Acute respiratory infections and acute respiratory viral infections in adults: risks, prevention, treatment

General practitioner

Shekinah

Natalya Nikolaevna

15 years of experience

General practitioner

Make an appointment

ARI is an acute respiratory disease. This is not a separate disease, but a collective term that unites a group of all pathologies of the respiratory system, regardless of genesis. Provocateurs can be viruses, bacteria and intracellular parasites. The prevalence is enormous; in the autumn-spring period, outbreaks occur that take on the character of an epidemic. Infections affect all groups of the population. They are especially dangerous for children under one year of age and people with reduced immunity.

What are acute respiratory infections and acute respiratory viral infections?

Both diseases are acute inflammations of various organs of the respiratory system, caused by various infections. Acute respiratory disease - acute respiratory disease - a broader name that is used when the viral component has not been established. And ARVI is an acute respiratory viral disease - when the clinical picture is clear and it is known for sure that the infection is caused by a virus. There are several such viruses: influenza, parainfluenza, respiratory syncytial infection, rhinovirus and adenovirus infection and others. Most often, the disease begins with an elevated temperature. Then it may be supplemented by headache, general weakness, fatigue, aching bones, redness of the pharyngeal mucosa, pain when swallowing, dry cough and nasal congestion. Among the troubles that accompany acute respiratory infections is the addition of a bacterial infection to the disease, which causes complications.

ARVI

Acute respiratory viral infections (ARVI) are a group of diseases caused by viruses with similar transmission routes (mainly airborne, that is, through the air with saliva particles) and clinical manifestations (cough, fever, sore throat, etc.). ARVIs are the most common diseases, accounting for about 90% of all infections.

The causes of ARVI are viruses that affect the mucous membranes of the upper respiratory tract and are transmitted from a sick person to a healthy person with drops of saliva and sputum during breathing, talking, crying, coughing, sneezing. Viruses can also enter the body of a healthy person through sharing household items (dishes, towels). The likelihood of infection is highest during close contact and high crowding: in transport, educational institutions, hospitals, etc. Susceptibility to respiratory infections is very high, but can be reduced through preventative methods.

With ARVI, the most common acute symptoms include a runny nose, pain and/or sore throat, an increase in body temperature to 38–39 °C, chills, general weakness, and fatigue, which persist for 3–7 days. A cough is often associated, usually dry or with a small amount of sputum. Sometimes the sputum may become greenish in color, but this does not necessarily indicate the development of complications. It should be remembered that cough can persist for 2 weeks after recovery and is not considered a warning sign if all other symptoms of ARVI have disappeared.

Complications of ARVI do not occur often; typical complications are pneumonia, inflammation of the paranasal sinuses (sinusitis, sinusitis, etc.).

Risk factors

Almost every person knows first-hand what acute respiratory infections are. For the vast majority of adults, unpleasant symptoms of acute respiratory infections make themselves felt 2-3 times a year. As a rule, the peak incidence occurs in the damp and cold seasons, during a period of decreased protective function of the body and increased activity of viruses. For various reasons, acute respiratory infections and acute respiratory viral infections are particularly dangerous for people over 55 years of age, asthmatics, diabetics, with endocrinological and neurological problems, as well as for hypertensive patients. Pregnant women should be very careful.

Causes of acute respiratory infections

Hypothermia is the main, but not the only reason why the common cold occurs. The gas pollution and dustiness of modern cities, various allergens, and air dried by air conditioners and radiators irritate the respiratory tract, causing various respiratory diseases. Another factor contributing to the prevalence of colds in the cold season is the people themselves, or rather their reluctance to be treated at home and adhere to the bed rest recommended by experts. We simply feel sorry for spending precious days of our lives aimlessly, as it seems to us, lying in bed with a thermometer and a cup of warm tea with lemon.

A person is drawn to heroic deeds and labor achievements, therefore, despising fever, headache, cough, runny nose and weakness, we go to where there are many people who are still healthy. Just one cough or sneeze is enough for a citizen with a weakened immune system to catch the infection. Thus, the number of sick people increases, and sometimes their number reaches such a level that the media begin to massively report on the epidemic. It’s clear that everything would be much simpler if everyone who suffers from acute respiratory infections simply stayed at home in their bed until they fully recovered.

Prevention of acute respiratory infections and acute respiratory viral infections

The only way to protect yourself from the flu is to get vaccinated. No medications provide a proven effect in preventing viral diseases. But the likelihood of catching ARVI can be reduced if you take preventive measures. Avoid crowds of people.

Viruses are transmitted by airborne droplets, so during epidemics it is worth protecting yourself as much as possible from contact with crowds.
This is the most reliable, albeit not always accessible, method. Strengthen general immunity.
To do this, it is enough to eat right, avoid lack of sleep and stress, and find time to play sports or at least take daily walks.
Strengthen local immunity.
When the mucous membranes dry out, the protective barrier that should protect us from viruses is reduced.
In this case, the risk of infection becomes higher. Therefore, it is important to avoid dry indoor air - frequently wash the floors or use a humidifier. Wash your hands regularly.
During epidemics, wash your hands or treat them with antibacterial gel every time after external contact.

