How swine is transmitted. Symptoms and treatment of H1N1 swine flu

Memo for residents of the Penza region on the prevention of highly pathogenic influenza A (swine flu)

What is swine flu?

H1N1 (commonly known as "swine flu") is a new human influenza virus that was first identified in the United States in April 2009. Diseases caused by this new influenza virus are rapidly spreading in various countries of America, Europe, and have been identified in China and Japan.

Why is the new H1N1 virus called "swine flu"?

It is believed that the primary source of the new virus were pigs, in whose body it was formed. Then the new H1N1 virus had the ability to infect people and be transmitted from a person by airborne droplets.

How is the swine flu virus transmitted from person to person?

The virus spreads from one person to another in the same way as regular seasonal flu, ie. by airborne droplets - when the patient coughs or sneezes.

Also, the influenza virus can enter the body (in the eyes, nose or mouth) through the hands when in contact with an infected surface.

Can you get swine flu from pork?

No. H1N1 viruses are not foodborne. Infection with the new HIN1 virus through pork or pork products is not possible. Properly processed and cooked pork products are completely safe to consume.

What kills the flu virus?

Studies have shown that the influenza virus is able to survive on surrounding objects with the possibility of infecting a person within 2-8 hours from the moment it hits the surface.

The influenza virus is destroyed by exposure to high temperatures (75-100°C). In addition, some chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohol solutions, are effective against human influenza viruses when used at the appropriate concentration for a sufficient period of time.

Of great importance for the release of surfaces from the virus is frequent airing of the room.

How dangerous is swine flu?

The inhabitants of the Earth have not yet met with a new type of H1N1 influenza virus, therefore, when this infection is brought into the country and spread, the incidence of the population will be much higher than with ordinary seasonal influenza. Also, when infected with a new variant of the influenza virus, a greater number of cases with a severe clinical course of the disease are possible.

In addition, it should be remembered that the flu is dangerous, primarily due to complications. Complications most often occur in representatives of "risk groups", which include people 65 years of age and older, children under 5 years of age, pregnant women, people of any age suffering from chronic diseases (such as bronchial asthma, diabetes mellitus, cardiovascular diseases) , and persons with reduced immunity (eg, persons taking immunosuppressive drugs, HIV-infected).

What are the symptoms of swine flu?

The disease can occur up to 7 days from the moment of contact with a sick person.

Symptoms of illness caused by the new H1N1 influenza virus in humans are similar to those of regular, seasonal influenza and include: high fever, cough, sore throat, runny or stuffy nose, muscle pain, headache, chills, and weakness. A significant number of patients also experience diarrhea and vomiting.

Symptoms to watch out for

If you are sick and have symptoms of the disease, contact your doctor immediately. Do not self-medicate!

You should also seek immediate medical attention if you experience any of the following warning signs:

• in children : fast or difficult breathing, bluish or gray skin, severe or persistent vomiting, drowsiness, soreness in which the child does not want to be held, and also in cases where flu symptoms subside but then return with a high fever and increased cough;
• in adults : difficulty breathing or shortness of breath, pain or a feeling of heaviness in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, and also in cases where flu symptoms weaken, but then return with high fever and increased cough.

Are there medications to treat swine flu?

Yes, there are. In any case, the doctor should prescribe the treatment. The main drug for the treatment of swine flu is oseltamivir (Tamiflu). Studies of domestic drugs are being conducted in relation to the sensitivity of the new H1N1 influenza virus to them.

Swine Flu Prevention Measures

Currently, vaccines to protect against infection with a new virus

H1N1 does not exist. Hygiene measures should be taken to prevent infection.

Take the following steps to protect your health:

• avoid crowded places;
• cover your nose and mouth with a tissue when you cough or sneeze. Throw away the used tissue in the trash. It is most optimal to use an ordinary medical mask to protect the respiratory organs from the virus;
• Wash your hands thoroughly and often with soap and water, especially after coughing or sneezing. Alcohol-based hand rubs are also effective;
• do not touch your eyes, nose or mouth;
• Try to avoid close contact with sick people.

How to wash your hands properly?

Washing your hands frequently will protect you from germs. Use soap or an alcohol-based hand rub to wash your hands. It is recommended to wash your hands - with soap and warm water - for at least 15-20 seconds. If soap and water are not available, disposable wipes soaked in alcohol-based hand rub or disinfectant gels can be used.

If you are ill, stay home for at least 7 days after you develop symptoms. Avoid contact with other family members as much as possible. This is necessary to prevent infecting others and further spread of the virus. Strictly follow all the recommendations and appointments of medical professionals.

What can be said about the use of masks?

• If you are not sick, there is no need to wear a mask.

• If you are caring for a sick person, you can wear a mask when in close contact with him. After such contact, immediately dispose of the mask and then wash your hands thoroughly.
• If you are sick and must travel or be around other people, cover your mouth and nose.
• The correct use of a mask in all situations is extremely important, as the incorrect use of masks does lead to a sharp increase in the likelihood of the spread of infection.

How to clean the house?

