SARS in adults
SARS in adults - polietiologichesky this group of pathological conditions of infectious origin that have similar clinical symptoms and the development of which is caused by a primary lesion of the proximal respiratory system.The diagnosis of "acute respiratory viral infections in adults," infectious disease is established only after reliable laboratory discovery of the presence of the virus in the epithelial cells.
When an adult is not confirmed the origin of the SARS virus, doctors use the term "acute respiratory illness."This classification is used with a view to distinguishing these two diseases with different tactics of treatment.
maximum incidence of SARS in adults occurs in winter, but some cases of infectious disease can be registered during the year.
frequent SARS in adults can become a cause of reduced resistance to disease, transient immunodeficiency states, general sensitization.
Causes SARS in adults
fundamental etiopathogenetic factor in the emergence of
infektsionistu after numerous randomized trials were to conclude that 90% of the pathological lesion of respiratory viral infection caused by the introduction into the body of an adult, and the remaining 10% are of bacterial origin of pathologies of the respiratory system.The epidemic of SARS associated with a lesion of at least 20% of the adult population, while the pandemic affects about 50% of the adult category of persons.
progressive development of diagnostic laboratory technology now allows the identification of up to two hundred species of the causative virus of SARS in adults, but the most common of these is the influenza virus, which has high virulence.The recent increase in the incidence of acute respiratory viral infections in adults caused by exposure to adenovirus, rhinovirus infection.
Regardless of the type of the pathogen of SARS in adults, as the source of infection is always the sick person who has observed the complex clinical manifestations, especially in the acute course of the disease.
SARS in adults is a highly infected as a priority way the virus is airborne.When this pathway is marked the introduction of SARS virus in the body of the adult healthy person has the greatest value close contact with a sick person, in which the exchange of notes with small particles of saliva, infected by a virus.
contact-household way of spreading SARS virus in adults is extremely rare, only if the failure to complete the elementary rules of personal hygiene.Viruses SARS in adults do not have a high stability in the environment, and therefore the contact method of transmission is the exception rather the rule.
for the development of SARS in adults maximum impact is the increased concentration of the virus, the causative agent in the environment.If you get a small amount of virus SARS on the mucous membranes of the respiratory tract in adults the risk of full clinical picture of disease is minimal.This minimum concentration of virus can be achieved elementary frequent airing of the room in which there is a large number of people.
Fortunately, not every contact healthy and sick human SARS accompanied by the development of the disease, which is caused by the individual level of natural immunity.As a rule, young people with no history of chronic diseases, are not exposed to emotional stress, as well as leading a healthy lifestyle, rarely become ill SARS.
introduction of SARS virus in the body of an adult going through the mucous membranes of the upper respiratory tract, conjunctiva and mucous membranes of the oropharynx.
All viruses that belong to the category of SARS in adults are epiteliotropnymi, i.e. the introduction and propagation of viral agents occurs in the epithelial cells.Reproduction of the SARS virus in adults accompanied by damage to a large number of epithelial cells, and then celebrated getting viruses in the circulating blood.Viremia period is always fraught with the development of intoxication syndrome, which is caused by toxic and allergic effect of the decay products of epithelial cells.
Complications of SARS in adults often have a bacterial nature and develop as a result of violation of the barrier function of epithelial cells.
symptoms and signs of SARS in adults
Each Etiopatogenetichesky variant of SARS in adults observed the development of specific pathognomonic symptom, however, for all variants characterized by the development of a single clinical course of obscheintoksikatsionnogo syndrome.Manifestations of this symptom is fever, widespread muscle aches, headache, diffuse, progressive weakness, fever and signs of upper respiratory tract.
debut SARS in adults accompanied by the development of signs of catarrhal syndrome, manifesting nasal congestion, the emergence of abundant mucous discharge from the nasal passages, severe pain in the throat when swallowing, tickling in the oropharynx, increased lacrimation.Development of the above symptoms is the result of excessive swelling of the mucous membranes of the nose and the mouth, as a result of inflammation, which occurs in response to the SARS virus from entering the body.