Acute respiratory infections. Prevention and treatment

Every year, 27.3–41.2 million cases of respiratory infections are registered in Russia. In the United States, the number of people sick with influenza is about 30 million. According to 2002 data, 1 million 719 thousand 106 cases of influenza were registered in Russia, which amounted to 6.2% of the total infectious morbidity [1,2]. The cost of treating influenza and its complications in the world annually reaches about 14.6 billion dollars [1]. In Russia, economic losses from this disease per year are estimated at 10 billion rubles [3], which emphasizes the social significance of influenza incidence. Among the cases, the majority of the patients are children, who account for more than half of all cases of acute respiratory infections (57.6%), mainly children of preschool and primary school age [7]. It is quite difficult to estimate the actual mortality due to influenza, so it is customary to talk about excess mortality during epidemics. The maximum mortality rate (35%) is observed among children under 2 years of age. Influenza is recorded as the direct cause of death in 25% of cases [6]. In the structure of mortality from influenza, the leading place is occupied by patients over 65 years of age (80–90%), while among patients 45–64 years of age without concomitant pathology, the mortality rate is 2 cases per 100 thousand people [4,5]. Among patients with chronic diseases, the risk of mortality is distributed as follows [6]: with a combination of heart and lung pathologies - 870 cases per 100 thousand people; diabetes mellitus and heart disease – 481 cases per 100 thousand; for lung diseases – 240 cases per 100 thousand; for heart disease - 104 cases per 100 thousand. Mortality among healthy adults is only 2 cases per 100 thousand people. ARI can be caused by about 200 viruses. During the period of rising incidence of acute respiratory infections, the following are detected: influenza A virus – 16.4%; influenza B virus – 15.7%; parainfluenza virus types 1, 2, 3 – 4.3%; adenovirus – 16.4%; respiratory syncytial virus – 6.4%; herpes simplex virus – 2.1%; Mycoplasma pneumonia – 2.1%; more than two viruses – 33%; the virus has not been identified – 3.6%. There is a tendency for the incidence of influenza to decrease with an increase in the incidence of acute respiratory infections [3]. Vaccine prevention of influenza is the most developed (Table 1). Vaccination according to the recommendations of the World Health Organization (WHO) is carried out with subunit vaccines. Thanks to vaccination, the number of deaths, incidence and severity of complications are reduced, which is confirmed by the experience of more than 50 years of using vaccines in millions of people [8,9]. According to the results of a meta-analysis in various countries, vaccination of older people against influenza can reduce the number of hospitalizations by an average of 33%, in connection with pneumonia and influenza - by 27-38%, and reduce overall mortality by 50% [11]. To reduce the incidence, it is necessary to vaccinate the largest number of people, and vaccination should be completed before the period of increase in the incidence of acute respiratory infections, with the desired coverage of 60–70% of the population, which increases its effectiveness. In a randomized controlled trial conducted in the Netherlands, after vaccination of 1838 people over 60 years of age, serologically confirmed influenza cases accounted for 58% of all acute respiratory infections [11]. The World Health Assembly recommended increasing vaccination coverage in the elderly population to at least 50% in 2006 and 75% by 2010 [19]. Vaccines do not always match the circulating strains, so the protective effect of vaccination is 70–90%. Vaccination is not always possible, especially in risk groups that are characterized by more severe infection, complications and deaths: children, people over 50 years of age, patients with concomitant diseases, immunodeficiencies, allergic diseases. In risk groups, the effectiveness of vaccination decreases to 30–40% [12–14]. Researchers have described the possibility of persistence of influenza viruses in cell culture. V.M. Pleskov showed the possibility of persistent infection in vivo; virion RNAs were determined in mouse macrophages using in situ transcription for 5 months. The duration of influenza virus isolation after an infection in humans is observed within 1–12 days, but virus antigens can be detected within 2–2.5 months, in some cases – 3.5–17 months. In the 1990s In blood clots, serum and lymphocytes of healthy people, hemagglutinins were detected by ELISA and nucleotide sequences of NP-, M-, HA genes by slot hybridization of influenza A viruses (H1, N1, H3N2). The level of detection of viral proteins and nucleotide sequences varied from 0.8 to 35.8%, correlating with the epidemic activity of the virus [15]. In more than 50% of cases after influenza, antigens of viruses A and B are detected in blood lymphocytes within 120–200 days [15]. The listed facts indicate the possibility of persistence of infection in the population, release of the virus by airborne droplets and reinfection. Vaccination has reduced the incidence of influenza, which has led to the activation of other viruses. Thus, in 1997, an avian influenza virus (H5N1) was isolated from a sick boy in Hong Kong, which infected both chickens and people. The virus could be directly transmitted from birds to humans, but did not lead to the development of an epidemic [17,18]. In 2009, there was an epidemic of “swine flu”. In Russia, after analyzing clinical materials from 1114 patients in 2009, the total incidence of influenza was 12.6%, incl. influenza A (H1N1), A (H3N2), influenza A and B – 2.9; 5.7; 1.4; 2.5%, respectively [16]. Ch.S. Harris in 1982 hypothesized that human influenza epidemics began about 4,500 years ago in southern China after ducks were domesticated and became capable of infecting humans. Before this, the influenza virus may have been an inhabitant of the gastrointestinal tract (GIT) of waterfowl for millions of years, in which biologists have found a wide range of virus genome combinations. It is assumed that viruses arose during the development of mankind from fragments of DNA and RNA cells. The genome of influenza viruses consists of RNA; reproduction of viruses is impossible without interaction with the host cell. The virus membrane contains the antigens hemagglutinin (H) and neuraminidase (N), a surface enzyme of the influenza virus. Viral neuraminidase ensures the release of viral particles from the infected cell, accelerates the penetration of the virus through the mucous barrier and infection of respiratory tract