To prevent the spread of the influenza virus, it is important to keep surfaces (especially bedside tables, bathrooms, kitchens, and children's toys) clean by wiping them down with household disinfectants according to label instructions.

What to do with linen, cutlery and crockery used by swine flu patients?

There is no need to wash linen and cutlery and dishes belonging to the patient separately. But it is important to remember that these items cannot be used by others without careful pretreatment. Linens (such as sheets and towels) should be washed using regular laundry soap and dried in a hot dryer.

Do not carry dirty linen "in an armful" to the place of washing. After carrying dirty laundry, wash your hands with soap and water or wipe them with an alcohol-based hand rub.

Should antivirals be taken beforehand?

No. You should only take antiviral drugs such as oseltamivir or zanamivir if your doctor tells you to. Individuals should not self-purchase drugs to prevent or treat this new flu without a doctor's prescription. And you should also take precautions when buying antiviral drugs over the Internet.

Prepared Kira BYKOVA.

(Information provided by the Office of Rospotrebnadzor for the Penza region)

Swine flu is a type of acute infectious disease caused by a specific type of H1N1 influenza virus. Such influenza is characterized by a rapid transition of individual outbreaks of the disease into a pandemic due to high contagiousness, severe course and an increased number of complications, up to death.

History of swine flu

The very name of the disease - "swine flu" - causes a lot of criticism from the experts of the World Health Organization. Specialists protest against the names of diseases based on ethnic, territorial, professional characteristics or the inclusion of epithets denoting the animal world as a source of infection (avian, swine flu). Such a choice of name for the diagnosis discriminates against living beings from certain groups, while the original swine flu viruses, as well as bird flu, did not carry such a threat to humans. Thus, as a result of the widespread name for a new type of disease, mass destruction of pigs began in some countries, not only as a preventive measure, but also with political aspects of the action. For example, in Egypt, where the majority of the population is Muslim with a ban on eating pork, farm animals belonging to local Christian communities were destroyed.

The group of swine flu viruses was discovered in 1930 by Richard Shope. For half a century, individual episodes of diseases were noted in the territories of Mexico, Canada and the United States among the pig population. In rare cases, swine flu infected people who were in close contact with animals (cattlemen, veterinarians, etc.), but the course of the disease was very different from the swine flu that exists today.

The cause of the 2009 pandemic was a mutation that occurred when one of the types of the swine flu virus and the human influenza A virus were crossed. Such mutations occur annually, but not all new viral species are able to actively reproduce and can affect humans.

The spread of the virus: how to get infected with swine flu

The new flu, type H1N1, is capable of infecting both humans and pigs. Therefore, both can become a source of infection. The disease does not appear immediately: the incubation period of swine flu lasts from 24 to 48 hours before the onset of symptoms, depending on the carrier. At this time, the virus is already actively multiplying, is released into the external environment and can be transmitted to other people and animals. The average duration of the period of high contagiousness of the patient is 7 days from the onset of the manifestation of the disease. However, approximately one in 6 people is able to infect others up to 2 weeks after the onset of symptoms despite therapy.
The high contagiousness of the swine flu virus is explained not only by its pandemic nature, but also by the methods of infection spread. The pathogen is transmitted from a carrier or a sick person to others in the following ways:

• aerogenic or airborne: the virus spreads with the smallest drops of biological fluids (, nasal secretions when coughing, sneezing). Radius of propagation - up to 2 meters;
• contact-household, when liquids get in during sneezing, coughing, using dishes, towels, from the hands of the patient to surrounding objects.

In a non-aggressive environment, the swine flu virus remains active for two hours, presenting an increased danger to those who come into contact with a sick person or an infection carrier.

People of all ages are susceptible to the H1N1 influenza virus, regardless of gender, race or place of residence. However, there are several groups with an increased risk of developing severe forms of the disease, complications, up to death:

• early age of the patient (up to 5 years);
• people of the advanced age period (65 years and older);
• women during the period of bearing a child, regardless of the duration of pregnancy;
• people with immunodeficiencies of various etiologies (due to diseases, pathologies of the immune system, during therapy with immunosuppressive drugs, etc.);
• persons with chronic diseases of the respiratory, cardiovascular system, endocrine diseases (diabetes), diseases of the liver, kidneys, etc.

Increased risks in these population groups are associated both with the characteristics of the body's defenses, and with the specific effect of the swine flu virus on the human body:

• the virus causes changes in the structure of the blood, provoking an increase in the number of platelets, as a result of which blood clotting increases and the risk of thrombosis increases;
• the course of the disease is often complicated by inflammation of the lungs of viral etiology, accompanied by swelling of the lung tissue;
• nephritis, kidney damage, is also a common complication of swine flu;
• one of the complications of swine flu is myocarditis, damage to the heart muscle.

With a reduced resistance of the body or the presence of diseases and pathologies of the corresponding organs and systems, the likelihood of a hurricane development of complications increases dramatically.

