics and Pediatric Surgery of the Ministry of Health of the Russian Federation, Moscow
Balyasinskaya G.L.	Professor, Russian State medical University, Moscow
Blistinova Z.A.	Leading specialist, Moscow Health Committee
Gavalov S.M.	Professor, Novosibirsk Medical Academy
Gorbunov S.G.	PhD, Central Research Institute of Epidemiology, Ministry of Health of the Russian Federation, Moscow
Zaplatnikov A.L.	Candidate of Medical Sciences, Associate Professor, Russian Medical Academy of Postgraduate Education, Moscow
Zeigarnik M.V.
Ilyin A.G.	Candidate of Medical Sciences, Ministry of Health of the Russian Federation, Moscow
Korsunsky A.A.	Professor, Ministry of Health of the Russian Federation, Moscow
Proshin V.A.	Head of Department, Moscow Health Committee
Kharlamova F.S.	Professor, Associate Professor, Russian State Medical University, Moscow
Samsygina G.A.	Professor, Russian State Medical University, Moscow
Erdes S.I.	Candidate of Medical Sciences, Associate Professor, Moscow Medical Academy named after. I.M.Sechenova
Shilyaev R.R.	Professor, Ivanovo State Medical Academy
SCIENTIFIC EDITORS
Zeigarnik M.V.	PhD, Scientific Center for Children's Health, Russian Academy of Medical Sciences, Moscow
Kazyukova T.V.	PhD, Russian State Medical University, Moscow
EXECUTIVE SECRETARY
Safronova A.N.	Candidate of Medical Sciences, Moscow Medical Academy named after. I.M. Sechenov, Moscow

Chapter 9. Prevention of acute respiratory diseases

Key points:

Taking into account the ways of spread of influenza and AR-VI, isolation of a child from a sick person and a potential source of infection plays a leading role in the prevention of acute respiratory infections.
There are a number of effective vaccines against certain types of pathogens that cause acute respiratory infections: influenza, Hemophilus imfluenzae type b infection, pneumococcal infection.
Bacterial vaccines against several respiratory pathogens, created on the basis of ribosomal fractions of pathogenic bacteria or their lysates, are widely used.
One of the main methods of increasing a child’s resistance to infectious agents is hardening.
Interferon prophylaxis is indicated for children with a severe premorbid background who are just starting to attend child care institutions, as well as for all children during an influenza epidemic.

9.1. Exposure prevention

Exposure prophylaxis aims to prevent a child from coming into contact with a source of infection. Taking into account the ways of spread of influenza and ARVI, isolation of a child from a sick person and a potential source of infection plays a leading role in the prevention of acute respiratory infections. The main measures that can be taken in this regard are as follows:

limiting the child’s contacts during seasons of increased respiratory morbidity;
reducing the use of public transport for traveling with children;
lengthening the child’s time in the air;
wearing masks by family members with signs of acute respiratory infections;
Thorough hand washing after contact with a patient with an acute respiratory infection or care items;
restriction of visits to child care institutions by children with fresh catarrhal symptoms. In areas of acute respiratory infections The following preventive measures are taken:
quarantine is introduced for a period of 7 days from the moment of the last case of the disease, the sanitary and epidemiological regime is strengthened;
Wet cleaning of premises is carried out;
patients with acute respiratory infections are isolated or hospitalized;
contact persons are examined daily and thermometered;
In the outbreaks, interferon prophylaxis and other methods of preventing acute respiratory infections are also carried out.

9.2. Dispositional prevention

The main methods of increasing a child’s resistance to infectious agents are vaccination (also see below) and hardening. When the skin cools, a reflex narrowing occurs blood vessels both the skin and the nasal mucosa, which reduces the air temperature in the nasal cavity by 2° C. This disrupts the functions of protective cells, reduces the flow of antibodies, which increases the risk of infection. Hardening trains the reaction of blood vessels; in those who are hardened, during cooling, the air temperature in the nasal cavity drops by only 0.3-0.5 ° C.

Hardening does not require very low temperatures; temperature contrast and systematic procedures are important. Effects on the soles of the feet, the skin of the neck, and lower back are good for hardening, but to obtain a uniform effect, it is better to act on the skin of the entire body. The maximum duration of cold exposure on a child should not exceed 10-20 minutes; its repetition and gradualness are much more important.

Hardening, if the child is kept in greenhouse conditions, will not have an effect; it is important to create a stimulating temperature environment: weather-appropriate clothing, normal temperature in the apartment (18-20° during the day and 2-4° C lower at night). From the age of 1, the child should be accustomed to walks (up to 4 hours a day), while avoiding excessively warm clothing.

Hardening should begin from the first weeks of life - these are air baths during swaddling, gymnastics, and before bathing. To do this, the child is left in the air undressed for several minutes at a temperature of 22° C, followed by a gradual decrease in temperature to 20° C at the age of 2-3 months and 18° C by 4-6 months. Bathing should also be used for hardening: at the end of the bath, it is appropriate to pour water over the child with a temperature 2-4 ° C lower than the water in the bath, i.e. start with a temperature of 32-34° C, reducing it every 3 days by 2-3° C. At this rate of decrease in water temperature, you can reach 18° C in a month, and lower for infant it should not be lowered. After dousing the baby, rub it with a towel.

Swimming of infants in the pool hardens not so much on its own (the water temperature in it usually does not fall below 26 ° C), but in combination with air baths before and after the pool.

In the second year, you can add daily washing of your feet with cool water to the douche after a bath (2-3 times a week). The procedures begin with a water temperature of 27-28° C, reducing it every 1-2 days by 2-3° C to a final temperature of 15° C (slightly colder than room temperature).