Between Qatar to SARS in adults develop a dry cough paroxysmal character which is not accompanied by sputum.
fundamental difference of influenza as SARS etiopathogenetic variants in adults, is the severity of symptoms of intoxication, which greatly prevails over breathing disorders.
Recently, infectious disease point prevalence of atypical variants of the flow of SARS in adults, manifested lack of temperature reaction.Temperature SARS in adults may rise to 39ᵒS and, in some cases, fever may be absent.
Asymptomatic SARS in adults is dangerous due to the fact that the absence of clinical manifestations are not causing health disorder, in connection with which a person has no alertness and he did not pay for specialized medical care.Along with the latent adult over SARS may be associated with severe complications in the form of septic lesions of the organism, bacterial lesions of the central nervous system structures.
Symptoms of SARS in adults who require special attention of the treating specialist are: the presence of severe fever patient that bad stoped taking antipyretics, various degrees of impaired consciousness, even a short-term nature, expressed headache, diffuse character, widespread rash, star-shaped with the presence of hemorrhagiccomponent expressed by the human breath, cough with bloody sputum presence.
Prolonged for SARS in adults, the duration of which exceeds seven days, should be regarded as complicated and is in need of medical and diagnostic procedures in hospital infection profile.
Along with common clinical manifestations of all forms of acute respiratory viral infections in adults, there are pathognomonic symptoms and criteria, the presence of which allows you to establish the correct diagnosis Etiopatogenetichesky prehospital.For example, parainfluenza characterized by a slow onset and moderately pronounced intoxication syndrome in the stage height.The incubation period of SARS in adults caused by the parainfluenza virus is not accompanied by the development of any clinical manifestations, and in the stage of the developed clinical picture of the patient is observed hoarseness, feeling sore throat and hacking cough without sputum discharge.
SARS in adults caused by rhinovirus introduction into the body, accompanied by the development of nasal breathing difficulty and isolation of the nasal mucous discharge in the absence of symptoms of intoxication.Adult category of patients suffering from rhinovirus infection, in most cases well tolerated acute phase of the disease and does not require hospitalization.
The introduction of adenoviruses, which are also able to provoke the development of acute respiratory viral infections in adults occur mucous membranes of the respiratory tract and organs of the lymphatic system, which is manifested by inflammation of regional groups of lymph nodes, hepatosplenomegaly, nonspecific pain in the abdomen and dyspepsia.The most characteristic feature of SARS in adults caused by adenovirus, conjunctivitis is asymmetrical, which is not observed in other etiopathogenic forms of the disease.
When SARS in adults caused by respiratory syncytial virus infection occurs mainly defeat the bronchial tree and pulmonary tissue, which leads to the prevalence of clinical symptoms such as prolonged cough, shortness of breath, the appearance of which is associated with the development of bronchospasm.Catarrhal symptoms for this type of SARS in adults are not observed or manifest minimum.
Treatment of SARS in adults
Recently collaborative works pharmacists and virologists are aimed at developing an effective drug has a pronounced antiviral activity against various pathogens of acute respiratory viral infections in adults.Existing antivirals with SARS in adults is not so effective because the SARS viruses propagate mainly intracellularly unlike bacteria.For this reason, an antibiotic with SARS in adults does not make sense to apply in the case of an uncomplicated course of the disease.
For drugs with proven antiviral activity in adults with SARS should include blockers M2-channel and neuraminidase inhibitors.Recently there has been increased incidence of acute respiratory viral infections in adults, provoked by the introduction of coronaviruses and rhinoviruses, but unfortunately, pharmacologists have not yet been able to develop a drug that would be effective in the fight against this type of infection.
