Respiratory syncytial virus is included in the group of acute infections that affect a fairly large number of the population, predominantly of young age. One-year-old children occupy the main place among the infected. If the disease is superficial in adults, then serious complications can develop in babies.
Definition
This is a virus that causes respiratory infections. The insidiousness is that it is difficult to diagnose, as it can easily be confused with a simple cold. At the moment, no vaccine has yet been developed, so the disease is sometimes fatal. The hospitalized are provoked by the appearance of bronchitis, whistles and asthma.
Etiology
Respiratory syncytial virus concentrates in the cytoplasm, after maturation begins to bud into the membrane. It belongs to the Paramyxoviridae family and is the only member of this group that can cause serious illness. Although the various stamps have some antigenic heterogeneity, the variation is predominantly in one of several glycoproteins, but the epidemiological and clinical significance of these differences is unclear. The infection grows in a number of cell cultures, causing the formation of a characteristic syncytium.
Reasons
Respiratory syncytial virus refers to diseases that are transmitted by airborne droplets. They can infect both sick people and carriers. Collective and familial outbreaks are characteristic, and cases of nosocomial infection have been recorded, often in pediatric hospitals. Distribution is ubiquitous and round-the-clock, most often in winter-spring time. The greatest susceptibility is observed in children from 4–5 months to 3 years. At an early age, most of the babies suffer from this disease, since then unstable immunity is observed, repeated cases of the disease are quite common, only in a more erased form. However, after the complete disappearance of antibodies (IgA) from the body, respiratory syncytial virus may reappear.
Spread through close contact with infected people. It was analyzed and found that if a sick person sneezes, then the bacteria easily spread to 1.8 m. This group of pathogens can survive on hands for up to 30 minutes, and on objects for several hours.
The pathogenesis of infection is very similar to the mechanism of development of influenza and parainfluenza, as it is associated with the movement of the disease toepithelium of the respiratory tract. The respiratory tract serves for penetration, and the primary reproduction begins in the cytoplasm of the nasopharynx and then spreads to the bronchi. At this point, hyperplasia of affected cells and symplasts occurs. Such phenomena are accompanied by hypersecretion and narrowing of the bronchioles, which further leads to blockage of their thick mucus. Then the development of infection is determined by the degree of accession of the flora and respiratory failure.
Symptoms
Respiratory syncytial virus, whose microbiology is complex and difficult to diagnose, is an early spring and winter disease.
To date, it has not been revealed why the lower respiratory tract is affected in babies and the upper respiratory tract in adults.
In children, the disease begins with fever, severe sore throat and runny nose. Other symptoms soon follow that resemble asthma. The infection is characterized by the following symptoms:
- rapid breathing (more than 40 breaths per minute);
- bluish skin tone (cyanosis);
- sharp and frequent cough;
- high fever;
- intermittent and uneven breathing;
-croupous seals;
- piercing breaths and wheezing;- difficult exhalations.
Lower respiratory tract infections occur when the bronchioles swell. If at this moment the patient experiences problems with the supply of oxygen, then it is imperative to consult a doctor for immediate medical attention. These ailments most often occur in children under one year of age, and they get worse quickly.
Classification
There are a large number of factors by which respiratory syncytial virus can be characterized, namely:
- typical - rhinitis, laryngitis, pneumonia, rhinopharyngitis, bronchitis, bronchitis, segmental pulmonary edema and otitis develop; - atypical - blurred or asymptomatic course of the disease.
There are 3 main forms of the disease.
1. Mild, occurs more often in adults and school-age children. Manifested as moderate nasopharyngitis, respiratory failure is not observed. Most often, body temperature remains normal or rises slightly, but literally by a few degrees. Signs of intoxication are completely absent.
2. Moderate, symptoms of acute bronchitis or bronchiolitis can be observed, accompanied by an obstructive syndrome and respiratory failure. The patient has oral cyanosis and dyspnoea. If a child is sick, he may be overly restless, drowsy, agitated, or lethargic. A slight enlargement of the liver or spleen is common. The temperature is often elevated, but it is normal. There is moderate intoxication.
3. Severe, at this point bronchiolitis and obstructive bronchitis develop. There is a severe lack of air, in which only an oxygen mask for breathing can help. Whistles and noises are traced, there is a pronounced intoxication and a strong enlargement of the liver and spleen.
The severity criteria most often include the following characteristics:
- presence of local changes;- difficultrespiratory failure.
By the nature of the flow:
- smooth - no bacterial complications; - non-smooth - the appearance of pneumonia, sinusitis and purulent otitis.