Has a good hardening effect cold and hot shower: changing warm water (up to 40° C for 30-40 seconds) with cold water (14-15° C) - lengthening its effect from 15-20 seconds to 30 seconds. Make cold exposure unpleasant (i.e. apply too much cold water or leaving a child under a cold shower for longer than 30-40 seconds) is unacceptable - not because of a possible “cold”, but because of the danger of causing negative attitude child for hardening. Any hardening procedure should cause positive emotions If a child “shivers” or is afraid, he should not be forced. For preschoolers, it is not difficult to organize contrasting air baths at home. To do this, in the child’s bedroom, before he wakes up, by opening the transom, they lower the temperature to 14-15 ° C, and then, after waking up the child, they play with him running from a warm to a cold room.

A visit to the sauna provides even more opportunities for contrasting effects; for young children, the temperature in the sauna should be about 90 ° C, the duration of stay is gradually increased to 10 minutes, sitting on the 1st step. In a Russian bath they use more than low temperatures(from 60° C with an exposure of 2-3 minutes, increase to 80° C for 6-8 minutes). During one session, children visit the steam room 2-3 times, in between they take a shower or air bath at room temperature or swim (slowly) in a pool with a water temperature of about 25° C.

Winter swimming and walking barefoot in the snow are unsafe types of hardening. If parents carry them out, this should be done very gradually and the procedure should not last longer than 40-60 seconds, since, having a large body surface area relative to mass, the child cools down much faster than an adult. The same can be said about dousing with cold water. For a preschooler, with a gradual decrease, it is quite possible to bring the water temperature to 8-10 ° C, although there is no need for this, the hardening effect will be good if you stop at 12-14 ° C. Cold dousing as curative measure should be strictly prohibited for a child with a fever: sudden cooling, leading to a sharp narrowing of the skin vessels, can be life-threatening.

Hardening after a mild acute respiratory infection can be resumed (or started) after 7-10 days, for a disease with a duration of temperature reaction of more than 4 days - after 2 weeks, and after a 10-day fever - after 3-4 weeks.

Does hardening reduce the incidence of ARVI? It cannot completely protect against disease when exposed to a virus that is new to a child. However, a hardened child’s protection against infection is much more effective than that of an unhardened child, so the number of respiratory diseases, especially more severe ones, will be much less.

9.3. Interferon prophylaxis

Interferons are widely used not only for treatment, but also for the prevention of influenza and acute respiratory infections of other etiologies. Interferon prophylaxis is especially indicated for children with a severe premorbid background who are just starting to attend child care institutions, as well as for all children during an influenza outbreak.

Interferon preparations used for the prevention of ARVI:

For preventive purposes, human leukocyte interferon is prescribed 5 drops 2 times a day in each nasal passage until the threat of infection ceases;
Grippferon is administered to children from 1 year of age 5 drops 2 times a day for 7-10 days;
Viferon in suppositories at a dose of 15-500 thousand units. 1-2 times a day for 7 days, then 1 time a day 2 times a week for 4 weeks.

9.4. Specific prevention of acute respiratory diseases

Vaccination against whooping cough and measles has long been the basis for the fight against these infections, vaccination against influenza is being increasingly introduced, but the large number of other pathogens of acute respiratory infections and their serotypes prevents the creation of effective universal vaccines.

Flu

The list of vaccinations of the Ministry of Health of the Russian Federation, carried out according to epidemiological indications, includes persons at high risk of developing influenza or its complicated course and death:

persons over 60 years of age;
patients suffering from chronic somatic diseases, children who often suffer from acute respiratory infections preschool age, pupils;
medical workers;
workers in the service sector, transport, educational institutions;
military contingents.

Vaccination is also recommended for the population as a method of individual protection against disease; with 50-80% coverage of teams, it can significantly reduce the incidence of influenza. The disease in vaccinated people occurs in more mild form with a low risk of complications.

Specific prevention is carried out by vaccines, which are prepared from the current strains of the A/H 1 N 1 A/H 3 N 2 and B viruses, recommended annually by WHO. For use in childhood Subunit and split vaccines are recommended.

The following drugs are licensed in Russia:

Grippol (Russia) - subunit vaccine with the immunostimulant polyoxidonium. Used in children from 3 years of age, adolescents and adults. Injected once subcutaneously in a volume of 0.5 ml (regardless of age) into the upper third outer surface shoulder;
Agrippal S1 (Kairon Behring, Germany) - subunit vaccine, administered intramuscularly to children over 3 years of age and adults, 1 dose (0.5 ml), at the age of 6 months to 3 years - 1/2 dose (0.25 ml) . For children who have not been vaccinated previously, double vaccination is recommended with an interval of 4 weeks; in subsequent seasons - 1 dose (0.25 ml for children under 3 years of age and 0.5 ml for children over 3 years of age);
Begrivak (Kairon Behring, Germany) is a split vaccine, used in the same way as the Agrippal vaccine;
Vaxigrip (Aventis Pasteur, France) - split vaccine, administered subcutaneously or intramuscularly from the age of 6 months; children under 9 years of age, if they have not previously been vaccinated and have not had the flu, are vaccinated twice with an interval of 1 month at a dose of 0.25 ml at the age of up to 3 years and at a dose of 0.5 ml at the age of 3 to 9 years; over the age of 9 years, vaccination is carried out once in a dose of 0.5 ml;
Influvac (Solvay Pharma, Netherlands) is a subunit vaccine that is administered to adults and adolescents over 14 years of age once (1 dose of 0.5 ml), children 6 months -3 years - 0.25 ml, 3-14 years - 0.5 ml; if children have not previously been vaccinated and have not had the flu, they are given 2 doses of the vaccine with an interval of 4 weeks;
Fluarix (GlaxoSmithKline, Germany) is a split vaccine, used in children over 6 months and adults, including those with chronic pathology. It is administered subcutaneously or intramuscularly. Children over 3 years old are administered 0.5 ml once, children under 3 years old - 0.25 ml twice with an interval of 4-6 weeks.

Immunity is developed 14 days after vaccination (for the Fluarix vaccine - after 10-12 days), it is short-term (6-12 months) and type-specific, which requires annual vaccinations. Preventive effectiveness is 70-90%, the degree of protection in children and the elderly is slightly lower than in adults. When infected with other types of influenza virus, the disease occurs in a milder form. There was a decrease in the incidence of acute respiratory viral infections in children vaccinated against influenza.

