Flu 2018: a new strain attacks

According to experts, the flu of 2018 will be marked by the appearance of new, more dangerous strains. Consider the methods of their treatment and prevention, as well as possible complications.

The first influenza epidemic was recorded in 1580, when people knew little about the nature of the disease and how it was treated. Another outbreak in 1918-1920, called "Spaniard", took thousands of lives since humanity was again not ready for a viral attack. And only in 1933 the nature of the disease was established, and the causative agent was called the A virus. In 1940, the virus of group B was isolated, and in 1947 - the type C virus. But despite the knowledge gained, the disease mutates annually, striking everything with new and new strains.

According to the International Classification of Diseases ICD-10, influenza is included in this category:

Diseases of the respiratory system (J00-J99)

• J09-J18 Flu and pneumonia.
  • J09 Influenza caused by an identified zoonotic or pandemic influenza virus.
  • J10 Flu, caused by the identified seasonal influenza virus.
  • J11 Flu, the virus is not identified.

The virus refers to RNA-containing orthomixoviruses. The dimensions of its particles are 80-120 nm, they are weakly resistant to chemical and physical factors. Destroy at room temperature in a few hours, but at a reduced temperature of -25 ° C can persist for several years. Destructive is drying, heating, exposure to UV radiation, ozone, chlorine and other factors.

The source of infection is an infected person with hidden or clearly expressed forms of pathology. The main transmission path is airborne. The maximum danger is observed in the first days after infection, when the virus is released into the external environment during coughing or sneezing with mucus particles. If the pathology proceeds in an uncomplicated form, the excretory excretion stops after a week from the beginning. With complicated flow, that is, with pneumonia, the virus remains in the body for 2-3 weeks or more.

The disease is especially dangerous in the cold season. According to medical statistics, an epidemic of virus A and its strains occurs every 2-3 years. At the same time, the level of infection is 20-50% of the population. Type B is characterized by a slower spread and lasts 2-3 months, affecting 25% of the population.

[1],

World Flu 2018 - already on the threshold

Annually in the world about 500 thousand people die from different strains of influenza infection. According to forecasts of scientists, in the season 2017-2018, the world flu will be affected by a mutation of three previously known strains: Hong Kong, Michigan and Brisbane. At the same time, many doctors are confident that the epidemic will not be avoided.

The degree of mutation is difficult to predict. For example, with minor, that is, point changes, the viruses will not be very different from the previous ones. Michigan is a derivative of the pandemic strain of California, it's A virus, identified in 2015 and struck the southern hemisphere of the planet.

The most vulnerable to infection and severe course of the disease are people at risk: children under 3 years old, pregnant, people of advanced age and patients with chronic diseases. According to experts' forecasts, the winter epidemic will make itself felt in November and will continue to flare up until March.

The flu epidemic 2018

According to the forecasts of physicians, the epidemic of the flu of 2018 will begin even before the arrival of winter, that is, in November. The acute course of the disease is likely to occur during the winter months and the first half of spring. Such a prolonged course of the most dangerous form of acute respiratory viral infection is associated with changes in the circulation of the virus and its properties.

Microscopic pathogenic structures have many varieties and infectious strains. To date, there are types of influenza infection that can cause an epidemic:

• Influenza A strains are the most dangerous and are responsible for most epidemics and pandemics. They are highly infectious and very quickly transmitted from sick to healthy. Infection is not only affected by humans, but also by animals, which can also act as carriers of bacteria. A type is characterized by a tendency to frequent mutations. Moreover, each subsequent virus is stronger and more resistant to existing drugs.
• H1N1 is a strain of swine flu that appeared in 2009 and hit the entire planet with great speed. In its symptoms it does not differ from other strains. It flows with severe intoxication and muscle pain. Gives significant complications to the lungs.
• H5N1 is avian influenza, which is also registered in 2009. The peculiarity of this strain is that in 70% of cases, patients die. A high percentage of mortality is a serious danger, as the flu mutates in the direction of increased infectiousness, which can cause a pandemic.
• Strains of influenza B - occupy the second place in the severity of the current. This flu is less contagious, easier to tolerate and less likely to mutate. It causes epidemics and very rarely a pandemic.
• The strains of influenza C - significantly inferior to the risk of the previous two. The incidence is isolated and occurs in an asymptomatic, mild form. Does not cause infections of epidemic proportions.