Swine flu virus: symptoms of infection

Swine flu at the very beginning of the disease does not differ in a special clinical picture and is similar to the course of most common influenza and acute respiratory viral infections.
In order to distinguish the manifestations of influenza from the "cold", an acute respiratory disease of bacterial etiology, it is necessary to know the pronounced manifestations characteristic of various types of diseases.

The incubation period for swine flu most often lasts from 1 to 4 days, less often - up to 7 days.
Features of swine flu symptoms in uncomplicated form:

• hyperthermia up to 38-39°C;
• nausea, vomiting against the background of high body temperature, regardless of food intake, diarrhea (up to 45% of patients);
• deterioration of health, drowsiness, feeling of weakness, lethargy;
• muscle, joint pain, "aches" in the body;
• respiratory symptoms are expressed in cough, sore throat, feeling of lack of air.

Symptoms of severe H1N1 influenza

The most common symptom that indicates the development of a severe form of influenza type H1N1 include severe headache with additional features:

• localization of pain most often in the frontal region, near the superciliary arches;
• muscle movements in this area (blinking, facial expressions) increase pain;
• possible development of photophobia;
• pain in the eyeballs when moving the eyes.

Swine flu, which occurs in severe form, is accompanied by severe respiratory failure: a feeling of lack of air, an accelerating rate of respiratory movements, a feeling of insufficient filling of the lungs (it is difficult to take a deep breath).

Complications of swine flu (H1N1 virus)

Complications of swine flu are the main cause of increased mortality of the disease. Among the most dangerous complications caused by the H1N1 influenza virus, the development of primary is distinguished. Inflammation of the lungs against the background of swine flu can be caused directly by this virus, that is, have a viral etiology; can be triggered by the addition of a bacterial infection to the underlying disease; and can also be a mixed bacterial-viral infection.

Primary pneumonia in swine flu is the most dangerous. It develops 2-3 days after the onset of symptoms of infection with respiratory failure, accompanied by rapid (2-3 times more often than normal) shallow breathing involving the muscles of the diaphragm, abdominals, symptoms of lack of oxygen (cyanosis, blue nasolabial triangle, fingers, legs), shortness of breath, dry, unproductive cough with clear discharge.

Inflammation of the lungs of viral etiology can lead to a distress symptom, the development of pulmonary tissue edema, which, without emergency therapy, causes death.
Pneumonia of bacterial etiology develops, as a rule, on the 7th-10th day of illness. In contrast to the viral type, there is an increase in cough, chest pain, cloudy discharge from the lungs, with a purulent tinge. Secondary intoxication causes a new wave of hyperthermia and deterioration of well-being. The treatment is long, up to 1.5-2 months, the prognosis for recovery depends on the timely diagnosis of the pathogen. Almost half of all pneumonias of bacterial etiology are caused by pneumococci, every 6 patients have contamination with Staphylococcus aureus, less common is such a pathogen as Haemophilus influenzae. With pneumonia caused by Staphylococcus aureus, an inflammatory process in the tissues of the lung, an abscess, often begins.

Pneumonia of mixed etiology is manifested by the whole spectrum of symptoms that change during the development of the disease. Treatment is complex, long-term, in a hospital.
Among other common complications of swine flu, there is a high probability of developing pericarditis, myocarditis, hemorrhagic syndrome, blood clots, nephritis, encephalitis, and serous meningitis.

Swine flu: signs of complications

What signs indicate the beginning of the development of severe complications of the disease in influenza type H1N1?

• Rapid breathing, increasing shortness of breath, bluish skin tone.
• Severe headaches, chest pain.
• , lethargy combined with dizziness, episodes of confusion.
• Indomitable, repetitive vomiting, at an early age - an increased number of regurgitation.
• Resumption of symptoms (fever, cough, respiratory failure) after improvement of the patient's condition.

Therapy and general measures for swine flu

Swine flu in patients who are not at risk, with timely treatment, in most cases proceeds without pronounced complications. What is included in the list of general measures for influenza (H1N1 virus):

• mandatory bed rest during the entire illness and 7 days after the end of severe symptoms in order to prevent possible complications;
• limiting the number of contacts both to reduce the likelihood of the spread of the virus and to prevent the accumulation of new infections;
• enhanced drinking regimen (compotes, fruit drinks with a high content of vitamin C: from rosehips, black currants, citrus fruits);
• a complete diet with easily digestible proteins (lean boiled meat, dairy products, eggs, etc.). Fatty, fried, spicy foods, canned foods, semi-finished products of industrial preparation are excluded;
• use of individual dishes for eating, frequent change of bed linen, towels, general hygiene of the room.

Patients at risk are hospitalized for treatment in a hospital setting, regardless of the presence of signs of complications.
Medical therapy includes the following areas:

• (Relenza, Tamiflu) is recommended when diagnosed with a specific type of H1N1 virus, as well as in the presence of characteristic symptoms for this disease and / or suspicion of them in patients from an increased risk of developing complications. Patients outside risk groups with mild and moderate forms of the disease may be prescribed drugs from interferon groups;
• symptomatic therapy aimed at reducing the severity of the symptoms of the disease: antipyretic, analgesic decongestants, local vasoconstrictor drugs to facilitate nasal breathing, mucolytic drugs that facilitate sputum discharge;
• pathogenetic therapy is carried out only in a hospital setting and includes the appointment of glucocorticosteroids, sympathomimetics in order to detoxify the body and reduce the likelihood of developing a distress syndrome.

