Respiratory syncytial virus is part of a group of acute infections that affect a fairly large number of the population, predominantly young. One-year-old children take the main place among those 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 insidious thing is that it is difficult to diagnose, since it can easily be confused with a simple cold. A vaccine has not yet been developed, so the disease can sometimes be fatal. In hospitalized patients, the appearance of bronchitis, whistles and asthma is provoked.
Etiology
The respiratory syncytial virus concentrates in the cytoplasm, after maturation it begins to bud out into the membrane. Belongs to the family Paramyxoviridae and is the only representative of this group that can provoke a serious illness. Although various stamps have some antigenic heterogeneity, the variations concern mainly one of several glycoproteins, but the epidemiological and clinical significance of these differences is unclear. Infection grows in a number of cell cultures, causing the formation of characteristic syncytium.
Causes
Human respiratory syncytial virus refers to ailments that are transmitted by airborne droplets. They are able to infect both sick people and carriers. Collective and family outbreaks are characteristic, as well as cases of nosocomial infection , often in pediatric hospitals. Distribution is ubiquitous and around the clock most often in winter and spring. The greatest susceptibility is observed in children from 4-5 months to 3 years. At an early age, most of the babies suffer this disease, since unstable immunity is further observed, repeated cases of the disease are quite common, only in a more erased form. However, after antibodies (IgA) have completely disappeared from the body, a respiratory syncytial virus may reappear.
Distributed through close contact with the infected. It was analyzed and revealed that if a sick person sneezes, then the bacteria spread easily at 1.8 m. This group of pathogens can survive on their 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 to the epithelium 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 the affected cells and symplasts occurs. Such phenomena are accompanied by hypersecretion and narrowing of the bronchioles, which subsequently leads to clogging 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 a disease of early spring and winter.
To date, it has not been revealed why the lower respiratory tract in children and the upper in adults are affected.
In children, the disease begins with fever, severe sore throat and runny nose. Soon, other symptoms that resemble asthma are connected. Infection is characterized by the following symptoms:
- rapid breathing (more than 40 breaths per minute);
- bluish tint of the skin (cyanosis);
- sharp and frequent cough;
- heat;
- intermittent and uneven breathing;
- lumpy seals;
- piercing breaths and wheezing;
- labored exhalations.
Lower respiratory tract infections appear when the bronchioles swell. If at this moment the patient is experiencing problems with the supply of oxygen, then you must definitely consult a doctor for immediate medical attention. Such ailments most often occur in children under one year of age, and they quickly worsen.
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 - erased or asymptomatic course of the disease.
There are 3 main forms of the disease.
1. Light , occurs more often in adults and schoolchildren. It manifests itself as moderate nasopharyngitis, respiratory failure is not observed. Most often, body temperature remains normal or rises slightly, but literally a few degrees. Signs of intoxication are completely absent.
2. Moderate , you can observe the symptoms of acute bronchitis or bronchiolitis, accompanied by obstructive syndrome and respiratory failure. The patient has oral cyanosis and shortness of breath. If a child falls ill, he may be too restless, drowsy, agitated or lethargic. Often there is a slight enlargement of the liver or spleen. The temperature is often elevated, but it is also normal. Moderate intoxication is observed.
3. Severe , at this moment bronchiolitis and obstructive bronchitis develop. Severe air deficiency is noted, in which only an oxygen mask for breathing can help. There are whistles and noises, there is a pronounced intoxication and a strong increase in the liver and spleen.
The severity criteria most often include the following characteristics:
- the presence of local changes;
- difficulty breathing.
By the nature of the course:
- smooth - the absence of bacterial complications;
- non-smooth - the appearance of pneumonia, sinusitis and purulent otitis media.
History
A respiratory syncytial virus, the symptoms of which can be confused with other diseases, was identified in 1956 by Dr. Morris. He, observing the chimpanzee in whom rhinitis was discovered, found a new infection and named it CCA - Chimpanzeecoriraagent (the causative agent of the common cold of chimpanzees). At the time of the examination of the sick employee who was caring for the monkey, an increase in antibodies was observed, 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 initiation of bronchitis and pneumonia. After that, and to this day, scientists have been unsuccessfully trying to develop a vaccine.
Diagnostics
The clinical definition of the disease is problematic, due to its similarity with other ailments. In adults, the most common symptoms are bronchitis and pneumonia. During laboratory studies, serological methods are used to detect antibody titer. If necessary, the doctor prescribes radiography and specific laboratory tests, for example, a virological examination of nasopharyngeal swabs.
Therapy
Patients in whom a respiratory syncytial virus was detected, treatment is prescribed in a comprehensive manner in order to 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, for preschool children with moderate severity and for those who have complications. A prerequisite is the presence of a diet appropriate for age. It should include mechanically and chemically sparing food, full of various 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 "Synagis". If a bacterial complication is detected, then antibiotic therapy is indicated.
Bronchial obstructive syndrome is well relieved by symptomatic and pathogenetic treatment. In this case, an oxygen mask is used for breathing, it alleviates severe symptoms and simplifies the flow of air.
Dispensary observation is required for complications. After pneumonia, it is recommended to conduct examinations after 1, 3, 6 and 12 months until complete recovery. Preventive diagnosis is necessary after recurrent bronchitis and is prescribed after a year of amendment. If necessary, then consult an allergist or pulmonologist, and laboratory examinations are also done.
Treating children
Kids always get sick more complicated, and the consequences are much more serious than in adults, so therapy should be thorough and intensive.
Antiviral:
“Ribavirin,” the price of this drug, as described earlier, is affordable, so it won’t hit the parents’s pocket;
- Arbidol, Inosine, Tiloran and Pranobeks are also often prescribed.
Syndromic therapy is required according to the relevant protocols for the treatment of acute respiratory failure, bronchitis and Croup syndrome.
Basic antihomotoxic therapy:
- “Flu-Heel”, “Engystol” (initiating scheme is used);
- “Euphorbium composite S” (nasal spray);
- "Lymphomyozot."
Additionally:
- “Viburkol” (rectal suppositories);
- “Echinacea compositum C” (ampoules);
- "Angin-Heel S";
- "Traumeel C" (tablets).
All these tools perfectly help to overcome the respiratory syncytial virus in children.
First steps
In order to quickly defeat the disease, it is necessary to correctly respond to the symptoms that appear, so that you can get the help you need if necessary.
1. It is required to consult a doctor if a small child has symptoms of SARS, namely sore throat, runny nose and severe wheezing.
2. An ambulance must be called if there is a high temperature, intense noise, shortness of breath and general severe condition.
You need to see doctors such as a therapist and an infectious disease specialist.
Complications
Respiratory syncytial virus has a negative effect on the respiratory tract. The consequences of this disease are considerable, since the secondary bacterial flora can join and cause such ailments 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 earlier detection of the disease and isolation of patients until they recover completely. During periods of outbreak of such infection, special attention must be paid to sanitary and hygienic measures. In children's groups and hospitals it is proposed to wear gauze dressings for staff. Babies are required to systematically disinfect their hands using alkaline solutions.
The measures of emergency prevention in the foci of infection include the use of drugs such as Anaferon, Viferon, Imunal and various inducers of endogenous interferon.
Immunoprophylaxis includes such drugs as 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 in 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 result of use, the tested developed an even more serious disease. Live attenuated components cause not very pleasant symptoms or turn into the same virus, only of the wild type. Today, they are considering a method of purifying subunit antibodies against one of the surface proteins or attenuated elements, and then try to adapt them to the cold.