Influenza 2014: know your enemy by sight

Despite the fact that the official "pedigree" of influenza dates back to the 16th century, when the first epidemic of a viral disease was documented, it is obvious that this disease is studied in detail, but is still a mystery for science. Every year, information appears about new strains, outbreaks of previously unseen types of influenza, which each time plunges the world's population into alarm. It has still not been possible to defeat and find an effective vaccine against bird flu, its strains, the already known H5N1 and the relatively "fresh" H7N9 continue to pose a danger to humanity. These types of the virus are especially insidious due to their increased mutability, and the high transmission properties of the strains are fraught with a global pandemic. The past winter, fortunately, was not marked by an intense outbreak of influenza, as was the case in 2004-2006 and earlier, but viruses are still a threat and carry the risk of rapid spread. Given the abnormally cold weather in September, the disappointing forecasts of weather forecasters regarding other autumn months and the assumptions about the upcoming extremely cold winter, the topic of “flu 2014” can be declared open for active discussion.

[ 1 ], [ 2 ]

Flu Season 2014 – The Unpredictability of the Virus

Viruses, its subtypes are a type of orthomyxoviruses and have RNA-containing virions, that is, they contain one of the three most important living molecules. The combined fragments of ribonucleic acid, responsible for the reproduction of the virus in a living cell, form a nucleoprotein, which in turn can be of three types:

• Influenza A virus.
• Influenza B virus.
• Influenza C virus.

The virus wall is equipped with substances that help to connect with the cell (hemagglutinin) and penetrate it (neuraminidase). It is these specific "spikes" of the flu that are constantly combined, combined in different variants, which determines the high antigenic mutability of the virus. The ability to change annually does not allow us to determine how dangerous the 2014 flu season will be in an epidemiological sense; the unpredictability of the virus remains the main problem in counteracting this formidable disease. Such unique "survivability", adaptability of hemagglutinin and neuraminidase makes the flu virtually invulnerable to both the immune system and to drug effects.

Flu can change in two ways:

1. Minor mutations in neuraminidase and hemagglutinin are called antigenic drift. Such changes are common to all types of flu and do not provoke pandemics; the percentage of complications and, especially, fatal outcomes is very small. This can be explained by the fact that the immune system is already familiar with the strain and is able to resist it even in such a variable form.
2. Every 20-30 years, sometimes earlier (after 10-15 years), the virus mutates, significantly changing its surface antigen structure. Most often, hemagglutinin changes dramatically, less often neuraminidase, such a transformation makes the flu "invisible" to the immune system and threatens rapid spread, serious complications and a high mortality rate. Pandemics of mutating influenza viruses are a threat to any country, as epidemiological practice shows, there is no territory on the planet where there have not been at least isolated outbreaks of the new strain. The mechanism of mutation is being studied, but the conclusions are too contradictory, it is obvious that the virus changes faster than clinical, statistical and epidemiological data are collected.

In addition, it has long been known that the flu virus can be transmitted not only by airborne droplets from person to person, but also by birds and animals. At the first stage, the flu spreads within the species, then it can be transmitted from animal to person and vice versa. This is the main danger of modern types of flu: their structure contains not only human nucleotides, but also bird and pig genomes (nucleotide sequences).

The annual forecast provided by WHO is quite comforting this year, there will most likely be no unexpected outbreaks of flu or new strains. However, according to experts, an epidemic is inevitable and can be provoked in 2014 by the following types of flu:

• H1N1 - A/California, the so-called swine flu (Swine influenza). The last serious outbreak of this strain was registered in 2009 in the USA and Mexico, hence the name California. In June of the same year, the WHO assigned the disease the status of a pandemic and the sixth level of threat out of six possible. In 2014, moderate prevalence of H1N1 is predicted, the percentage of complications and fatalities is expected within the framework of epidemiological risks. Obviously, over four years, the human immune system has become accustomed to the California flu and is able to recognize its variants, in addition, during this period, AH1N1 has not been able to mutate significantly, it can be stopped by timely vaccination and preventive measures.
• H3N2 - A/Victoria, a relatively new variant of a reassortant virus that threatens serious complications - hemorrhagic lesions of organs, most often the lungs. A small percentage of the population suffered from this type of flu last year, and the virus has not been studied well and has not fully demonstrated its epidemic characteristics.
• The Yamagata lineage virus, B/Massachusetts/2/2012, is a new strain that most people's immune systems are unfamiliar with. Many doctors consider it relatively safe compared to bird flu or swine flu, but B/Massachusetts/2/2012 remains dangerous because it is so little understood.