Treatment of secondary pneumonia against the background of this type of influenza is carried out with antibacterial agents, depending on the identified pathogen, symptomatic drugs, it is possible to prescribe physiotherapeutic procedures at the final stage of the disease and during the rehabilitation period.

Prevention methods

General methods of prevention include limiting contact and staying in public places during epidemics, personal hygiene: frequent washing of hands with soap, wiping with alcohol-containing solutions, use of separate dishes, etc. immune status of the body, state of health, good nutrition, mode of work and rest.

Non-specific drug methods may include taking antiviral drugs in contact with a possible carrier (Viferon, Kagocel, Tamiflu, etc.), taking vitamin complexes or individual vitamin-containing preparations (A, B, C), using barrier methods of prevention (Oxolinic ointment).
For specific preventive measures, a complex vaccine has been developed that protects against the most common influenza viruses in accordance with the forecast of specialists for the coming season.

Before you ask a doctor a question, you need to understand the purpose of your appeal well. Sometimes, an incorrectly formulated patient's question provokes an unreliable or biased answer from a specialist. Guided by what principles, the doctor answers questions? How to ask about symptoms and treatment correctly so that a paid or free consultation is effective?

When a person asks a doctor a question, wanting to get advice, he is guided by the following principles or needs:

• wants to understand the causes of his malaise, illness;
• wants to know the history of the disease that interests him;
• wants to learn about modern methods of treatment of the disease of interest;
• needs to receive recommendations regarding his health or illness;
• wants to consult about the illness of a relative, a child;
• considers that the methods of treatment he used are ineffective;
• wants to receive recommendations within the framework of the diagnosis - lifestyle, nutrition, exercise, side effects, prospects for recovery;
• wishes to be consulted regarding alternative methods of treatment;
• wants to know about the side effects of the drugs he takes;
• needs to draw up a plan of preventive measures for alarming symptoms;
• wants to learn how to prevent complications after diagnosis.

If a person has health problems, due to anxiety, various feelings may arise, for example, such as anxiety, fear, worries. Obeying the negative, people may choose the wrong strategy when trying to ask a question to their doctor online or in person. Instead of being objective and impartial, the patient then tends to talk more about his experiences than about the issue that really worries him. So, he unconsciously tries to get rid of the anxiety that overwhelms him.

Therefore, before asking questions to the doctor through online services for free or for a fee, you should calm down, calm your anxious feelings and fear. Otherwise, there is a risk of paying for a consultation, but not getting the desired answer, spending time working through your own anxiety.

Today, every person has the opportunity to ask a doctor a question online, to do it for free and without prior registration. However, at the same time, people sometimes avoid consulting about treatment. This happens for several reasons:

• they are afraid to hear that the disease is incurable, it requires large financial costs, effort, changes in lifestyle. Silence and inaction, in such cases, will not lead to a good result, on the contrary, the physical condition may worsen, and the specialist will not know about it and will not be able to give timely recommendations regarding treatment;
• do not trust the doctor for various reasons - they doubt his competence, experience, proposed methods of treatment;
• believe that the disease or symptom will go away on its own, and the need to be interested is not important. In this case, the person avoids accepting his illness, perhaps because he is afraid to hear that it is difficult to treat or requires changes in the conditions of his lifestyle, and he is not ready for this.

Do not be afraid and resist communicating with specialists. When a doctor communicates with a patient and answers his questions, certain relationships are formed between them, thanks to which a person receives information about his health, and the doctor has the opportunity to prevent the development of complications, provide timely assistance, and confirm professional competence.

In addition, during communication, the doctor can hear from the patient the details of his condition, which will facilitate the diagnosis and search for treatment methods.

Currently, there are no major barriers to getting quality medical advice on health, wellness and prevention. The patient can ask a question of interest to the attending physician online, at a personal meeting - free of charge or by paying for the necessary consultation time.

The doctor gives information about the symptoms, disease and diagnosis, based on his knowledge and experience. In addition, when answering questions, he can be guided by assumptions that have proven their effectiveness in his medical practice and are objective.

During a medical consultation, the doctor takes into account the medical history, age, mental and individual characteristics of a person. Only with an integrated approach to health and well-being, it provides objective and high-quality information.

Today, there are many Internet sites where each person has the opportunity to ask a free, interesting question to a doctor without the registration procedure on the site.

Questions to a specialist via the Internet

It is worth remembering that the more specific the question is, the more likely it is that the doctor's answer will be detailed, complete and satisfy the patient's needs.