Vaccination reactions and complications when using subunit and split vaccines are, as a rule, absent. Weak reactions are short-term (48-72 hours), occur in no more than 3% of vaccinated people and are manifested by slight pain at the site of vaccine administration.

Allergy to proteins is a contraindication for all vaccines. chicken egg, to aminoglycosides (for vaccines containing them), allergic reactions to the administration of any influenza vaccine, acute diseases and exacerbations of chronic diseases (vaccination 2-4 weeks after recovery/remission), progressive diseases nervous system. These vaccines are compatible with others (in different syringes).

Split and subunit vaccines can be used to vaccinate immunocompromised individuals, pregnant and lactating women, and can be administered during immunosuppressive therapy.

Hemophilus influenzae infection

According to WHO recommendations, the vaccine against Hib infection is included in the vaccination schedule for infants in all developed and many developing countries. It has been shown that mass vaccination can reduce the incidence of both meningitis and severe bacterial pneumonia (by 20%). In 1998, the WHO Regional Committee for Europe set one of its goals to reduce the incidence of this infection in all countries of the region to less than 1 case per 100 thousand population by 2010 or earlier. This vaccination, although not included in National calendar Russia, recommended by the Ministry of Health of the Russian Federation for use where there are opportunities for this.

Mass vaccination of children in the first months of life became possible after the creation of protein-conjugated vaccines. The Act-HIB vaccine, which is a capsular polysaccharide of the H. influenzae type and conjugated with tetanus toxoid protein, is licensed in Russia. The vaccine is combined with DTP in one syringe or separately, administered in a dose of 0.5 ml intramuscularly. Vaccinations are carried out starting from 3 months of age with an interval of 1-2 months, revaccination is carried out after 12 months. after the third vaccination. When starting vaccination at the age of 6-12 months, 2 injections with an interval of 1-2 months and revaccination 12 months after the second vaccination are sufficient. To vaccinate children aged 1 to 5 years, 1 vaccine injection is sufficient.

Vaccination reactions to Hib vaccines are mild and manifest as hyperemia and thickening at the injection site (less than 10% of vaccinated people), low-grade fever is possible; Temperatures above 38.0° C develop in no more than 1% of vaccinated people.

The vaccine has a high preventive effectiveness (95-100%), and the countries that introduced it have practically eliminated this infection. The duration of detection of a protective antibody titer is at least 4 years. Act-HIB vaccine has no special contraindications: it is not administered when hypersensitivity to any components of the drug, especially to tetanus toxoid. It is not recommended to vaccinate elevated temperature and acute infectious diseases.

Pneumococcal infection

The main difficulties in creating a vaccine are the availability large number(about 100) serotypes of Streptococcus pneumoniae and the low immunogenicity of polysaccharide vaccines in children under 2 years of age. The polysaccharide 23-valent vaccine Pneumo 23, which includes 90% of pneumococcal serotypes that cause serious illnesses. It is used to protect children at risk: over 2 years of age, with asplenia and a removed spleen, liquorrhea, lymphogranulomatosis, hemoglobinopathies, neutropenia, HIV infection, chronic renal failure, heart disease, diabetes and other conditions predisposing to pneumococcal infection. There are reports of the use of this vaccine in children over 2 years of age with repeated diseases of the nasopharynx, middle ear and paranasal sinuses nose

Pneumo 23 is administered once subcutaneously or intramuscularly, the vaccination dose is 0.5 ml for all ages. It causes the formation of immunity lasting 5-8 years. Revaccination (single injection of 0.5 ml) is recommended no more often than at intervals of 3 years. Complications are rare and may include redness and soreness at the injection site lasting less than 48 hours.

IN last years conjugate pneumococcal vaccines have been created to protect very young children; their wide application is currently held back by high costs.

Bacterial vaccines against several respiratory pathogens

Bacterial vaccines against several respiratory pathogens, created on the basis of ribosomal fractions of pathogenic bacteria (Ribomunil) or their lysates (Bronchomunal, IRS19), have become widespread. It has been proven that ribosomal fractions are more purified than lysed whole bacteria and more immunogenic (1 μg of ribosomes is equivalent in immunogenicity to 1 mg of lysate). The inclusion of membrane fractions of Klebsiella pneumoniae in Ribomunil as an adjuvant makes it possible to increase the severity of the antibody response by 5 or more times compared to the isolated administration of ribosomes. Oral administration of Ribomunil leads to contact of pathogen antigens contained in ribosomes with macrophages located in the mucous membrane of the gastrointestinal tract, followed by their presentation to lymphocytes of the MALT system (lymphoid tissue associated with mucous membranes). As a result, committed clones of B-lymphocytes appear, producing specific antibodies to the antigens of those pathogens whose ribosomes are contained in Ribomunil. In addition, the migration of committed B-lymphocytes from Peyer's patches to other lymphoid organs of the MALT system (palatine and pharyngeal tonsils, lymphoid formations of the respiratory tract, etc.) and their subsequent differentiation into plasmacytes leads to the production of specific secretory IgA and the development of effective local immune defense against Streptococcus pyogenes, Streptococcus pneumoniae, Hemophilus influenzae and Klebsiella pneumoniae. Thus, oral administration of the ribosomal vaccine Ribomunil is accompanied by the induction of an antigen-specific antibody response from both local and systemic immunity. In a double-blind, placebo-controlled study, it was shown that the formation of specific antibodies while taking Ribomunil was statistically significantly higher than the body's response to the use of lysates and placebo.