World Flu 2014 is Coming

Due to abnormal weather conditions, which are not typical for autumn, many countries around the world are expecting a shift in the time frame for the development of influenza. Isolated outbreaks of influenza have already been noted in European countries, but they cannot yet be considered epidemiologically significant. Active movement of viruses from north to south is expected, unlike the last flu season, when the virus migrated from west to east. An exception is the disappointing forecast for the spread of bird flu, its new strain - H7N9, which, since the spring of 2013, has periodically affected residents of China. This type of influenza is extremely aggressive and has a high contagiousness (infection) capacity, in addition, cases of H7N9 transmission from person to person have already been registered, which has not been observed before (the virus was transmitted through contact with an infected bird). Later, in the summer, outbreaks of swine flu (AH1N1) were noted in Chile, where 11 Chileans died from this virus in the north of the country, and in Venezuela. In August of this year, WHO received information about cases of the H7N7 virus, a type of bird flu. Obviously, the chaotic circulation of serotypes is not yet a threatening indicator for assigning it the status of an epidemic. However, infectious disease specialists are sounding the alarm, unpredictability and high mutation rate of genomes do not allow making an epidemiological forecast and taking preventive measures.

However, in September 2013, WHO traditionally notified all countries that the 2014 global flu was already approaching. According to previously collected and analyzed statistical data, WHO specialists recommended using vaccines against the following types of flu for prevention:

• California flu – A/H1N1.
• A/H3N2/361/2011 – virus.
• Yamagata lineage virus - B/Massachusetts/2/2012.

Flu epidemic 2014

The World Health Organization systematically conducts epidemiological monitoring of influenza incidence worldwide. According to experts, the 2014 influenza epidemic should not have been unexpected, since in August the organization's information center began receiving clinical, statistical and other data on periodic outbreaks in different countries. There are also positive changes regarding the A/H1N1 virus, which was previously assigned pandemic status and rated "6" on a six-point threat scale for humanity. The rapid increase in California flu incidence has been halted, and the mortality rate has been decreasing annually due to the introduction of mass vaccination. Today, every developed country has a vaccine against H1N1, which significantly reduces the epidemiological threshold and the number of people who become ill. There is also more alarming news regarding a new, as yet unstudied type of disease - the MERS-CoV coronavirus, which may be similar in symptoms to the flu or pneumonia. Today, the threat of the spread of coronavirus is more global than the already studied strains of the influenza virus.

Flu 2014 in Russia

According to the forecasts of WHO infectious disease specialists and epidemiologists, as well as their Russian colleagues, the following varieties and strains of influenza are expected in Russia:

• Swine flu - A/California/7/2009 (H1N1).
• New strain of type B for Russians - Massachusetts/2/2012.
• The A/Victoria/361/2011 (H3N2) virus is already known to residents of Russia.

Vaccination against the so-called swine flu A/H1N1 has been carried out since 2010, so the population has already developed certain immune reactions and resistance to the virus. More dangerous is the B/Massachusetts/2/2012 virus, since according to doctors, it is little known to Russians; there are no exact statistics, but some doctors are convinced that about 5% of people have already had this type of flu last year. Due to the fact that all B-type viruses are somewhat milder than their "brothers" of type A, it is possible that Massachusetts/2/2012 was mistakenly diagnosed as ARVI.

Nevertheless, a large-scale preventive campaign to vaccinate the population is already underway in Russia. As Mr. Onishchenko, the chief sanitary doctor of Russia, stated, there are plans to vaccinate about 38 million residents, which is much higher in comparison with last year. The past flu season did not bring any unpleasant surprises, so epidemiologists expect that the 2014 flu in Russia will pass without serious losses. Moreover, in the period 2012-2013, almost a quarter of the population was vaccinated, which means that the immune system of every fourth Russian is capable of coping with the disease.

The new vaccine, which will be used starting in October, contains three inactive strains, the main one being the weakened swine flu gene (as the most dangerous due to its complications). It is assumed that free vaccination will be carried out with domestic drugs (Grippol, Grippol Plus).

In addition, government agencies are already creating hospital reserves - beds, replenishing supplies of medicines, protective masks and delivering the necessary equipment to medical institutions.

[ 3 ], [ 4 ]

Flu 2014 in Ukraine

According to forecasts of epidemiologists and infectious disease specialists, there will not be a large variety of flu species in 2014. The return of A/ Victoria (H3N2) and the rather severe "Californian" strain - H1N1, which infected and recovered from last season more than 11% of the entire population of Ukraine, almost every tenth resident of the country, is expected. In addition, in the period from January to March 2014, outbreaks of B/Massachusetts/2/2012 are possible, a virus that is considered relatively unfamiliar to Ukrainians. However, in the spring of 2013, this strain was already circulating around the country without exceeding epidemiologically acceptable limits; to some extent, the immune system is already familiar with its genome. The spread of the B/Massachusetts virus is expected from northern European territories, most likely from the Scandinavian countries and Finland. According to forecasts, the Massachusetts type of flu will spread in the north-east direction and cover most of Russia. Ukrainians can also feel its echoes. The symptoms of the B virus are almost identical to those of other flu strains - persistent hyperthermia, complications in the form of pneumonia, bronchitis. Influenza B/Massachusetts is characterized by its rapid development, the body is affected literally before our eyes, in a matter of hours. Despite such alarming forecasts regarding serotype B, it is worth noting that this type of flu belongs to a less dangerous category of viruses compared to serotype A, the B/Massachusetts virus causes fewer complications.