Sometimes, the desire to ask about a disease or disturbing symptoms is hidden by the unconscious processes of the personality. For example, a person is afraid of the consequences of his diagnosis or how the operation will go, and this fear fills all of him. In this case, people tend to behave not very objectively - they, having paid for a doctor's consultation, do not delve into what he says or writes about, because they are disturbed by anxiety or fear. Psychologically, a person wants his anxiety to be understood and needs to share negative feelings, but the doctor, who is waiting for a question within the framework of the disease, is unaware of such internal processes.

The specialist, during such communication, may seem incompetent, because he will not be able to satisfy the patient's need for security, calmness and understanding.

Therefore, the questions that will be asked to narrow specialists or attending physicians should be thought out in advance, consciously, quite simple and not have a double, secret meaning.

This possibility exists on many sites on the Internet. In order to get information about the disease of interest, advice on the prospects for treatment, side effects of drugs, alternative methods, the development of symptoms, you must first register on a site that offers free medical assistance as part of medical services. To do this, you need to provide your details and email.

The next step is to choose a doctor or referral. In most cases, online help can be obtained from such specialists as: therapist, dermatovenereologist, gastroenterologist, neurologist, cardiologist, neurologist, psychologist, psychiatrist, oncologist, gynecologist, urologist, allergist, orthopedist, surgeon, endocrinologist, andrologist, mammologist and others.

Usually, site services provide their customers with complete information about specialists who can be quickly contacted online and find out answers about a disease that worries. Thanks to this, a person has the opportunity, before asking, to get acquainted with a brief medical portfolio of the selected specialist. Most often, it mentions work experience, education, academic degree, specialization, sometimes personal preferences and professional path. So, the user has the opportunity to choose a doctor on their own.

Special trust is enjoyed by specialists who have already answered a large number of questions - which are in the public domain for all readers. Having become acquainted with them, a person has the opportunity to draw a conclusion about the individual and professional characteristics of the doctor, his objectivity and competence. After writing a question, it should be sent to the doctor and wait for feedback. Usually, confirmation of its receipt comes to the e-mail specified during registration.

How to get a free consultation with a doctor?

This service is popular on many medical portals. In addition, on some sites you can ask a question of interest to any doctor without registration. This is easy to do - you just need to follow the prompts of the site. As a rule, these are: choosing a specialist, describing the problem, sending a message.

Sometimes, patients remain dissatisfied with communication with the doctor, experience strong negative feelings after trying to find out about their health or disease. One of the reasons for this is the wrong question. Therefore, in order not to be disappointed by misinformation, you need to know what you should not ask your doctor about.

List of prohibited questions:

Does the doctor consider the patient's disease completely curable? He can express his personal opinion, however, without having a medical history and the results of a comprehensive examination, the risk of an erroneous answer increases. Then, if he says "yes", the patient may be very disappointed if the doctor's words are not confirmed. In the case of an incorrect negative answer, the person will also be disappointed in the doctor and begin to judge his competence biasedly. It is difficult to answer this question unequivocally, since, in addition to the diagnosis, one should take into account the symptoms, heredity, age, occupation of the patient and his desire to improve his health.

Please choose a treatment that will definitely “put you on your feet”. It is impossible to ask for such guarantees from a doctor if communication with him takes place in the format of a video consultation or online correspondence. This variant of the question is acceptable in a personal meeting, however, in this case, it can be problematic to get a lifetime guarantee for recovery.

Questions about the doctor's personal opinion regarding a particular disease will not contribute to the patient's understanding of the causes of the disease and how to treat it.

Usually people ask the “wrong” questions and get angry when their interest is not met or a medical error occurs, in the same case: in the presence of severe anxiety and fear. Usually such feelings overwhelm patients with serious diseases that threaten life and require physical, emotional and financial costs. Therefore, in combination with medical treatment, people with serious diagnoses, which sometimes sound like a sentence, are recommended the mandatory help and support of a psychotherapist.

What to do if the doctor's answers are not clear?

It happens that a person received an answer from a specialist, however, it is difficult for him to understand the terminology used by the doctor when he wrote or said the answer. Some, hearing incomprehensible words, are afraid of their diagnosis or symptoms, even more. To avoid this, the patient is advised, if he uses the correspondence format in the consultation, to read the reviews of other people about the specialist he wants to contact. Also, you can read his answers to other users. Thus, it will become clear in what form the specialist answers, how accessible his language is for a person who is far from medical concepts, how detailed and complete he gives the answer.

When a person decides to ask a doctor a question online, he, having done so, eagerly awaits an answer. If he turns to the doctor for free, without the registration procedure, then he will have to wait a while until his question is processed by the site administrator and an answer is given to him. The more questions a specialist has and if his activity on the site is high - every day he gives advice on dozens of questions - then you may have to wait for an answer for more than one day. This format of counseling is suitable for non-urgent questions, the answers to which do not depend on the methods of treatment and the patient's well-being does not worsen.

If a person urgently needs a doctor - he wants to get help, recommendations or even call him to his house - then the procedure for communicating with a specialist online is not suitable. In this case, it is better to give up the desire to ask a doctor a question via the Internet, without registration. Instead, you should call the clinic and make an appointment with the right specialist, or, if the symptoms are life-threatening, call an ambulance.