It has been proven that therapy with Ribomunil is accompanied by a significant increase in the content of secretory IgA in bronchial secretions and a statistically significant increase in the titers of specific antibodies of the IgG and IgM classes to pathogens, the ribosomes of which are presented in Ribomunil, in the tonsils. A statistically significant increase in titers of specific antibodies of classes IgA, IgM, IgG to these pathogens compared to the initial values and control is achieved in the blood serum already by 24 days from the start of Ribomunil therapy and persists in the case of IgA, according to A.V. Karaulov, no less 12 months Thus, the use of Ribomunil leads to the active production of specific antibodies against the antigens of the most common pathogenic bacteria, the ribosomes of which are included in the drug, and the creation of effective post-vaccination immunity, the duration of which is determined by the characteristics of the body and the external environment, the age and lifestyle of children. According to N.A. Korovina, average duration The therapeutic effect after a three-month course of treatment with Ribomunil is 1.5-2 years. Ribomunil causes positive changes in the cellular immunity, expressed in a significant decrease in the number of CD4+ after 3 weeks of treatment and a simultaneous increase in the number of CD8+ and CD3+ T-lymphocytes. After 6 months of treatment with Ribomunil, these positive changes in the immune response continue to increase, and there is a significant reduction in cellular activation indicators (a significant decrease in the number of CD25+, CD23+ and the level of beta-2-microglobulin).

Ribomunil is well tolerated and can be used in children of different age groups, does not have significant side effects (the most common is hypersalivation at the beginning of treatment, which does not require discontinuation of therapy) and can be combined with other vaccines and immunomodulators. In recent years, the possibility of its combination with the topical IRS19 vaccine, produced in the form of a nasal aerosol, has been discussed. It is known that the combination of oral administration of Ribomunil with inhalation of nasal aerosol IRS19 can increase the effectiveness of treatment by 8% (94% of children suffer from acute respiratory infections less than 2 times during 12 months of observation). Thus, this combination may be of undoubted therapeutic interest.

In recent years, the possibility of complex application ribosomal vaccine (Ribomunyl) and various influenza vaccines to increase the effectiveness of specific immunization of children. In Russia and abroad, it has been convincingly proven that the preventive effectiveness of influenza vaccination in children at risk is increased when vaccinations are carried out simultaneously with ribosomal immunization. According to V.F. Uchaikin et al. (2000), carrying out a full course of treatment with Ribomunil in combination with influenza vaccination leads to a 2.5-fold reduction in the incidence of acute respiratory viral infections compared to a group of children receiving only the influenza vaccine, and prevents exacerbation of chronic diseases. According to N.A. Korovina (2000), the total incidence of influenza and acute respiratory infections was also lower in children immunized against influenza while using Ribomunil. Thus, vaccination of frequently ill children against influenza is characterized by more high index epidemiological effectiveness, especially against the background of its implementation during the period of taking the ribosomal vaccine.

Reception of Ribomunil can be started at any stage infectious process, and the greatest therapeutic effect is achieved with a duration of use of the drug of at least 6 months. The effectiveness of ribosomal vaccination against acute respiratory infections has been convincingly demonstrated in organized children's groups, in children who are often and long-term ill, including those with chronic ENT and bronchopulmonary pathologies, and in patients in areas of environmental and radiation disadvantage. The main effects of Ribomunil should be considered a statistically significant and significant reduction in the number of episodes of acute respiratory infections over 1-2 years, a decrease in the duration and severity of infectious episodes, a pronounced reduction in the number of children missing visits to organized children's groups, a statistically significant sharp reduction in the need for antibacterial therapy, reducing the risk of complications and recurrent ENT and bronchopulmonary infections.

According to a meta-analysis that covered 14,213 patients in 11 countries who received the ribosomal vaccine Ribomunil, taking the drug causes a significant reduction in the frequency of acute respiratory infections - on average 1.92±0.25 episodes per person (versus 3.35±0.41 episode in the placebo group); and the number of courses of antibacterial therapy - on average 1.70±0.12 courses per person (versus 3.02±0.44 courses in the placebo group).

Literature

Guide to the epidemiology of infectious diseases. Ed. V.I. Pokrovsky. M.: Medicine, 1993, vol. 1, 464 p.
Titkova I.V. Prevention of influenza in medical workers. Attending Physician, 1999, No. 7, p. 38-39.

It is easier to prevent any disease than to cure it. This rule is true for most human diseases (except for congenital and genetic pathologies). That is why the prevention of acute respiratory infections and acute respiratory viral infections occupies an important place in the list of recommendations of medical workers in the autumn winter period. It is especially important to properly strengthen general health child, since the common cold is early age may cause serious complications.

First you need to understand the terminals. The abbreviations ARVI and ARI stand for acute respiratory diseases of a viral and infectious nature. Most often, the causative agents of such diseases are parainfluenza, adenovirus, and RS infection. It is with these “activators” pathological condition and we need to fight preventively by following prevention tips.

This point of recommendations from infectious disease specialists and therapists raises the most questions among people. Despite the prevailing opinion about the pointlessness of preventive injections, recent statistical studies have shown a reduction in the likelihood of influenza in adults by 80-90%.

Unfortunately, the main disadvantage of this treatment approach is the narrow focus of the injections. Prevention of acute respiratory infections and acute respiratory viral infections works only with one type of pathogenic microorganisms.

Preventive treatment by introducing a weak stamp of the virus is not indicated for everyone. First of all, people who are at risk for somatic pathologies, employees of public institutions (schools, hospitals, prisons), and military personnel are vaccinated. Injections for children aged from six months to 24 months will not be superfluous.

Antiviral drugs

Another popular option for preventive action on microbes and viruses is the timely intake of special pharmacological drugs. Indeed, this is possible significantly during seasonal epidemics, but many pathogens of respiratory tract diseases are resistant to medications and easily overcome such protection.

Prevention of acute respiratory infections and acute respiratory viral infections comes down to taking two types of drugs.

Adamantanes (“PK-Merz”, “MIdantin”, “Rimantadine”).
Influenza neuraminidase inhibitors (Oseltamivir).

It is important to remember that any medications have a number of contraindications and, under certain conditions, can provoke dangerous allergic reaction. You can take medications only with a doctor's prescription.

Strengthening immunity

The longest, but most correct path to health. Most often, acute respiratory infections and acute respiratory viral infections affect children and the elderly, that is, people with weakened or underdeveloped immunity. In this case, prevention is based on individual characteristics the patient's body. Some people benefit from changing their diet and hardening, others choose active species sports and stress management.