cells. Influenza viruses are distinguished by antigens (H1N1, H5N1, H2N8, etc.), for example, the 1918 Spanish flu virus and the swine flu virus have the H1N1 subtype. The genome of the virus undergoes frequent mutations. Two viruses of different subtypes (H1N1 and H2N8) can penetrate a cell; as a result of interactions, a new hybrid (for example, H1N8 or H2N1) appears, most often in the gastrointestinal tract of birds, pigs or horses, which leads to the emergence of new viruses that cause pandemics [18] . The development of antiviral drugs began with the creation of rimantadine. In recent years, the development of resistance to antiviral drugs has been observed: to rimantadine - in 48–61%, to oseltamivir - on average in 5% of cases [15]. According to the Research Institute of Virology named after. DI. Ivanovsky, resistance to oseltamivir in 2009 in Russia was observed in 16% of cases. According to WHO, the level of resistance was higher [25]. Oseltamivir is a neuraminidase inhibitor that is active against all influenza viruses. Its effectiveness has been shown against strains of avian influenza virus H7 and H9, as well as H5N1 [20]. The drug penetrates into all organs and tissues where the virus multiplies, inhibits the synthesis of neuraminidase, the virus cannot leave the host cell and dies. Oseltamivir is prescribed for the prevention and treatment of influenza. The use of the drug is permitted in adults and children over 1 year of age, including people vaccinated against influenza who still get sick, as well as in representatives of risk groups: elderly people; patients suffering from chronic diseases; people taking several medications at the same time [21,22]. Short-term gastrointestinal symptoms can be reduced by taking the medication with food. To prevent influenza, oseltamivir can be used by adults and adolescents over 12 years of age, persons from high-risk groups for infection (military units, large production teams, debilitated patients), and children over 1 year of age. Treatment should begin on days 1–2 of the onset of flu symptoms. In adults and children over 12 years of age, it is recommended to take 1 capsule (75 mg) of oseltamivir 2 times a day for 5 days. or 75 mg suspension 2 times/day. inside. Increasing the dose (more than 150 mg/day) does not increase the effect. In children over 1 year of age, the drug is used 2 times a day. in the form of a suspension in doses: for weight up to 15 kg – 30 mg; >15–23 kg – 45 mg; >23–40 kg – 60 mg; >40 kg – 75 mg. Taking the drug in the first 12 hours after the onset of symptoms shortens the duration of the disease by more than 3 days compared to taking it after 48 hours. In children, taking oseltamivir on the 1st day. disease reduces the duration of the acute period by 36 hours. When used for prophylaxis, oseltamivir is effective against influenza A and B viruses. After contact with a patient, administration of the drug reduces the likelihood of illness by 60–90%; preseason prophylaxis leads to similar results [22]. For preventive purposes, oseltamivir should be started in the first 2 days after contact with an infected person. The prophylactic dose for adults and children over 12 years of age is 1 capsule (75 mg) taken 1 time per day. no less than 10 days, during the epidemic season - up to 6 weeks. The prophylactic dose for children from 1 year to 12 years is equal to the therapeutic dose, taken 1 time/day. Oseltamivir has been used by more than 40 million patients in 80 countries: the USA, Japan, Canada, Australia, Europe, and Latin America. The duration of influenza symptoms, such as cough, myalgia, headaches and fever, when treated with oseltamivir is reduced by 40% [23], and the incidence of complications in influenza patients is reduced by 50% compared to placebo. According to O.V. Kladova et al., the use of oseltamivir in children with influenza reduced the severity of intoxication syndrome by 3 times, rhinitis - by 2.6 times. The clinical effect was noted on the 2nd day of treatment in 72% of children, on the 5th day – in 84% [15]. Zanamivir is an antiviral drug, a highly selective neuraminidase inhibitor. The activity of zanamivir has been demonstrated in vitro and in vivo and is aimed at all 9 subtypes of influenza virus neuraminidases. Available in powder form for inhalation through a diskhaler, bioavailability is low - an average of 2%. It is used for the treatment and prevention of influenza A and B in children over 5 years of age and in adults. For treatment, adults and children are recommended to take 2 inhalations (5 mg x 2) 2 times a day. (daily dose – 20 mg) for 5 days. For prophylaxis, use 2 inhalations (5 mg x 2) 1 time/day. (daily dose – 10 mg) for 10 days. The course can be extended up to 1 month. at risk of infection. Allergic reactions, including swelling of the face and larynx, bronchospasm, difficulty breathing, rashes, and urticaria, are recorded very rarely. A number of reports have indicated that seizures, delirium, hallucinations and deviant behavior have been reported in patients infected with influenza virus and receiving zanamivir (primarily children in Japan). Adverse events were observed in the early stages of the disease and often had a sudden onset and rapid outcome. A cause-and-effect relationship between taking zanamivir and the above adverse events has not been proven [27]. Recent studies show that the administration of oseltamivir and zanamivir even after 48 hours from the onset of the disease leads to a reduction in the frequency and severity of complications [24]. In 2008–2009 the development of resistance of the A (H1N1) virus to zanamivir was not observed [25,26]. Rimantadine and oxolinic ointment are also used for the treatment and prevention of influenza. Rimantadine inhibits the synthesis of the M2 protein of the influenza virus, disrupting the process of reproduction and assembly of the virus. It has antiviral activity against the influenza A virus and reduces the toxic effect of the influenza B virus [27]. Prescribing the drug in the acute period reduces the clinical manifestations of acute respiratory infections in children, especially with influenza A and B [27]. Contraindications are hepatitis, nephritis, renal failure, thyrotoxicosis, pregnancy, breastfeeding. Possible side effects: allergic reactions, abdominal pain. For treatment, the drug is prescribed: on the 1st day after the onset of the disease 0.1 g x 3 times, on the 2nd day – 0.1 g x 2 times, on the 3rd day – 0.1 g x 1 time; for prevention – 0.05 g x 1 time/day. within 10–15 days. Rimantadine is allowed for children from 7 years of age: at 7–10 years old take 0.05 g 2 times/day, at 11–14 years old – 0.05 g 3 times/day. within 5 days. The drug is taken after meals