Instruction

Mumps is transmitted by airborne droplets from a sick person to a healthy person when coughing, sneezing, talking. The patient from the end of the incubation period to the 9th day of the disease. The maximum isolation of the virus occurs on the 3rd-5th day of illness. Once in the body, the virus begins to multiply in all glandular tissues of the body - in the genital, salivary glands, as well as in the pancreas and thyroid gland. The salivary glands are the first and most affected.

The disease usually begins acutely with fever, pain in the ear, which is aggravated by swallowing, chewing and getting acidic food into the mouth. The patient develops profuse salivation, and then a swelling in front of the ear, which quickly increases and becomes as large as possible by the 5th-6th day of illness, when palpated, this place is sharply painful. The earlobe protrudes upward, while the face acquires a specific appearance, hence the name of the disease. The fever may persist for several days.

The disease itself proceeds, as a rule, quite easily, but it is scary with its complications. Since the glandular tissues are affected, the pancreas is involved in the process, and an attack of acute pancreatitis may occur. It is manifested by the appearance of girdle pain in the abdomen, nausea, vomiting and stool disorders. If these signs appear, you should immediately consult a doctor.

The gonads may also be affected. Boys develop soreness of the testicle, it becomes swollen. In the future, this can develop into testicular atrophy. In girls, inflammation of the ovaries can lead to menstrual irregularities and infertility in the future.

Parotitis should only be treated by a doctor. Dry heat is prescribed for the inflamed gland, rinsing the mouth with disinfectant solutions. Be sure to follow a diet, exclude dishes that cause profuse salivation, food should be liquid or crushed. To prevent pancreatitis, it is recommended to reduce the amount of white bread, cabbage, pasta and fats. It is better that the food is dairy and vegetable.

Vaccination is used to prevent mumps. Vaccinations are given at 12 months and 6 years. If a child falls ill, he is isolated until the 9th day of illness, and all contacts are not allowed in the team for 21 days. The problem is that in 40% of the sick, mumps is asymptomatic, so it is not always possible to avoid infection even with timely isolation of the patient.

"Swine flu" is an acute highly contagious infectious disease caused by a pandemic influenza A (H1N1) virus, transmitted from pigs and humans to humans, having a high susceptibility among the population with the development of a pandemic and characterized by fever, respiratory syndrome and severe course with the possibility of death.

The swine flu virus itself was discovered in 1930 by Richard Shope (USA). For 50-60 years, this virus was found and circulated only among pigs in North America and Mexico. Then swine flu was recorded sporadically in humans, mainly in pig farm workers and veterinarians.

We all remember the last high-profile swine flu epidemic in 2009 (the so-called California/2009), which was emotionally and persistently informed the population by the media. The epidemic has been spreading since March 2009. The first cases of infection with an unknown strain of the virus were reported in Mexico City, and then in Canada and the United States. Many countries were involved in the epidemic process - the USA, Canada, Mexico, Chile, Great Britain, France, Germany, Australia, Russia, China, Japan and many others. As of the end of October, according to the World Health Organization (WHO), 537,248 cases of swine flu have been laboratory confirmed. The greatest susceptibility was noted among the group of people from 5 to 24 years old, in second place were children under 5 years old. During the epidemic, the virus was assigned hazard class 6 (that is, the registration of a swine flu pandemic, which is easily transmitted from person to person, and the disease captures many countries and continents). According to official WHO information, the deaths following the pandemic (California / 2009) amounted to 17.4 thousand people. The pandemic came to Russia in the autumn of 2009, but peaked at the end of October - beginning of November. In total, more than 2,500 patients with a confirmed diagnosis were registered. There were deaths.

The causative agent of swine flu

There are several subtypes of influenza virus in pigs (H1N1, H1N2, H3N2, H3N1), however, only the H1N1 subtype has acquired highly pathogenic properties and the ability to be transmitted from person to person. The influenza A (H1N1) virus is the result of crossing the human influenza A (H1N1) virus and the swine influenza virus, as a result, the virus mutated and became highly pathogenic, and it is called the California / 2009 pandemic virus. Just like the normal human influenza virus, the pandemic virus has hemagglutinin in its shell (facilitates the attachment of the virus to the cell) and neuraminidase (facilitates the penetration of the virus into the cell).

swine flu virus

Reasons for the spread of swine flu

The source of infection is pigs (sick or carriers of the virus) and a sick person. A sick person becomes contagious a day before the onset of symptoms of the disease and even during the week of illness. Accordingly, potential patients at the end of the incubation period are of great epidemic importance. Up to 15% of patients on the background of treatment continue to isolate the virus for 10-14 days.

Infection mechanisms:
- aerogenic (airborne droplets) - the patient's discharge during sneezing, coughing is dangerous - in a diameter of 1.5-2 meters;
- contact-household - the patient's discharge on the hands of others is dangerous, as well as on household items (tables, surfaces, towels, cups) - the virus retains its properties for 2 or more hours (you can bring the virus from your hands to the mucous membranes of the mouth and eyes) .