There is a definite classification of influenza according to the peculiarities of its course:

1. Seasonal - occurs annually, usually in the cold season. It affects about 15-20% of the world's population. Easily transmitted by airborne and by contact. Symptoms appear 3-5 days after infection. Patients suffer from severe headaches and aches throughout the body, severe cough and fever. With complex treatment, it retreats within a week. It has several forms of severity:
   • Light - body temperature is not higher than 38 ° C, signs of intoxication are absent or weakly expressed.
   • Moderate - elevated body temperature with signs of intoxication and changes in the posterior pharyngeal wall, nasal congestion, cough.
   • Severe - high body temperature 39-40 ° C and intoxication. Possible nasal bleeding, vomiting, convulsions and hallucinations.
   • Hypertensive - the temperature is above 40 ° C, signs of intoxication are pronounced. There is a toxicosis from the central nervous system, an infectious-toxic shock, respiratory failure.
   • Lightning fast - is at risk of death, especially for patients with weakened immune system and chronic diseases. It is accompanied by respiratory failure, bleeding, swelling of the lungs and brain.
2. Atypical influenza - has a fast and acute onset, which is different from seasonal infection. It flows with complications. Its peculiarity is that you can get infected in any season, because the virus is constantly present in the air.
3. Highly pathogenic - a disease associated with the action of a specific strain.
4. Rotavirus - is an intestinal flu, which is not inferior to its seriousness and danger. Its first symptoms are manifested by various disorders of the gastrointestinal tract: diarrhea, flatulence, foamy stools. Also, there is an increased body temperature and cough. Infection occurs by airborne droplets, and the first symptoms make themselves felt in 10-12 hours. Treatment is aimed at increasing the protective properties of the immune system.

Flu in 2018 in Russia

The International Health Organization has notified that the 2018 flu in Russia will begin with an attack of three strains:

• Brisbane
• H3N2- Hong Kong
• H1N1- Michigan

Thanks to this forecast, the Ministry of Health is already developing vaccines to combat the upcoming epidemiological season. In the fall, the Michigan virus will begin circulating in Russia, which is projected to match the 2009 swine flu. It was recorded as early as in January-March 2017. During this period, the disease took more than 100 lives. At the same time, the main reason for its appearance was abnormally warm weather conditions.

As the new strain of Michigan shows itself, one can only guess. Therefore it is extremely important to think about vaccination and preventive measures. At the same time, according to the Ministry of Health of Russia, it is possible to be vaccinated throughout the epidemiological season. Antigens of pathogens will be included in the vaccine. The vaccination company should cover from 70 to 90% of the population. Particular attention will be paid to risk groups.

[2],

Flu 2018 in Ukraine

A new season of colds is coming to Ukraine. Experts point to an increase in the number of infections compared to the previous epidemic season. The flu of 2018 in Ukraine, like that of the north-eastern neighbors, will be marked by the functioning of three previously known, but mutated strains:

1. Michigan H1N1 - a new kind of Californian or swine flu. It will function in December and January, affecting an able-bodied population of 25-49 years.
2. Hong Kong H3N2 - the most dangerous for people over 50 years and children under 6 years. It is expected in the middle of January.
3. Brisbane type B virus is a "family" virus with a mild course. It is forecasted for February-March.

A type strain / Michigan / 45/2015, similar to A (H1N1) pdm09, will replace the strain of California, which is known as pork pandemic flu. It has a virus in its composition, which functioned in the world in 2015. When analyzing the morbidity in the next season, the development of large epidemics is not predicted.

According to the research, the incidence has its own peculiarities. Thus, the most weakened immunity among residents of the Dnieper, Kherson, Kharkov and Kiev regions. Virologists and immunologists explain such statistics by an increased accumulation of people. The strongest immunity is enjoyed by residents of the western regions of the country.

The first symptoms will be similar to the signs of the incidence of previous years. In addition to preventive measures, vaccination is recommended to prevent infection. To date, vaccines have been registered in Ukraine from 5 manufacturers. Anti-influenza vaccinations are updated annually, undergoing a procedure for changing the strain composition. The most popular are: "Vaxigripp" France, "Lyuarix" Belgium, "Influvak" Holland, there are also Chinese and South Korean vaccines.

Flu 2017-2018: special risk groups

Like any disease, acute viral infections have special risk groups that are most prone to infection. According to the World Health Organization, the flu of 2017-2018 is most dangerous for such categories of the population:

1. People who are susceptible to developing a serious form of the disease with a risk of death and requiring hospitalization:
   • Pregnant women constitute the highest priority group for vaccination. The vaccination is carried out at any stage of gestation to prevent the risk of serious complications in the mother and fetus.
   • Children - preventive inoculation is indicated only for patients older than 6 months. Babies younger must be protected by vaccinating mothers during pregnancy. Children under 2 years of age are to be vaccinated because they are subject to severe, and in some cases incompatible with life, complications. Patients aged 2 to 5 years respond well to vaccination, so they induce broad protection in their age category. This applies to patients of school and adolescence.
   • Older people 65 years of age and older represent the greatest risk group for complications of influenza and death. For them, vaccination has less effect than for other categories of the population
   • People with chronic diseases make up a group of high risk of developing severe disease and exacerbating existing pathologies.
2. Persons exposed to increased viral exposure due to the characteristics of the profession are medical workers and everyone whose work is associated with close contact with the population.