with water. Oxolinic ointment has virucidal activity and has a preventive effect against influenza. Apply 0.25 or 0.5% ointment 2-3 times a day. for several days, lubricating the nasal mucosa. For pre-season and emergency prevention and treatment of acute respiratory infections, drugs that have both antiviral and immunomodulatory effects can be used: isoprinosine, arbidol, interferons, inducers of interferon synthesis. Arbidol inhibits the synthesis of viruses A and B, induces the synthesis of IFN, stimulates T- and B-cells, phagocytosis of macrophages. With its use, a decrease in intoxication, the severity of catarrhal phenomena and a decrease in the duration of the febrile period, the frequency of complications and exacerbations of chronic diseases are noted [28]. Indications for use are the treatment and prevention of influenza A and B, acute respiratory viral infections (ARVI), severe acute respiratory syndrome (SARS), including those complicated by bronchitis and pneumonia [27]. Contraindications: individual hypersensitivity, age under 3 years. To prevent influenza and acute respiratory infections, adults and children over 12 years of age take (before meals) 200 mg/day, children 6–12 years old – 100 mg/day, children 3–6 years old – 50 mg/day. within 10–14 days; during treatment – up to 5 days. During an influenza epidemic or during acute respiratory viral infections with complications (bronchitis, pneumonia, etc.), arbidol is prescribed to children from 3 to 6 years old at a dose of 50 mg, from 6 to 12 years old - 100 mg, over 12 years old and adults - 200 mg 2 times / days up to 3 weeks Isoprinosine suppresses the synthesis of RNA and DNA containing viruses; in children it is allowed from 3 years of age. According to L.V. Osidak et al., influenza B and avian viruses of the H5N2 subtype, respiratory syncytial virus (Long strain) and parainfluenza viruses are sensitive to isoprinosine. 2503 frequently ill children received isoprinosine during the acute period of ARVI, which led to a reduction in the duration of the febrile period, a decrease in the severity of intoxication and catarrhal symptoms, and a decrease in the number of episodes of ARVI within 4 months. after a course of treatment [29]. According to our data, the effectiveness of isoprinosine was assessed over 6 months. observations on its preventive effect on frequently ill children with chronic diseases of the oropharynx (CHD-CHD) (with a frequency of acute respiratory infections 6 or more times a year outside the acute period of acute respiratory infections and exacerbation of foci of chronic infection of the nasopharynx and oropharynx or after their sanitation). Isoprinosine was prescribed at a dose of 50 mg/kg/day. within 10 days. There was an increase in the number of T cells (CD3+–, CD4+–, immunoregulatory index), relative and absolute number of NK cells (CD3+CD16+–, CD3–CD16+–), CD3+HLA–DR+–cells, an increase in the level of serum IgA, M , indicators of the macrophage link, the level of IFN in the blood and the synthesis of α- and γ-IFN by cells (p <0.05). After 6 months the positive dynamics of indicators were leveled out [30]. The use of isoprinosine in the complex treatment of acute respiratory infections after rehabilitation of foci of chronic infection of the oropharynx and nasopharynx in 50% of children provides effective prevention of acute respiratory infections, reduces the frequency of acute respiratory infections episodes by 3.5 times, exacerbations of recurrent bronchitis by 2.3 times, chronic pharyngitis by 2.5 times, reduces the need for antibiotics, and reduces the frequency of clinical manifestations of herpesvirus infection compared to the control group [30]. Viferon is a human recombinant α2-IFN that has antiviral (against influenza and herpes viruses), immunomodulatory and antiproliferative effects. Available in the form of ointment, gel, rectal suppositories in doses of 150,000, 500,000, 1,000,000 and 3,000,000 IU. The drug contains cocoa butter, as well as ascorbic acid, tocopheryl acetate, which have antioxidant, anti-inflammatory, membrane stabilizing and regenerating effects. The use of Viferon reduces the incidence of acute respiratory infections by 2–5 times, shortens the duration of the acute period, reduces the severity of clinical symptoms and the frequency of complications. Its immunomodulatory effect is associated with the influence on T and B cells, an increase in the level of IgA in the blood, the synthesis of γ-IFN by cells, phagocytosis of neutrophil leukocytes, and restoration of the IFN system. The effect of Viferon in pneumonia, including chlamydial etiology, and meningitis is described. Z.S. Makarova showed the preventive effectiveness and immunomodulatory effect of Viferon ointment, including an increase in the synthesis of γ-IFN by cells, a decrease in the circulation of early IFN, and a decrease in the incidence of acute respiratory viral infections [31]. Viferon in the form of a gel can be used for the prevention of ARVI and stenosing laryngotracheobronchitis (tonsils are lubricated for 3 weeks, in the acute period of ARVI - for 5 days, 2 courses per year). Viferon is well tolerated, compatible with all medications, approved for use in pregnant and lactating women, newborns and premature infants, but individual intolerance is possible [31]. The fluppferon, the recombinant IFN --α–2B, is introduced in the form of drops in the nose, blocks the reproduction of the influenza virus, has a drying and adsorbing effect, reduces the number of viral particles secreted during sneezing, coughing from the patient [15]. IFN synthesis inducers stimulate the synthesis of their own IFN, providing high efficiency and duration of antiviral action. They go well with antibiotics, chemotherapy [32,33]. Cycloferon (meglumin acridonacute) is a low molecular weight synthetic inductor of the synthesis γ -ifn and α - ifn. It is quickly excreted from the body, 99% of the drug is eliminated by the kidneys unchanged after 24 hours. Interferonogenic activity remains for 3 days. The main cells -producers of interferon after the introduction of cycloferon are macrophages, T- and B - limphocytes. The drug increases the level of IFN in the mucous membrane of the small intestines, spleen, liver, lungs, activates bone marrow stem cells, stimulating the formation of granulocytes, overcomes the hematoencephalic barrier. Cycloferon activates T cells and EC cells, normalizes the balance between CD4+ - and CD8+cells, increases the activity of α -IFN, suppresses the reproduction of the virus in the early stages (1-5 days) of infection. Adults in the treatment of influenza and acute respiratory viral diseases are prescribed 4 cycloferon tablets 1 time/day. for 30 