Susceptibility to infection is universal. There are risk groups for the development of severe forms of swine flu:
- children under 5 years old;
- adults over 65;
- pregnant women;
- persons with concomitant chronic diseases (chronic lung diseases, oncology, blood diseases, diseases of the liver, urinary system, heart, diabetes mellitus, and infectious immunodeficiencies, such as HIV).

The clinical symptoms of swine flu are similar to those of regular seasonal flu, with a few differences. The incubation period (from the moment of infection to the appearance of the first complaints) with swine flu lasts from a day to 4 days on average, sometimes extended to a week. Patients are concerned about the symptoms of intoxication (high temperature up to 38-39 °, severe weakness, muscle pain, nausea, vomiting of central origin, that is, against the background of high temperature, body aches, lethargy).

Another group of complaints is related to the development respiratory syndrome(dry cough, pronounced sore throat, feeling of lack of air), as well as the likelihood of the rapid development of one of the complications - the development of pneumonia in the early stages (2-3 days of illness).

The difference from seasonal flu is the presence of dyspeptic syndrome in 30-45% of patients - patients develop constant nausea, repeated vomiting, and impaired stool.

Manifestations of severe forms of swine flu

In the first days of the disease, intense headaches, pain in the eyeballs, photophobia, which increases with eye movement. Perhaps the development of serous meningitis, encephalitis. Muscle pain is one of the pronounced symptoms of the disease.

One of the dangerous complications of swine flu is the development of pneumonia. Inflammation of the lungs may result from exposure to the influenza virus (primary; may be associated with the addition of a secondary bacterial flora (secondary); may be due to the action of both the virus and the accompanying layering of the bacterial flora (mixed).

Primary pneumonia develops on the second or third day from the onset of the disease and is characterized by the development of symptoms of acute respiratory failure: the patient breathes frequently (about 40 breaths per minute at a rate of 16), auxiliary muscles actively participate in the act of breathing (diaphragm, abdominal muscles), pronounced dry or unproductive cough (mucous and transparent discharge), severe shortness of breath, blue skin (cyanosis). When listening to the lungs: moist rales in the lower parts of the lungs, mainly at the height of inspiration, dullness of percussion sound when the lungs are tapped.

Often, primary pneumonia leads to the formation of respiratory distress syndrome (development of pulmonary edema) with a possible fatal outcome.

secondary pneumonia occurs 6-10 days after the onset of the disease. Most often, there is pneumococcal contamination (in 45% of patients), less often Staphylococcus aureus (no more than 18%), as well as Haemophilus influenzae. A feature of this pneumonia will be an increase in cough: it becomes painful, almost constant, against the background of an increase in cough, the patient has a second wave of fever and intoxication, the patient practically does not take food. Growing pain in the chest when coughing and even breathing. The discharge of the lungs (sputum) is no longer transparent, but has a purulent hue. X-rays show foci of inflammation in the lungs. The course of secondary pneumonia is long, patients cannot recover for a month and a half. Often, staphylococcal pneumonia leads to the formation of a lung abscess.

Pneumonia with swine flu

Mixed pneumonia have clinical symptoms of both one and the second pneumonia, proceed for a long time (progradiently), and are difficult to treat.

Other complications of swine flu include:

pericarditis, infectious-allergic myocarditis, hemorrhagic syndrome.

What worrisome symptoms in terms of "swine flu" should you see a doctor for?

For kids:
- Rapid breathing, difficulty breathing;
- Bluish tint of the skin of the limbs and torso;
- Refusal to eat and drink;
- Repeated vomiting (vomiting "fountain", as well as frequent regurgitation in infants - the equivalent of vomiting at this age);
- Lethargy and drowsiness of the child;
- On the contrary, excitement, resistance even when taking the child in his arms;
- The appearance of a second wave of symptoms with increased cough and shortness of breath.

For adults:
- Shortness of breath and its strengthening during the day;
- Pain in the chest when breathing and coughing;
- Severe dizziness, appearing suddenly;
- Periodically confused consciousness (forgetfulness, loss of individual events from memory);
- Repeated and profuse vomiting;
- The second wave with fever, cough, shortness of breath.

Immunity after swine flu is type-specific and short-lived (1 year).

Diagnosis of swine flu

Preliminary diagnostics difficult due to the similarity of the symptoms of the disease with the usual seasonal flu. The following features will help the doctor:

Contact with a patient with influenza, as well as arrival from an endemic zone for swine flu (countries of North America);
- patient complaints about gastrointestinal disorders against the background of temperature and respiratory syndrome;
- unexpressed or no sore throat against the background of a strong cough, mostly dry;
- Development of pneumonia on days 2-3 with characteristic symptoms (described above).

Today, it is not difficult to distinguish influenza from other acute respiratory viral infections, because modern rapid tests allow you to independently determine the influenza virus in a matter of minutes at the first suspicion of infection. They are sold in pharmacies, they determine influenza type A, B, and also determines the H1N1 subtype - swine flu.