Many experts advise trying to drink the course special drugs. Doctors' prescriptions contain names such as Mega Immunity, Zdorov, Lizobakt, Immunal, Aflubin.

Useful and vitamin complexes. Needed for immunity groups B, C, A, E, iron, zinc and selenium.

Elimination of harmful factors

And last but not least important point. Prevention of acute respiratory infections and acute respiratory viral infections must necessarily include control of any external “activators” of the pathological condition. Need to exclude:

excessive physical activity;
exposure to stress and strong emotional experiences;
, consumption large quantity fats, fast carbohydrates.

It should be taken into account that prolonged exposure to the open sun can cause disruptions in the body’s defense system, and also strictly monitor the humidity and temperature inside the room. Gastroenterologists note that it is not advisable to go on diets in winter, since strict restrictions on food will weaken the immune system.

In general, the prevention of acute respiratory infections and acute respiratory viral infections is not a complicated process that does not require complex medication measures from a person. Usually it is enough to follow the doctor’s clear recommendations and give up bad habits.

Frost and sun, a wonderful day.. or not? The cold season can be filled with magical moments, but a cold or flu can easily ruin and work days, and a long-awaited vacation with family. How to protect yourself and your loved ones from influenza and ARVI? Now we'll tell you everything.

Colds gain strength at the beginning of winter and can spoil and new year holidays, and all the holidays. To maintain health, strength and great mood for loved ones, it is worthwhile to prevent influenza and ARVI. Viral diseases and common colds can be prevented if you take the necessary preventive measures. Agree, preventing a disease is better than treating it.

If you are going to defeat the disease, you need to study your opponent well. Seasonal viral diseases quite a lot, but often all of them, without understanding them, are called with one word “cold”. What is the difference between influenza and ARVI? The simplest answer would be “everyone,” but we are not looking for easy ways.

Let's start with terminology- “flu” is translated from French as “to grab, to scratch,” and if you have ever experienced this disease yourself, you understand why it received such a name. In general, influenza, acute respiratory infections and acute respiratory viral infections are diseases that are initially caused by different viruses and differ in both symptoms and the course of the disease.

There are more than two hundred viruses that cause colds.
We will answer the most FAQ about the differences between these diseases.

How is the flu different from a cold?

Cold- a common name that refers to any ailment caused by viruses or ordinary hypothermia. All these ailments have a number of common symptoms in common with the flu, but the course of the disease itself will not allow you to confuse the flu with a cold. Even healthy person with strong immunity, the flu occurs with symptoms of intoxication - aching joints, pain in eyeballs, may be accompanied by nausea and chills; this disease is also characterized by temperature fluctuations, which remain above normal for 2 days to a week, and severe headache.

If the body is weakened or the immune system is unstable, as happens in children, the elderly and pregnant women, the flu is more severe, can cause seizures and lead to pneumonia (pneumonia) or other respiratory diseases, so they are most vulnerable during epidemics.

At the beginning of the disease, influenza is characterized by a dry cough, but if complications occur, sputum may appear, as with bronchitis. Colds go away faster and do not require long-term recovery, while the flu requires a long recovery. recovery period with dizziness and changes in blood pressure.

What is the difference between acute respiratory infections and acute respiratory viral infections?

acute respiratory infections and acute respiratory viral infections- abbreviations that are often confused, which is not surprising - these groups of diseases are almost identical. acute respiratory infections stands for acute respiratory disease, and ARVI is an acute respiratory viral infection. Thus, the main difference between them is the viral nature, acute respiratory infections can be limited to one patient, and ARVI has the ability to be transmitted.

Thus, influenza viruses are included in the concept of ARVI, and before an accurate diagnosis is established - determining the specific infection that has appeared in the human body - the first diagnosis for patients is precisely these four letters.

Typically, colds occur in the off-season, and we often wonder how to avoid getting a cold in the fall, but the most dangerous flu epidemics occur in the winter-spring period; outbreaks of the disease occur especially often in February and March. If you care about your health, then you should prevent colds early stage or protect yourself from it altogether with the help of preventive measures.

First of all, relevant general events to maintain immunity - high-quality nutrition, multivitamins, exercise. To prevent a cold from appearing at an early stage, it is enough to follow basic precautions:

avoid hypothermia, especially freezing feet and nose, since a weakened body can become infected more quickly;
try not to contact sick people;
wash all things regularly, which end up with you in public places, especially during epidemics, including outerwear, since viruses can be stored in it for quite a long time;
If you have a runny nose, use disposable tissues so that it does not become a “mobile home” for a bacterial colony;
during epidemics or if you yourself have caught the virus and are forced to be on the street or in a public place, you need wear a sterile medical mask, and change masks at least once every 4 hours.

Also, when answering the question of how to prevent disease, you need to remember the rules of hygiene when visiting public places - a must clean your hands and face after visiting public transport and public places.

If the disease has already affected your household, you should think about how not to get infected with ARVI from a patient, since often the disease can infect everyone living in the house in a circle. If there is a person in the house who is sick with ARVI or influenza, then after contact with him you should be especially careful about hygiene. The room with the sick person should be regularly ventilated; this will benefit both the sick person and the healthy household members.

Through ventilation is most effective, but it can negatively affect the patient’s condition. To refresh the air in a room without, it is better to use it - it will promptly supply fresh air to the room without the street cold, as well as dirt, dust and allergens due to several stages of filtration.

During epidemics, ordinary precautions may not be enough, and it is worth turning on the “heavy artillery” in the form folk remedies and medical supplies.

Before we highlight folk remedies for flu and colds, we remind you that treatment of diseases must be carried out under the supervision of a qualified doctor, and these methods can only be used as prevention; self-medication can be dangerous to health.

The most common folk remedies include:

Garlic

If eating garlic is impossible for some reason, you can inhale: grate a few cloves of garlic and half a small onion and breathe over the mixture.