min. before meals at 1, 2, 4, 6, 8th day. (20 tablets per course). Treatment should begin at the first symptoms of infection. In severe flu on the 1st day, 6 tablets are taken, if necessary, symptomatic therapy (antipyretic, expectorants) are added. Children aged 4-6 years take 1 tablet (150 mg), at 7-11 years old - 2 tablets, older than 12 years - 3 tablets 1 time/day. for 30 min. before meals. For the treatment of influenza and acute respiratory infections in children, cycloferon is prescribed in age dosages of 1, 2, 4, 6, 8, 11, 14, 17, 20, 23 days. And then 1 time in 3 days. The course of treatment is from 5 to 15 doses depending on the severity of the state and severity of clinical symptoms. The repeated course is advisable to be carried out after 2-3 weeks. After the first course. For prevention, the drug is prescribed during the seasonal lifting of acute respiratory infections in 1, 2, 4, 6, 8th day, then taken 5 times with an interval of 72 hours (3 days) in age dosages for children and adults [27]. The appointment of cycloferon with preventive goals in children reduces the frequency of acute respiratory infections by 2.9 times [31]. Kagocel is a high molecular weight compound, induces the synthesis of the late IFN (a mixture of α– and β -IFN) T- and B - limphocytes, macrophages, fibroblasts, epithelial cells. In the blood, the maximum level of IFN is observed after 48 hours, in the intestine - after 4-5 hours, the therapeutic level in the blood is maintained for 4-5 days. For the treatment of influenza and SARS, adults are prescribed in the first 2 days for 2 tablets 3 times/day., In the next 2 days - 1 tablet 3 times/day. In total, the course is 18 tablets, the duration of the course is 4 days. For prevention, the drug is prescribed 2 tablets 2 days a week (from one week to several months). For the treatment of influenza and SARS, children over 6 years old take in the first 2 days 1 tablet 3 times/day., Then 2 days - 1 tablet 2 times/day. For prevention - 2 days a week 1 tablet 1 time/day. For the treatment of influenza and SARS, children aged 3 to 6 years are prescribed in the first 2 days for 1 tablet 2 times/day., Then 2 days - 1 tablet 1 time/day. In total, 6 tablets per course, the duration of the course is 4 days. Tiloron is a low molecular weight synthetic inductor of the synthesis α–, β-, γ -IFN epithelial cells of the intestines, hepatocytes, T -limphocytes, neutrophilic leukocytes. The maximum of IFN products is determined in the intestines, liver, blood after 4–24 hours. Tyloron stimulates stem cells, depending on the dose - antibodies, reduces immunosuppression, normalizes the balance between CD4+ - and CD8+cells, suppresses the broadcast of viral proteins and reproduction of viruses. Tiloron is effective in relation to DNA and RNA -containing viruses, including influenza virus and other respiratory viruses. For the treatment and prevention of influenza and other Tyloron acute respiratory infections, Tyloron is allowed in children from 7 years old and in adults. For the treatment of influenza and SARS, children are prescribed 60 mg 1 time/day. In the first 2 days, then 60 mg after 48 hours, for the course - 3 tablets. With the development of complications of influenza and other SARS, the drug takes 60 mg per 1, 2, 4, 6th day from the start of treatment. The course dose is 240 mg (4 tablets). Adults in the treatment of influenza and SARS take 125 mg 1 time/day. In the first 2 days, then 125 mg after 48 hours per course - 6 tablets. For the prevention of influenza and SARS, the drug is prescribed at a dose of 125 mg 1 time/week. within 6 weeks. The course dose is 750 mg (6 tablets). In children for prevention, the dose of the drug is 60 mg/day. According to I.V. Volchek, the appointment of tyloron by patients with influenza (22 people), adenovirus infection (8 people), paragraph (8 people), unspecified acute respiratory infections (32 people) in a complex with standard symptomatic therapy led to a decrease in the duration of the acute period, including symptoms of fever, headache, headache, headache, headache, headache, headache, headache, headache cough, rhinitis. Among those who received tiloron, pneumonia developed in 3.5%, and in the control group - in 12% of patients; Bronchitis - in 28 and 49%. The development of otitis media, sinusitis and exacerbation of chronic tonsillitis in the used tiloron was not observed, while in the control group the development of the above diseases was observed in 3.5 and 3.5% of patients, respectively, and chronic tonsillitis worsened in 7.5% of patients. The use of tylorone for preventive purposes in 31,667 people reduced the incidence of SARS by 3.6 times, a easier course of respiratory infections was noted. Side phenomena (rashes, nausea, fever) were observed in 0.65% of cases [32]. 90 children with a duration of symptoms of SARS 48 and 72 hours received tiloron 60 mg 1 time/day. After eating on the 1st, 2nd and 4th day (per course - 180 mg) with uncomplicated forms of the disease or on the 1st, 2nd, 4th and 6th day (for the course - 240 mg). Tiloron was not appointed 90 children of the control group. All children could receive symptomatic treatment. Experienced and control groups were comparable by age, severity and complications. With uncomplicated forms of SARS, the receiving Tiloron had a decrease in the duration of the acute period, including the symptoms of fever, headache, cough, rhinitis, and a decrease in appetite. In children with complications that received antibiotics and tiloron, a decrease in the duration of intoxication was observed: 7 ± 0.9 and 14.7 ± 1.9 days, respectively, when compared with the control group (p <0.05). In all children who received Tiloron, the level of α–, γ -IFN was higher than in the control group. No side effects were noted [33]. Based on the results of the placebo -controlled study, the effectiveness of Tilorone for the prevention of acute respiratory infections and influenza is shown. The control and main groups included 100 people from the risk group by acute respiratory infections. In case of acute respiratory infections in patients, 2 types of paragraph and adenovirus viruses were identified. The main group received Tiloron within 6 weeks, the observation period was 8 weeks, the security level was 75%. The duration of the acute period in the control group reached 10 ± 5.2 days, and in the main group that received Tiloron - 2.0 ± 1.0 days [34]. The limited selection of vaccines for acute respiratory infections, in addition to vaccines against influenza viruses, leads to the need to develop new antiviral drugs and the use of immunotropic drugs for prevention and treatment in order to reduce the incidence and severity of complications.