The features that may distinguish the 2014 flu in Ukraine are difficult to predict, but already in September of this year, according to the head of the State SES, Mr. Kravchuk, an atypical for this time of year increase in the incidence of viral infections is observed. Due to the fact that the symptoms of ARVI are very similar to the signs of influenza, the latter often remains undetected. According to preliminary estimates by infectious disease specialists, the first wave of influenza may sweep the country as early as the end of October, and the epidemiological peak is predicted for February 2014.

[ 5 ], [ 6 ]

Flu 2013-2014 group: special risk

All those who are weakened, who have a reduced immune defense, as well as those who have not taken preventive measures, are at risk of infection with the flu virus. The 2013-2014 flu can also be threatening for those who, for some reason, have not been vaccinated in a timely manner.

Particular risk groups:

• Children from birth to 2-3 years. Especially babies with congenital pathologies or often suffering from acute respiratory viral infections, acute respiratory infections.
• Pregnant women throughout the entire period of bearing a child. The risk of complications is especially high in the third trimester.
• People with a history of neurological pathologies.
• People with asthma.
• Anyone with a history of chronic respiratory diseases (lungs, bronchi).
• People who are overweight and have metabolic disorders.
• Any type of flu is dangerous for older people.
• People suffering from tuberculosis.
• Patients with diabetes mellitus.
• People suffering from cardiovascular diseases.
• HIV-infected patients.

In addition, the risk group includes everyone who, due to the specific nature of their work, is associated with frequent and constant contacts – doctors, teachers, public transport drivers.

[ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ], [ 12 ]

Flu Symptoms 2014 – Know Your Enemy

The main signs and symptoms of influenza are quite typical, although its manifestations may differ from each other in people of different age groups, and also depending on the strain. However, there are the same, "classic" symptoms - sudden malaise, headache, aches in all joints of the body and elevated body temperature, which does not respond to medical treatment for several days. It is the suddenness that distinguishes influenza from all other colds.

The most typical symptoms of flu 2014:

• Elevated body temperature – from 38 degrees, sometimes up to 39-40. The temperature lasts for at least 3 days.
• A feverish condition, periodic severe chills associated with fluctuations in body temperature.
• Headache, pain may increase with movement, physical activity.
• Photophobia (photophobia) is possible – painful sensations when looking at bright light or light sources.
• Muscle pain (myalgia), aching joints.
• Severe weakness, decreased appetite.
• Painful sensations in the throat, irritation, scratching pain.
• A runny nose is possible.
• With hyperthermia above 39 degrees, hemorrhagic manifestations in the eye area are possible - reddened whites of the eyes, nosebleeds, hemorrhagic rash on the face.

In addition, the symptoms of influenza can be differentiated depending on its form:

• Mild form of flu.
• Moderate severity of influenza.
• Severe form of flu.
• Hypertoxic form of influenza.

1. A mild course of the disease is characterized by a persistent temperature within 37.5-38 degrees, as a rule, the temperature does not rise higher and signs of intoxication of the body are not observed.
2. Moderately severe flu is characterized by a rapid rise in body temperature to 39-39.5 degrees, the patient develops classic signs of the disease - weakness, headache, aching joints and pain in all muscles. Increased sweating, cough, manifestations of pharyngitis, abdominalgia (abdominal pain) are also possible.
3. In severe cases of flu, the temperature rises sharply to 40 degrees and remains within these limits for about a day, which provokes delirious states, convulsions, and severe intoxication of the body. This form of flu requires an immediate call to a doctor and emergency medical care.
4. The toxic form is characterized by neurological symptoms and can be manifested by intense headaches accompanied by hemorrhagic rashes, myalgia, drowsiness, and often muscle rigidity. These symptoms are very similar to meningitis, can be clinically vague and make accurate diagnosis difficult. The severity of symptoms is variable - from transient headaches to serious complications - encephalopathic manifestations

Symptoms of flu 2014 may differ slightly from the standard ones, however, from year to year the manifestations of all types of viral diseases fit into standard patterns, as well as typical incubation periods:

• The onset of clinical symptoms occurs within 24 hours.
• Development of symptoms – 2-2.5 days from the onset of the disease.
• Residual effects of influenza for 2-3 weeks after a person is considered healthy.