Vitamins

Winter and the beginning of spring are often accompanied by massive stress - if the body is deficient in vitamins, then it is more difficult for it to resist diseases. Therefore, most of the folk methods of prevention against influenza are occupied by vitamins - they are replenished by consuming honey, berry fruit drinks, cranberries and lingonberries, herbal decoctions, rose hips, aloe and other plants are especially effective. In addition, it is recommended to consume lemons and ascorbic acid- at least 500 mg per day - and drink more fluids.

Inhalations

At the early stage of colds, the first “swallow” is a runny nose. Inhalations can be carried out using essential oils. To do this, heat 500 ml of water in a small saucepan to a boil, after which oil is added to the water - usually eucalyptus or mint - and breathe in the fragrant steam under a towel for 10-15 minutes. You can also use decoctions of sage, oregano, lavender or other herbs for inhalation, as well as steam from freshly boiled potatoes. This “breathing” slightly reduces the risk of catching an infection, but helps restore the nasal mucosa and get rid of a runny nose.

Folk remedies have their pros and cons. Their advantages include:

availability: both recipes and ingredients are easy to find in any store at low prices;
minimal amount side effects: even if the chosen remedy does not help prevent the disease, there will be no harm from it either;
no contraindications they can be used during pregnancy and breastfeeding;
they are universal, since they support the immune system as a whole, and are not aimed at a specific virus.

The disadvantages of folk remedies include low efficiency- in order for them to have an effect, you need to practice them constantly. Such prevention is more of a way of life than a set of measures.

Prevention of influenza and ARVI, drugs for which you find in the pharmacy, are more effective than traditional methods. Medicines work effectively if used according to instructions. Today there are many drugs to prevent diseases, first of all they support our immunity. The fact is that due to the diversity of viruses, it is impossible to invent flu pills - what will defeat one strain of the virus will not be suitable for fighting another. Respectively, drugs are divided according to known modifications of influenza and types of drugs.

Exist selected drugs against influenza A, They are used as prescribed by a doctor, they shorten the course of the disease, and the symptoms become less pronounced.
Antiviral drugs are used to treat and prevent influenza A and B. Such drugs are used during epidemics upon contact with an infected person according to the instructions.
Homeopathic anti-flu remedies, most often syrups can be used to prevent flu and colds in children.
Complex soluble powders with paracetamol, which are most often used as an answer to the question “What should I take to prevent colds?” They are characterized by a high speed of work and almost immediately relieve the symptoms of the disease, however, they have a strong effect on the gastrointestinal tract and liver, so it is not recommended to use them for prophylaxis.
Nasal drops Most often used when in contact with someone who is sick with ARVI, so as not to catch the virus. Among them there are both preventive and more strong drugs. For example, nasal drops for flu and colds are used at any stage of the disease, and some of them also help fight the destruction of the nasal mucosa. A doctor will help you select the appropriate drops, depending on the characteristics of the body and the stage of the disease.
Often used to prevent influenza ointment in the nose. The locality of their effect allows the use of ointments even during pregnancy and breastfeeding.

Should I get a flu shot?

The flu shot is one of the most talked about ways to protect against the disease. It is considered most effective if the vaccine is selected correctly and matches the current strain. The purpose of vaccination is to strengthen immune system, trigger the production of antibodies and prevent infection. There are several vaccines; it is best to choose the right one together with your doctor. When answering the question whether it is possible to get a flu shot, the doctor considers the general medical history and condition of the body.

The vast majority of infectious and cold diseases are caused by ARVI. It is not often possible to meet a person whose health has not been visited by this ailment at least once.

True, it would be more accurate to say that ARVI is a collection of diseases infectious nature, the occurrence of which is provoked by viruses that have entered the body. Unfortunately, almost everyone suffers from this disease.

The autumn-winter season is a favorable time interval for viral activation.

Most often, children suffer from the disease, as well as adults, whose body’s defenses (immunity) are extremely weakened. Any person has every chance of encountering this disease several times a year. Prevention of ARVI is based on the general maintenance of the fundamentals of healing and strengthening the body.

It is necessary to stimulate the immune system through hardening, systematic exercise, and daily consumption of balanced food enriched with vitamins.

How to promptly recognize an impending infection, avoid this insidious, extremely common disease, and finally, what to do when primary symptoms appear, we will try to talk about this in this material.

Causes of ARVI

Already from the name itself - acute respiratory viral infections, often referred to simply as acute respiratory infections, it becomes clear that the key culprits in the occurrence of the disease are viruses. Pathogens penetrate the body mainly through airborne droplets.

Taking this into account, it is precisely those who are exposed to maximum danger. The development of the disease is rapid, and the duration is usually short.

The list of viruses that cause disease is simply very extensive, and the most famous one is very familiar to all of us - virus flu In addition, the list includes: adenovirus, rhinovirus, reovirus, parainfluenza, and many others.

I should note that usually, acute respiratory infections have a damaging effect on a certain area respiratory tract. For example, parainfluenza “wounds” the larynx and trachea, and rhinovirus injures the nasal mucosa.

The internal environment is the most destructive for viruses, “ death” pretty fast. However, when in contact with a sick person, the transmission rate is high. Coughing, sneezing, and indeed even ordinary conversation, all this is an excellent “tool” for infection.

Viruses, firmly located on the mucous membrane of the respiratory tract, and they are capable of occupying any area from the nose and throat to the lungs, secrete extremely harmful substances called toxins. Subsequently, the blood carries them throughout the body, and the foundations of human health are significantly undermined.

Signs of acute respiratory infections

The interval between the moment when the body becomes infected and the appearance of the primary symptoms of the disease is called incubation; its duration is several hours. The maximum period of time is four days. I think the symptoms of this ailment are very familiar to many, but still, I will read out the entire list again.

1. The body experiences general weakness, malaise.

2. Constantly haunts you, as if something is breaking you from the inside.

3. Severe pain in the head, as well as during eye movements.

4. High temperatures.

5. Cough, runny nose, they come to “visit” a little later.

It is worth considering that the individual signs of ARVI, taken for a particular specific case, have a very direct dependence on which particular part of the respiratory tract was affected by the virus.