Literature 1. Zaitsev A.A., Sinopalnikov A.I. Influenza: diagnosis and treatment // Breast cancer. 2008. T. 16. No. 22. P. 1494–1502. 2. On the sanitary and epidemiological situation in the Russian Federation in 2002. State report. M.: Federal Center of State Sanitary and Epidemiological Supervision of the Ministry of Health of Russia, 2003, 221 p. https://www.fcgsen.ru 3. https://www.gripp.ru/info.aspx?id=69 4. Neuzil KM, Reed GW, Mitchel EF, Griffin MR Influenza–associated morbidity in young and middle– aged women // JAMA. 1999. Vol. 281. P. 901–907. 5. Thompson WW et al. Mortality associated with influenza and respiratory syncytial virus in the United States // JAMA. 2003. Vol. 289(2). R. 179–186. 6. http:/www.vaxigrip.ru 7. www.mossanepid.ru dated September 26, 2008 8. World Health Organization. Influenza vaccines // Wkly Epidemiol. Rec. 2000; Vol. 75. R. 281–288. 9. World Health Organization. Influenza vaccines // Wkly Epidemiol. Rec. 2002; Vol. 77. R. 229. 10. World Health Organization. Influenza vaccines. Wkly Epidemiol. Rec., 2002; Vol. 77. R. 229. 11. Nichol KL, Wuomema J., von Sternberg T. Benefits of influenza vaccination for low–, intermediate–, and high–risk senior citizens // Arch. Intern. Med. 1998: Vol. 158. R. 1769–1776. 12. Uphoff H., Cohen JM, Fleming D., Noone A. Harmonization of national influenza surveillance morbidity data from EISS: a simple index // Euro Surveill. 2003 Jul. Vol. 8 (7). R. 156–164. 13. Palache AM Influenza vaccines. A reappraisal of their use // Drugs. 1997. Vol. 54. R. 841–856. 14. WHO checklist for influenza pandemic preparedness planning. Geneva, World Health Organization, 2005. 15. Kiselev O.I., Sologub T.V., Maly V.P., Romantsov M.G. Medicines for the treatment and emergency nonspecific prevention and pathogenetic therapy of influenza type A/H1N1 and ARVI. Lecture for doctors. St. Petersburg – Kharkov, St. Petersburg: Semax LLC, 2009. 38 p. 16. https://www.gripp.ru. Section “News” dated 02/16/2009 17. https://www.gripp.ru. Section “News”, 2008 18. The New Times, 2009, No. 18 dated May 11. 19. World Health Assembly. Prevention and control of influenza pandemics and annual epidemics. Fifty–sixth World Health Assembly; Resolution WHA56.19. 28 May 2003. Available from: https://www.evm–vaccines.org/pdfs/wha_resolution_ipd.pdf 20. Yen H.–L., Monto As., Webster RG, Govorkova EA Virulence may determine the necessary duration and dosage of oseltamivir treatment for highly pathogenic A/Vietnam/1203/04 influenza virus in mice // J. Infect. Dis. 2005. Vol.192. R. 665–672. 21. Treanor JJ et al. Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: a randomized controlled trial // JAMA. 2000. Vol. 283. R. 1016–1024. 22. Nicholson KG et al. Treatment of acute influenza: efficacy and safety of the oral neuraminidase inhibitor oseltamivir // Lancet. 2000. Vol. 355. R. 1845–1850. 23. Thompson WW et al. Mortality associated with influenza and respiratory syncytial virus in the United States // JAMA. 2003. Vol. 289(2). R. 179–186. 24. McGeer A. et al. Antiviral therapy and outcomes of influenza requiring hospitalization in Ontario, Canada // Clin Infect Dis. 2007. Vol. 45 (12). R. 1568–1575. 25. WHO. Influenza A(H1N1) virus resistance to oseltamivir – 2008/2009 Influenza season, northern hemisphere. Available at: https://www.who.int/csr/disease/influenza/H1N1webupdate20090318%20ed_ns.pdf (Accessed 12 March 2009) 26. CDC. 2008–2009 Seasonal Influenza Update. Bridges CB. Available at: https://emergency.cdc.gov/coca/ppt/Influenza–10–28–08.ppt#257,1,2008–09 Seasonal Influenza Update. (Accessed 12 March 2009). 27. Directory VIDAL. Medicines in Russia. M., 2011. 28. Drinevsky V.P. and others. Chemotherapy in the treatment of influenza and other respiratory viral infections in children // Antibiotics and chemotherapy. 1998. No. 9. pp. 29–34. 29. Osidak O.V. and others. Isoprinosine in the treatment of ARVI in frequently ill children // Children's infections. 2008. No. 4. pp. 35–41. 30. Markova T.P. Use of Isoprinosine for the prevention of recurrent respiratory infections in frequently ill children // Farmateka. 2009. No. 6. pp. 46–50. 31. Romantsov M.G., Goryacheva L.G., Kovalenko A.L. Antiviral and immunotropic drugs in pediatric practice: A guide for doctors. St. Petersburg: MediKa, 2008. 119 p. 32. Volchek I.V. Preventive and therapeutic effectiveness of amixin for influenza and other acute respiratory infections // TERRA MEDICA nova. 2004. No. 4. pp. 25–28. 33. Uchaikin V.F., Cheshik S.G., Balabolkin I.I. Therapeutic effectiveness and safety of amixin for respiratory viral infections in children // RMZh. 2001. T. 9. No. 19. 34. Lytkina I., Grekov T. Preventive effectiveness of the drug Lavomax for influenza and ARVI // Doctor. 2010. No. 4. pp. 64–67.