What is the difference between a cold and the flu?

Flu and acute respiratory infections may be similar in symptoms, but only for those who are not particularly familiar with the signs of diseases. Indeed, ARVI is a pathological condition caused by a virus, or rather, various types of viruses, but their list does not include flu.

What is the difference between a cold and the flu?

Signs	Influenza virus	ARVI
Debut of the disease	Sudden, sharp development of symptoms	The disease develops gradually, often unnoticed, and in a clinical sense it manifests itself already in the acute stage.
Pain and discomfort in the throat	It may appear after 2-4 days, but is not typical.	As a rule, with ARVI, a sore throat is one of the main symptoms, the pain is irritating, sometimes intense, and lasts until the disease subsides completely.
Temperature increase	The temperature rises quickly to critical levels - 39-40 degrees. The temperature can last for several days and is very difficult to control with antipyretic drugs.	The temperature is rarely very high, it rises and falls, and is often subfebrile
Runny nose	It happens very rarely	Mucous discharge from the nose is one of the typical signs of ARVI
Cough	It may appear after a few days, but is not typical.	The cough is persistent and may be complicated by tracheobronchitis.
Signs of intoxication	With flu, signs of intoxication are typical - severe headache, pain in the eyes (photophobia), increased sweating, fever, myalgia	Signs of intoxication may occur with purulent inflammation of the tonsils, but are not typical
General condition	Severe weakness, sleep disturbances, delirious states are possible with hyperthermia. Weakness may persist even after flu symptoms subside	Weakness is present, but not clearly expressed and transient. As soon as the main symptoms subside (temperature) strength is quickly restored

How to treat flu 2014?

It is best to treat flu before it develops, that is, the main method of treatment is still prevention. Even if a person gets sick, despite all the measures taken, the flu proceeds in a milder form and is not accompanied by complications.

How to treat flu 2014? How is therapy different for new types of flu?

There are no fundamental differences in the treatment of viral diseases; influenza is treated according to standard regimens; only vaccines may be different, depending on the specific strain.

Since flu is a virus, using antibiotics will not only be useless, but sometimes harmful.

Drug therapy for influenza:

• Symptomatic drugs.
• Antiviral agents.

Read also: Correct treatment of flu

Unfortunately, there is no universal antiviral drug today, a panacea for the flu will obviously not be found soon, and if it is invented, it will most likely be called a vaccine. The following are well-proven remedies:

• Arbidol.
• Amizon.
• Rimantadine.
• Zanamivir.
• Ingavirin.
• Tamiflu.
• Kagocel.

In addition, there are non-specific agents that help neutralize the virus:

• Interferon and its inducers.
• Immunoglobulins.

Symptomatic treatment of flu involves taking antipyretics (mefenamic acid, paracetamol), anti-inflammatory drugs for myalgia, aching joints - ibuprofen. But one of the most important means in the treatment of flu is considered to be drinking plenty of fluids and bed rest.

How to prevent flu this 2013-2014 season?

The first rule of prevention against flu 2013-2014 is vaccination. Mass preventive measures, given the atypical weather conditions and expected outbreaks of flu by November, must begin at least in October. Today, there are many options for vaccination - from free vaccines purchased at the expense of the state to visiting paid medical offices, where you can consult and choose a drug that suits your budget and your health parameters. Every year, new means are created to prevent complications of flu, your doctor will tell you how to use them. Please note that constantly mutating flu viruses negate all so-called "folk" methods of treatment, only a specialist should diagnose and prescribe treatment against flu.

How to prevent flu 2014 without using medications? If we take as a basis the route of transmission of the virus - airborne, then you can reduce the risk of infection in the following ways:

• Eliminate or minimize contact with people who show signs of a cold. It is difficult to determine visually and verbally, without a medical education, what a person is sick with - ARVI or flu. In any case, both diseases are very contagious, that is, the probability of infection is high.
• It is necessary to minimize the number of visits to crowded events and places where large numbers of people gather.
• You need to wash your hands more often and bring them to your nose or mouth less often.
• Ventilation of the premises is mandatory, both at home and in the office.
• An indisputable assistant in the prevention of influenza is a gauze or other material mask. Please note that the mask should be changed every 1.5-2 hours to avoid self-infection.
• Strengthen your immune system in advance. Summer vegetables and fruits that have been eaten throughout the season are not a storehouse of vitamins in the body, vitamin reserves are constantly being used up and need to be replenished regularly.

In general, according to medical forecasts, the 2014 flu will not be threatening in an epidemiological sense; with properly implemented preventive measures, an active immune system, and adherence to healthy lifestyle rules, the human body is capable of coping with any type of flu virus.