History
Respiratory syncytial virus, the symptoms of which can be confused with other diseases, was identified in 1956 by Dr. Morris. He, observing a chimpanzee who was diagnosed with rhinitis, found a new infection and named it CCA - Chimpanzeecoriraagent (causative agent of the common cold of a chimpanzee). At the time of examination of the sick employee who was caring for the monkey, an increase in antibodies was noticed, very similar to this virus.
In 1957, R. Chenok isolated a similar pathogen in sick children and determined that it was he who was responsible for the excitation of bronchitis and pneumonia. Since then, and until today, scientists have been unsuccessfully trying to develop a vaccine.
Diagnosis
Clinical definition of the disease is problematic, due to its similarity with other ailments. In adults, the symptoms of bronchitis and pneumonia most often predominate. During laboratory studies, serological methods are used that allow the detection of antibody titer. If necessary, the doctor will order x-rays and specific laboratory tests, such as virological testing of nasopharyngeal washings.
Therapy
Patients who have been diagnosed with respiratory syncytial virus, treatment is prescribed in a complex, forto strengthen the body. Bed rest is recommended for the entire period of exacerbation. Hospitalization is indicated for children with a severe form of the disease, preschool children with moderate severity, and persons who have complications. A prerequisite is the presence of a diet appropriate for age. It should include mechanically and chemically sparing food, full of a variety of trace elements and vitamins.
Etiotropic therapy is also carried out, which is characterized by the use of drugs such as human leukocyte interferon, Anaferon, Grippferon and Viferon. In severe forms, it is recommended to take Immunoglobulin and Ribavirin, the price for it varies from 240–640 rubles, depending on the dosage. Perfectly helps to prevent the occurrence of consequences in bronchitis drug "Sinagis". If a bacterial complication is detected, then antibiotic therapy is indicated.
Broncho-obstructive syndrome is well relieved by symptomatic and pathogenetic treatment. In this case, an oxygen breathing mask is used, which relieves severe symptoms and simplifies air supply.
Dispensary observation is required for complications. After pneumonia, it is recommended to conduct examinations after 1, 3, 6 and 12 months until complete recovery. Prophylactic diagnosis is necessary after recurrent bronchitis and is prescribed after a year of correction. If necessary, an allergist or pulmonologist consultation is attended, and laboratory tests are also done.
Treatment of children
Children always get sick more difficult, and the consequences are much more serious than in adults, so the therapy should be thorough and intensive.
Antiviral:
- "Ribavirin", the price of this drug, as described earlier, is affordable, so it will not hit the parents' pockets much; - Arbidol, Inosine, Tiloran and "Pranobex".
Syndromic therapy is required according to the relevant protocols for the treatment of acute respiratory failure, bronchitis and Croup's syndrome.
Basic antihomotoxic therapy:
- "Flu-Heel", "Engystol" (initiating scheme is used);
- "Euphorbium compositum C" (nasal spray); - "Lymphomyosot".
Optional:
- "Viburkol" (rectal suppositories);
- "Echinacea compositum C" (ampoules);
- "Angin-Heel C";- "Traumeel C" (tablets).
All of these remedies are great for fighting respiratory syncytial virus in children.
First steps
In order to quickly defeat the disease, it is necessary to respond correctly to the symptoms that appear, so that you can get the right help if needed.
1. You need to see a doctor if a small child develops symptoms of SARS, namely sore throat, runny nose and severe wheezing.2. Be sure to call an ambulance if there is a high temperature, intense noises, difficulty breathing and general serious condition.
Required to see doctors such as a general practitioner andinfectiologist.
Complications
Respiratory syncytial virus has a negative impact on the respiratory tract. The consequences of this disease are considerable, as secondary bacterial flora can join and cause ailments such as:
- sinusitis;
- otitis media;
- bronchitis;
- pneumonia;- bronchiolitis.
Prevention
All viral diseases are difficult to treat, as their symptoms are often hidden. One of the measures is early detection of the disease and isolation of patients until their full recovery. During periods of outbreak of such an infection, special attention must be paid to sanitary and hygienic measures. In children's groups and hospitals, it is proposed to wear gauze bandages for staff. Babies must and systematically disinfect their hands using alkaline solutions.
Emergency prevention measures in foci of infection include the use of drugs such as Anaferon, Viferon, Imunal and various inducers of endogenous interferon.
Immunoprophylaxis includes Motavizubam, RespiGam and Palivizubam.
Vaccine
To date, they have not yet developed a component that will prevent this disease. The creation is quite active, experiments began to be carried out since the 1960s, after which the substance was inactivated with formalin and precipitated with alum. Such a vaccine caused a pronounced formation of serum antibodies, although as a resultuse, those tested developed an even more serious disease. Live attenuated components cause not very pleasant symptoms or turn into the same virus, only the wild type. Today, a method is being considered for purifying subunit antibodies against one of the surface proteins or attenuated elements, and then trying to adapt them to cold.