Final diagnosis possible after laboratory confirmation of the disease:
- PCR diagnostics of nasopharyngeal mucus samples to detect influenza A (H1N1) California/2009 virus RNA;
- Virological method of sowing nasopharyngeal mucus, sputum on certain media.

Swine flu treatment

The main goal of treatment is to reduce the number of patients with severe and complicated swine flu.

1. Organizational and regime measures- at the time of making a preliminary diagnosis, hospitalization is carried out according to clinical indications (severe forms, as well as moderate forms in children, the elderly and people with chronic concomitant diseases). With laboratory confirmation of the diagnosis of swine flu, mandatory hospitalization with the appointment of specific therapy is carried out. For the entire febrile period and 5-7 days of normal temperature, bed rest is prescribed to prevent complications.

What to do if you suspect swine flu:

If symptoms of swine flu are detected, stay at home, do not go out to crowded places.
- At home, protect your loved ones from the spread of infection - put on a mask and change it every 4 hours.
- Call a doctor at home. If you come from endemic countries (Mexico, USA), then tell your doctor about it.

To enhance the body's resistance, a physiologically complete diet is shown with a sufficient amount of protein and a high content of vitamins A, C, group B. To reduce fever, a sufficient amount of liquid is indicated (preferably fruit drinks from blackcurrant, rosehip, chokeberry, lemon). All products are prescribed in the form of heat, spicy, fatty, fried, salty, pickled dishes are avoided.

2. Drug therapy includes:

Antivirals- oseltamivir (Tamiflu) and zanamivir (Relenza), which significantly affect the release of new viral particles from cells, which leads to the cessation of virus reproduction. Reception of Tamiflu and Relenza is recommended in the following cases:

1) If the patient has one of the listed symptoms (fever, nasal congestion, cough, shortness of breath);
2) Laboratory-isolated influenza virus A/2009 (H1N1);
3) Age group under 5 years old;
4) Elderly people - over 65 years old;
5) pregnant women;
6) people with severe comorbidities and immunodeficiency;

Usually the course of treatment is 5 days, sometimes more depending on the severity.

Mild and moderate forms of swine flu allow the appointment of the following antiviral drugs - arbidol, interferon alpha 2b (grippferon, viferon), interferon alpha 2a (reaferon lipid) and gamma interferon (ingaron), ingavirin, kagocel, cycloferon.

When pneumonia of a bacterial nature occurs, antibacterial drugs are prescribed (III-IV generation cephalosporins, carbapenems, IV generation fluoroquinolones, vancomycin).

Pathogenetic therapy includes infusion detoxification therapy, glucocorticosteroids, sympathomimetics to reduce the manifestations of intoxication, facilitate breathing (performed in a hospital). At home, with a mild form of swine flu, drinking plenty of water (fruit drinks, tea, honey water) is indicated.

Symptomatic remedies: antipyretic (paracetamol, ibuprofen), vasoconstrictor for the nose (nazol, tizin, nazivin, otrivin and others), to relieve cough (tussin, stoptussin, ambroxol, acc and others), antihistamines (claritin, zodak).

Particular attention is paid to children and pregnant women. Children - taking aspirin-containing drugs is prohibited due to the risk of developing Reye's syndrome (encephalopathy with cerebral edema and the development of liver failure), therefore, paracetamol and nurofen are preferred from the antipyretic group. Of the antiviral agents, Tamiflu, Relenza, Viferon 1, influenzaferon, reaferon lipind, kagocel from 3 years old, anaferon are shown.

Pregnant women - drink plenty of water in the absence of edema;
- in mild forms - from antiviral agents - viferon in suppositories, influenzaferon, arbidol, if it is impossible to take pills (vomiting) - the introduction of Panavir intramuscularly; in severe forms of Tamiflu, Relenza, Viferon;
- to reduce the severity of fever - paracetamol, ascorutin;
- with the development of bacterial pneumonia - III-IV generation cephalosporins, macrolides, carbapenems;
- during the epidemic, mandatory hospitalization is indicated for all pregnant women with severe intoxication.

Prevention of swine flu

Activities for the healthy (as recommended by WHO):
Wash your hands often with soap and alcohol-based solutions.
Avoid close contact with sick people.
Avoid hugs, kisses and handshakes.
If you are sick, stay at home and limit contact with other people.
Seek medical attention immediately if you experience flu symptoms. If you are ill, stay home for 7 days after experiencing symptoms to avoid infecting others.

For nonspecific drug prophylaxis the following drugs are used: kagocel, arbidol, anaferon, influenzaferon, viferon for pregnant women, tamiflu.

For specific prevention To date, a vaccine has been developed against the highly pathogenic swine influenza (H1N1) virus. This vaccine protects against influenza B and strains A/H1N1 (swine) and H3N2 influenza A (Grippol plus), i.e. both swine flu and seasonal flu. It is impossible to get sick after vaccination, since it does not contain a whole virus, but contains only the surface antigens of viruses, which by themselves cannot cause disease. The vaccine is administered annually.

Infectious disease specialist Bykova N.I.