Just until recently, all adult patients with SARS, regardless of the form of etiopathogenetic appointed Rimantadine, which is representative of a group of blockers M2-channel.Recent recommendations infectious disease specialists suggest that the drug is effective only in relation to the treatment of influenza A. The effectiveness of rimantadine group with SARS in adults, according to randomized study does not exceed 25%.
Another antiviral drug Oseltamivir is used in adults with SARS at a daily dosage of 75 mg, which can significantly reduce the incidence of morbidity of the disease, and also helps to reduce the intensity of the clinical manifestations of intoxication syndrome.Prophylactic administration Oseltamivir reduces the risk of SARS in adults, and the minimum range of its side effects allows the use of a drug for the treatment of various categories of the population.The average duration of antiviral treatment is not more than five days.
In a situation where there is laboratory confirmation of RSV infections, as an antiviral drug for the treatment of a patient should use ribavirin.Unfortunately, this drug has a wide range of adverse reactions manifested by bronchospasm, hemorrhagic rash, eye irritation, sleep disorders, psycho-emotional disorders, and leukopenia, which limits its application.
When SARS caused by rhinovirus infection shows the use Plekonarila, and despite the fact that the drug is under development, the high efficiency of its proven findings of numerous randomized trials.
antibiotics for viral respiratory infections in the majority of adults are not appointed by the infectious disease, the only exception is a complicated course of the disease with a proven bacterial nature.There are strong indications for the use of antibacterial drugs in the group against their inclusion in the scheme of treatment of SARS in adults, which should include hyperthermia, the duration of which is more than 3 days, pain in otitis media, as well as the development of bacterial pneumonia.
basis symptomatic therapy, which must take place in the treatment of acute respiratory viral infections in adults is preparations of nonsteroidal antiinflammatory drugs, which have a pronounced analgesic effect and intepireticheskim (Nimid a daily dose of 200 mg).Since SARS in adults in most cases occurs with nasal congestion and obstruction of nasal breathing, which greatly impairs the overall health of the patient, to eliminate these symptoms should be used intranasal form vasoconstrictors category decongestants (Nazol 0.1% solution of 1 drop in each nostril).
in a required treatment of SARS in adults should also include antihistamines, modern dosage forms which allow to use them even against sotsialnoaktivnyh patients (Tsetrin 1 tablet 1 time per day).
Regarding the fight with a cough that often accompanies SARS for adults nekodeinsoderzhaschie advisable to use tools, and preparations with mucolytic action (acetylcysteine 200 mg per day), the positive effect of which it is desirable to support the appointment of antisense drugs.
Currently, pharmaceutical companies are actively developed symptomatic drugs combined action allows the use of which in the first days of the disease to facilitate the patient with SARS.The components of such formulations are generally all of the above formulations with the addition of ascorbic acid.When assigning funds combined with SARS in adults should be aware that this group of drugs has no antiviral effect, so as a primary treatment it should not be used.
based pathogenetic treatment of acute respiratory viral infections in adults laid prescribing, the effect of which is to eliminate the manifestations of intoxication syndrome.In most cases, intoxication with SARS in adults is low intensity in nature and quickly eliminated by oral rehydration therapy, which implies the normalization of drinking regime with special solutions such as rehydron.The mechanism of detoxification therapy in this situation lies in the fact that the increase in the amount of fluids you drink triggers the implementation of elimination of toxins formed in the destruction of virus in the urine.In the appointment of oral rehydration therapy should be aware that its use is absolutely contraindicated in patients with SARS in adults who have signs of heart failure stagnant.
as a topical treatment for adults with SARS should apply various types of salt solutions in the form of nasal sprays, the effect of which is aimed at moisturizing the nasal mucous membranes, which are the gateway for viruses.
Of course, there are a lot of people's non-traditional methods of treatment of SARS in adults who in some cases may have a good positive effect, but their use also has contraindications and limitations.Thus, when existing patient symptoms of intoxication syndrome, which is a clear manifestation of fever, it is absolutely contraindicated the use of any thermal treatments, whether mustard or sauna.