Priority group for disease prevention are medical workers. Their vaccination allows supporting the provision of medical care during epidemics at the proper level. This applies to other people whose vaccination can reduce the risk of spreading the virus among the most vulnerable categories. Each of the above risk groups is susceptible to the most severe forms of the disease. At the same time, timely vaccination minimizes the severity of the course of the disease.

[3], [4],

Season of the flu 2018 - the infection is already in the air

With the advent of the first cold snap, colds begin that affect both adults and children. The season of influenza 2018 made itself felt much earlier than expected. These epidemiological changes are associated primarily with climatic factors and, of course, with a weakened immune system that is not prepared for viral attacks.

In order to have the correct understanding of this pathology and its prognostic factors, one should know the structure of the RNA-containing virus:

1. The virus has internal NP and M antigens and surface antigens. Outside the structures is a lipoprotein membrane with two external antigens-proteins: hemagglutinin and neuraminidase.
2. According to the antigenic structure, the virus has several types: A, B, C. Also there are antigenically independent viruses. In this case, epidemics arise due to types A and B, and pandemics - type A.
3. Type A is characterized by high variability:
   • Antigenic drift is a point mutation in the gene that controls the H antigen.
   • Antigenic Shift is the total modification of several antigens or the entire RNA segment due to the exchange of genetic material with animals, birds. It leads to the appearance of new antigenic variations, to which the human body is not ready.
4. Virus A to date has 13 subtypes for H1-H13 and 10 species for N1-N10. For man, the first three subtypes of H and the two N. Are the most dangerous.

If the influenza season begins with mutated strains of type A, then it causes an epidemic that can easily go to the pandemic stage. This is due to the fact that the immune system does not have time to develop timely protection, as well as the lack of proper preventive measures and vaccination.

Symptoms of the flu 2018

The mechanism of development of influenza infection has a number of characteristics. The first symptoms of the 2018 flu will completely depend on which strain is progressing. The disease begins with an incubation period. From infection to the appearance of the first symptoms passes from several hours to several days (2 days type A, C and 4 days type B). The disorder begins very sharply, so the patient does not always accurately indicate the onset of painful symptoms.

Symptoms of intoxication:

• Feverish condition and fever, in severe cases above 40 ºС.
• Chills, general weakness and malaise.
• Pain in the joints, legs, lower back, muscles.
• Severe headache (in the forehead and eye sockets).
• Nausea and vomiting.
• Disorders of appetite.

The above symptoms of intoxication persist for 5-7 days. If the temperature persists for longer, this may indicate bacterial complications.

Gripposis can be of several forms of severity, which differ in their symptoms:

1. Light form - mildly expressed signs of intoxication. The patient is confronted with mild headaches, reduced appetite, minor catarrhal symptoms and body temperature up to 38 ° C.
2. The medium-heavy form is a moderate intoxication, the temperature is up to 39 ° C. Catarrhal syndrome.
3. Heavy is a toxic form with marked signs of intoxication. It flows with a febrile condition, a temperature of up to 40 ° C, hemorrhagic signs.
4. Hypertensive form - occurs extremely rarely. It is characterized by a sudden acute onset, development of hemorrhagic, respiratory and encephalic syndrome. In the first hours of the disease, a weakly expressed catarrhal syndrome is observed.

Most often, the disease occurs with catarrhal (inflammation and swelling of the mucous membranes, hyperemia), hemorrhagic phenomena (increased bleeding) and respiratory infection toxicosis. Such processes are observed in the nasopharynx, conjunctiva of the eyes, upper respiratory tract.

Catarrhal symptoms last for 7-10 days:

• Coryza.
• Dry cough.
• Increased lacrimation and rubbing in the eyes.
• Sore throat and hoarseness.

Hemorrhagic symptoms:

• Hemorrhage in the mucous membranes.
• Nasal bleeding.
• Hyperemia of the face with a general pallor of the skin.
• Minor hemorrhages and vasodilation of the sclera.
• Nausea, vomiting, diarrhea.

Respiratory infection toxicosis consists of several stages:

• Compensated - there is a violation of peripheral blood flow, which is manifested by hyperthermia, tachycardia, increased blood pressure. Irritative disorders of consciousness, convulsions, blanching of the skin are possible, diuresis increases.
• Subcompensated - increased permeability of the walls of the vessels, cerebral edema, muscle hypertension, persistent hyperthermia, pallor and marbling of the skin, greatly reduced blood pressure.
• Decompensated - due to circulatory hypoxemia there is damage to cell membranes, muscle atony, areflexia. Skin covers pale cyanotic color, bradycardia, abnormal breathing rhythms, violation of vital organs and body functions.