Treatment of acute respiratory infections and acute respiratory viral infections in adults

Antibiotics are powerless against viruses. For acute respiratory viral infections in adults, you must first help the body cope with the disease and avoid complications.

Non-drug therapy

Drink a lot.

Drinking plenty of warm fluids is one of the key factors on the road to recovery.
Water is needed to remove toxins and prevent mucus from thickening and causing even more inflammation. At high temperatures, the body loses a lot of fluid, so its replenishment is also necessary to prevent dehydration. Warm drinks are ideal - water (plain or with lemon), cranberry juice, ginger tea, compotes. Ensure optimal room humidity.
A sick person needs moist air even more than a healthy person.
After all, dry mucous membranes provoke thickening of sputum and, as a result, make breathing difficult. Use Doctor MOM® Phyto ointment.
This remedy helps relieve major cold symptoms, including nasal congestion, headache and muscle pain.
Rinse your nose.
The saline solution reduces bacteria and helps reduce inflammation.

Drug treatment

Drug therapy for acute respiratory viral infections in adults includes the use of antiviral drugs. It is important to take medications from this group from the first hours of the disease. If your temperature has already risen and you feel a general “weakness,” this means that the virus has already entered the body, and antiviral drugs will not help. Non-steroidal anti-inflammatory drugs are used to relieve severe headaches and muscle pain. People who have a hard time tolerating high body temperature may be advised to take antipyretics or complex medications, for example, RINZA® tablets or RINZASIP® powder with vitamin C. To relieve nasal congestion and runny nose, local vasoconstrictors are used, for example TIZIN® Xylo or TIZIN ® Xylo BIO. To avoid the development of negative side effects, they are allowed to be used for no more than 3-5 days, after which a mandatory break is required. To treat an acute dry cough, which often accompanies ARVI, it is necessary to prescribe drugs to thin and facilitate the separation of sputum, for example, mucolytic herbal remedies (in in particular, cough syrup Doctor MOM®). This complex herbal medicine, containing extracts of 10 medicinal plants, not only has an expectorant effect, but also has anti-inflammatory properties.