In other words, where inflammatory process manifested itself most strongly.

If the doctor is able to accurately identify the striking signs, then this fact will greatly facilitate the diagnosis.

In addition, the likelihood of a more accurate identification of the virus that triggered the onset of the disease increases.

However, the most reliable result for identifying the pathogen can be provided by an appropriate analysis, a special study that detects viral antibodies.

The slightest, primary manifestation of symptoms of the disease requires the patient to stay at home, call a doctor for an accurate diagnosis, and prescribe the correct therapeutic course. Staying at home is extremely necessary, since the infected person himself can easily “transmit” the virus to people in contact with him. It is better for the patient to stay in an isolated room; the use of common everyday items (towels, dishes) is prohibited. Close people who provide assistance and care for the patient are required to wear a gauze bandage.

Treatment of ARVI

If, nevertheless, a viral infection has found the key to your body, then it is extremely important point is strict compliance bed rest. You should increase the volume of fluid consumed.

Juices, fruit drinks, tea with lemon, fresh berries, will be an excellent help in the fight against the disease. It is recommended to give priority to “sour” drinks. Herbal decoctions (expectorants, diaphoretics) are quite effective.

Frequent drinking will help reduce the level of intoxication in the body, and the temperature will drop. In addition, the body, weakened by the disease, receives the necessary portion of vitamins, the cough is relieved, and the general state sick.

High temperature (over 38) requires taking antipyretic drugs. In addition, the doctor may prescribe vasoconstrictor medications for the nose, mucolytics, cough medications, and multivitamins.

It has a very positive effect on therapy for acute respiratory viral infections. breathing exercises. Forty-eight hours is the maximum permissible period for providing an effective antiviral effect. Later, the significance of taking such drugs rapidly decreases.

As for antibiotics, for a viral infection or cold, their benefit is negligible. Their use is appropriate only for medical purposes, mainly in the presence of a bacterial infection or complications that have arisen.

Please note that if the problem is diagnosed late or treatment is not started in a timely manner, a viral infection can open the door to bacteria, which in turn can cause complications in the respiratory tract.

Previously existing chronic diseases can become seriously aggravated. The list is very impressive, so I’ll focus on the main ones: inflammation of the kidneys, liver, diabetes.

Prevention

- try to stay in places as little as possible large cluster people, especially in indoors

– do not forget to systematically ventilate the room and carry out regular wet cleaning

– various methods strengthen your immunity

During the peak of the epidemic, regularly, when you leave home, you should treat the nasal mucosa with 0.25% oxolinic ointment.

Traditional treatment of acute respiratory infections

1. Fill a container (200 ml) 20% with sea buckthorn berries, crush them with a spoon, add sugar (2 tsp), then pour hot water. If you wish, you can strain the berries. This sea buckthorn tea significantly strengthens your immune system.

It is worth noting that sea buckthorn is rightfully considered an inexhaustible storehouse of vitamins. It is successfully used in the treatment of many ailments, here are just a few: radiation damage to the skin, problems of the throat, esophagus, cardiovascular diseases, diseases of the nervous system. Although, of course, there are contraindications: gastritis, cholecystitis, cholelithiasis, increased acidity gastric juice.

2. Place thoroughly washed pine (green) cones in a thermos. Add a small (d=2 cm) ball pine resin, and then pour 500 ml of hot milk over everything. Mix well and let stand for five hours.

Strain through several layers of gauze. It is permissible to use the cones for re-solution, after thoroughly washing them first. Take 200 ml in the morning, evening, for several weeks.

3. You need to boil 500 ml of milk, adding 100 grams of honey. After allowing the milk to cool, add a quarter kilogram of pre-mashed black currant. Should be taken slightly chilled.

4. Dried thyme (50 g) is combined with three liters of boiling water. Bring to a boil, leave on low heat for five minutes, then filter. Next, add 500 ml of viburnum juice, 200 grams of honey, pour into containers.

5. If you are unexpectedly caught in heavy rain and you are soaked to the skin, then a number of the following preventive recommendations will minimize your body’s chances of getting sick:

- hot Herb tea based on linden, ginger, raspberry, elderberry

– hot foot bath with salt or mustard

– thoroughly rub your wet feet with tincture of lilac, horseradish, and chestnut. Put on warm, woolen socks, drink a diaphoretic herbal decoction, lie down to rest.

6. If you have a runny nose, you should systematically rinse your nose with a decoction medicinal herbs. For example, chamomile, sage, St. John's wort.

7. Rinse thoroughly nose, lightly salted green tea(half a teaspoon of salt per 200 ml of loose leaf, freshly brewed tea) + a drop of iodine.

8. Instillation of Kalanchoe juice, aloe with honey (1:1), honey with onion, garlic juice (1:1) are very productive. Of course, with all this, a number of factors must be taken into account: age category patient, available accompanying illnesses, allergies, general health.

Prevention of ARVI will achieve maximum efficiency if you adhere to the fundamental rules: pay due attention to sleep, eat rationally, never leaving home hungry, make it a rule to take regular walks on fresh air. Smart exercise good mood, are also excellent assistants in solving the task. And then, no infection will be able to disrupt the protective bastions of your immune system.

Take an interest in your health in a timely manner, goodbye.

In the structure of all infectious diseases 95% are acute respiratory viral infections and acute respiratory infections. These two diagnoses are inherently somewhat different from each other: acute respiratory viral infections, which can include and, are caused only by viruses, while acute respiratory infections can be caused by bacteria, mycoplasma, and other pathogens.

ARVI together with influenza account for about 70% of all diseases in children. Children attending nurseries are especially susceptible to these diseases. preschool institutions and schools. In the autumn-winter-spring period colds Approximately 80% of children get sick.

Naturally, all parents are interested in protecting their beloved child from viral infections, and are trying to find some effective measures prevention.

General information, types of prevention

ARVIs make up 70% of all diseases in children, so it is important for every parent to know how to protect themselves from these infections.

Universal remedy There is no protection against all viral infections, since more than 300 viruses can cause ARVI. But you can reduce the risk of the disease. This is achieved by preventing infection and by strengthening the child’s body in order to increase resistance to infection.

The influenza virus is highly variable, so vaccination should be done annually. According to the WHO influenza program, there are 4 international centers and 120 special virology laboratories around the world that study the circulation of the virus and, on this basis, predict which influenza virus will circulate in the coming year. These forecasts are quite correct: 92% confidence level over the past 15 years.

And if you consider that influenza vaccines, despite their high effectiveness, are well tolerated, then from October you should seriously take care of vaccinating your child against influenza. This is very important, because the chances of not getting sick during the period of rising incidence when visiting kindergarten or the child has very little school. Even if a vaccinated child gets sick, the disease will be mild and with minimal risk complications.

It is especially important to vaccinate children who have any chronic illness(respiratory organs, cardiovascular system, urinary system, etc.), since influenza can lead to an exacerbation of these diseases and the development of fatal dangerous complications. And in order to reduce the risk of infection for such children, it is worth considering vaccinating all family members.

Each vaccine contains 3 types of viral antigens: virus A (two types) and virus B. Influenza vaccines are:

live – they contain a live but weakened influenza virus;
inactivated whole virion - contain whole dead viruses;
split (split vaccines) - do not contain the whole virus, but its particles - proteins (internal and surface);
subunit - contain only the surface proteins of the virus.

Alive and inactivated vaccines refer to 1st generation vaccines. They give a good immune response, but are highly reactogenic: after their use, the temperature rises within 37.5˚C, and may be mild severe symptoms intoxication. This is due to the fact that whole vaccines are not sufficiently purified.

In Russia, children (from 3 to 14 years old) are given a live dry intranasal allantoic influenza vaccine (produced in Russia) and a live (weakened) influenza vaccine for children from 1 to 5 years old (administered intranasally).

Inactivated vaccines are not used in pediatric practice due to their high reactogenicity.

Split vaccines refer to II generation vaccines. They are characterized by fewer adverse reactions, as they are better cleaned. Does not contain toxins. Malaise and fever are observed in 1% of cases. But, unfortunately, in 5-10% of cases of their use, immunity is not developed. In Russia, the use of the following split vaccines is permitted: Fluarix (Belgium), Vaxigripp (France), Begrivak (Germany).

TO III generation Subunit vaccines provide the most significant antibody protection against influenza. Given the high efficiency and low reactogenicity of such vaccines, they can be used for children from 6 months. The use of the following subunit vaccines is permitted in Russia: Influvac (Netherlands), Grippol (Russia), Agrippal (Germany), Invivac (Netherlands-Switzerland), Inflexal B (Switzerland).

Each of these vaccines has its own contraindications, its own side effects, principles of dosing and route of administration. Doses depend not only on the age of the child, but also on whether the baby is being vaccinated against influenza for the first time or again, so only a doctor should choose the vaccine and dose for each child.

Immunity is developed 7-20 days after vaccination (the period for the formation of immunity is determined by the type of vaccine). Not recommended for use live vaccine during an already ongoing epidemic. After using the vaccine, you should avoid contact with sick people for 3 weeks.

Vaccines are ineffective only if their storage temperature is violated (more than a day at room temperature or frozen). It has been proven that vaccines increase the production of interferon in the body, thereby strengthening overall immunity. Thanks to this, although the influenza vaccine does not protect against acute respiratory viral infections, the frequency of colds after vaccination still decreases.

When vaccinating children prone to allergies, they are prescribed antihistamines. In France, a vaccine that does not contain allergenic components is being prepared for production.

Imported and domestic vaccines They protect against influenza equally well, but the reactogenicity of imported vaccines is less (1-2% instead of 3%). American scientists have proven that the spray vaccine is 55% more effective than injection vaccination. But spray vaccines contain whole viruses, so they have more contraindications, and they have higher reactogenicity.

With the help of vaccines, specific active immunity is formed. Ready-made antibodies can also be introduced into the body to create passive immunity against influenza - they are contained in anti-influenza immunoglobulin. It is highly effective when administered both prophylactically and therapeutic purpose. Among the disadvantages of the product, the potential risk of transmitting blood-borne infections should be noted, since immunoglobulins are prepared from human blood.

Use of immunomodulators

Immunotropic drugs include drugs that affect the immune system. This group of drugs does not have a single name: they are called immunocorrectors, immunostimulants, and immunomodulators.

Immunomodulatory medications should be prescribed only for strict indications after an immunological examination. A frequently ill child in early childhood is not an indicator of “weak” immunity or immunodeficiency. This is only evidence of the child’s frequent encounters with the source of infection and the body’s acquisition of immunological experience.

Without a previous immunological examination, the doctor can only prescribe drugs called herbal adaptogens. These include preparations containing aloe extract, Echinacea purpurea, Eleutherococcus, ginseng, etc. They are produced in the form of tablets, lozenges, drops, and liquids for internal use.

If the child does not have allergies, beekeeping products (honey, royal jelly, propolis).

An effective method of preventing ARVI, stimulating the immune system, is teaching older children the technique of self-massage of active biological points on the neck and face.

Summary for parents

Preventing ARVI and influenza in a child is not an easy task, because there is neither a magic pill nor a vaccine that would protect a child from any of these common diseases. But there are no insoluble problems in this matter either. Just preventive measures require from parents time, patience, and basic knowledge about these methods.

Right and on time Taken measures protect the child from viral infections. We need to worry about this protection in the summer, in the absence of epidemics, when nothing threatens the child. You just have to remember that the little things in these preventive measures no: it is important to ventilate the room and different types hardening, and vaccination.

Which doctor should I contact?

To learn more about measures to prevent ARVI, you should contact your pediatrician or infectious disease specialist. A frequently ill child needs to visit an immunologist to decide on treatment. Immunostimulating drugs cannot be prescribed to a child on their own; this can lead to serious consequences.

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