Types of drugs for the treatment of acute respiratory infections

The choice of medications for the treatment of acute respiratory infections depends on the type of infection and the severity of the disease. Only a doctor can choose the right medications based on an examination of the patient. The following drugs can be used:

Antiviral. They destroy the virus and prevent its spread in the body.
Symptomatic. Their goal is to relieve symptoms of the disease, which allows stabilizing the general condition.
Immunostimulating. When used, the body's natural defense reactions are enhanced, which increases the effectiveness of treatment.

Antiviral drugs

Antiviral drugs can speed up the treatment of acute respiratory infections and prevent the development of complications. They should be taken immediately after the first symptoms of the disease appear. All antiviral agents additionally have an immunostimulating effect.

The most commonly used medications are:

Amiksin. The drug is intended for the treatment of adults. The active ingredient tiloron significantly enhances the functioning of the immune system.
Arbidol. The active substance umifenovir has a negative effect on various types of viruses. The drug improves the body's resistance to infections and reduces the intensity of symptoms. The medicine has no age-related contraindications.
Kagocel. The medicine is made from natural raw materials. It stimulates the body's antiviral activity and can be used as a prophylactic during the spread of seasonal infections.

All antiviral drugs have contraindications. They should be used with caution during pregnancy and lactation. The therapeutic dosage is indicated by the manufacturer in the instructions for use, but it can be changed by the doctor depending on the severity of the disease.

Remedies against high temperature

A common symptom of acute respiratory infections is high fever. It is necessary to take antipyretic drugs only when the readings rise above 38 degrees.

The following medications are considered the most effective:

Paracetamol. The drug belongs to the group of antipyretics and has a pronounced analgesic, antipyretic and anti-inflammatory effect. With long-term use, it is necessary to monitor blood counts.
Aspirin. An anti-inflammatory and analgesic that can quickly reduce fever. There are certain indications for its use, so caution should be exercised when taking it.

It is important to know!

Expectorants and mucolytics should not be taken simultaneously with antitussives: this can cause an excess of phlegm in the bronchi. For a dry cough or cough with little sputum, sputum thinners are prescribed; for a wet cough, expectorants are prescribed. Antitussive drugs are prescribed in exceptional cases when a person has a persistent cough.

Treatment of acute respiratory infections in adults should be carried out under the supervision of a doctor, especially if there are the following symptoms:

high temperature, which has no or almost no effect from paracetamol;
high temperature persists on the fourth day of illness;
severe pain in the chest or head;
purulent discharge;
return of temperature a day after it disappears or on the seventh day of illness;
deterioration of the condition after a short period of improvement;
pale skin, severe lethargy, shortness of breath;
intense sore throat in the absence of a runny nose or cough;
severe dry cough that cannot be softened, attacks when trying to take a deep breath;
rash.

It is important to know!

Despite numerous advice and the strong belief that a glass of vodka at night is the best medicine, alcoholic drinks do not help treat acute respiratory infections and acute respiratory viral infections. Alcohol lowers an already weakened immune system, blocks the ability of the kidneys to remove toxins, constricts blood vessels, causing headaches - in a word, it prevents the body from fighting infection. And drinking alcohol at high temperatures increases dehydration and leads to an exacerbation of the disease.

Treatment of acute respiratory infections in children, effective relief of symptoms

Recommendations on how to treat acute respiratory infections in children are aimed at relieving clinical manifestations associated with the inflammatory reaction.

Recommendations on how to treat acute respiratory infections in children are aimed at relieving clinical manifestations associated with the inflammatory reaction.

a diet rich in vitamins;
drinking plenty of water;
antipyretic drugs.

Locally, symptoms are relieved by the following means:

for nasal congestion - with vasoconstrictor drops;
if the throat is affected - with sprays, local antiseptics, gargles;
to relieve a wet cough - with expectorants;
for dry cough - antitussives. Source: T.A. Samsygina Modern treatment of acute respiratory diseases in children // Pediatrics, 2013, No. 3, pp. 38-42

Inhalations and physiotherapy may also be prescribed.

Antibiotic treatment for acute respiratory disease is prescribed to children when the causative agent is a bacterial infection; only a doctor should give clinical recommendations, select the drug and dosage. If a child is prescribed an antibiotic for the flu, it is necessary to relieve complications that arise from bacterial damage (for example, pneumonia). In general, antibacterial drugs are powerless against viruses.

Doctors recommend avoiding antibiotics for uncomplicated respiratory viral infections. Their use is not justified even with mucopurulent runny nose lasting less than 2 weeks. Source: Seto WH, Conly JM, Pessoa-Silva CL et al Infection prevention and control measures for acute respiratory infections in healthcare settings: an update // East Mediterr Health J., 2013, i9 (Suppl. i), p. 39-47

Signs of a bacterial infection for which antibiotics are indicated:

anaerobic sore throat;
purulent processes;
acute tonsillitis when group A streptococcus is detected;
sinusitis, if clinical changes persist in the sinuses after 2 weeks from the onset of the disease;
acute otitis media;
pneumonia;
chlamydia and mycoplasmosis (respiratory form);
bronchitis caused by mycoplasma (mycoplasma bronchitis).

The child is required to have bed rest

until body temperature normalizes,
eat a balanced diet, take multivitamins
. You can gargle with decoctions of medicinal herbs, infusions, and antiseptic solutions. If the body temperature is normal, then the following will be useful: dry heat on the lower back and feet, hot foot baths.