Doctors identify a number of symptoms that require urgent emergency calls: temperature above 40 ° C, which persists longer than 3-5 days, there are severe headaches (do not pass after taking pain medications), as well as shortness of breath, impaired consciousness, convulsions, hemorrhagic eruptions skin.

The severity of the symptoms of influenza 2018, as well as the diseases of previous years, depends on the state of the patient's immune system. Worst of all, people with chronic diseases of the cardiovascular system, lungs, kidneys and hematopoietic system suffer from the disease. Also, it is not necessary to exclude patients from special risk groups, that is, children, pregnant women and elderly people.

Features of the flu 2018

According to the forecasts of medical experts, features of the 2018 flu will consist in the functioning of three dangerous strains at once.

Characteristic features of influenza infection:

• Rapid development of the disease - due to the rapid development of influenza infection, doctors do not always manage to diagnose and start treatment on time. Therefore, it is necessary not to neglect the prevention of seasonal diseases.
• A high level of deaths - according to medical statistics, every year in the world about 500 thousand patients die of this infection. In the period of epidemics, mortality is doubled.
• Severe complications - neglect of timely diagnosis and treatment can cause a variety of consequences. It can be pneumonia, problems from the central nervous system, diseases of internal organs and much more.

The mechanism of origin and development of the disease passes through five pathological phases:

1. Reproduction of the virus in the cells of the upper respiratory tract, the development of inflammatory factors:

• Disturbance of the metabolism and integrity of membranes of epithelial cells.
• Death of epithelial cells.
• Further spread of the virus and its penetration into the blood.

At the site of inflammation, the activation of factors of nonspecific defense of the organism takes place.

2. The virus and cell decay products enter the blood, exerting a selective destructive effect on capillaries and precapillaries, the receptor apparatus of the cerebral membranes and vascular plexuses of the brain, and the autonomic nervous system. Microcirculatory disorders lead to the development of hypoxemia and tissue hypoxia, acute cardiovascular insufficiency, pulmonary edema, hemorrhagic, meningeal and encephalic syndrome.
3. Inflammatory processes in the respiratory system. The lesion most often occurs from the side of the epithelial cells of the trachea. If the disease occurs in severe form, the pathological process involves the respiratory tract, including the alveoli.
4. Various bacterial complications, most often occurring in patients at risk. Typically, this is pneumonia, which can be caused by both exogenous (staphylococci, streptococci) and endogenous flora.
5. The reverse development of the pathological process due to the activation of factors of nonspecific defense of the body.

In this case, the source of infection can be both sick people and animals. The main transmission path is airborne.

[5], [6], [7]

Complications of the flu 2018

The main danger of influenza infection is the risk of serious consequences. Complications of the flu of 2018 most often arise due to improper treatment of the disease, when the pathology passes into a neglected form.

The main complications:

• Primary viral pneumonia is a serious complication of influenza caused by the spread of infection from the upper respiratory tract along the bronchial tree with lung damage. Accompanied by intoxication, shortness of breath and severe respiratory failure. Cough is dry with the separation of scant sputum and impurities of blood.
• Bacterial pneumonia - begins 2-3 days after the acute course of the disease. After a slight improvement, the temperature rises sharply, a cough with sputum green or yellow.
• Infectious-toxic shock is the most severe degree of intoxication with marked disruption of the work of important organs (cardiovascular system, kidneys).
• Otitis, sinusitis is a bacterial inflammation of the sinuses and the ear.
• Glomerulonephritis is an inflammatory lesion of the renal tubules with a marked decrease in renal function.
• Meningitis, encephalitis - inflammation of the tissues and membranes of the brain. Most often occurs in patients at risk.

In addition to the aforementioned complications, septic conditions are observed in especially severe cases. This is the penetration of bacterial pathogens into the blood. This complication significantly increases the risk of death.

What is the difference between a cold and flu?

The flu, unlike a cold, is a fairly serious disease, which, without timely treatment, is fraught with serious consequences and complications. That's why you need to know the difference between cold and flu.

The difference between flu and flu is TOP-10:

1. Infection - the symptoms of influenza manifest immediately, which can not be said about the common cold. Its signs increase gradually, and in some cases proceed in a latent form.
2. The first signs - the cold begins to appear very slowly. At first, a runny nose, then a sore throat and a low-grade fever later in the evening. With the flu, the symptoms are acute: severe headaches and fever throughout the day.
3. Symptoms - with a cold its first signs gradually increase. Flu is characterized by a stable fever, a strong dry cough.
4. Throat - for catarrhal lesions, perspiration is typical, after which a short cough and sneezing begins. With influenza infection, the pain in the throat appears immediately, like the active cough. There may also be pain in the chest.
5. Headache - with a cold, discomfort occurs against a background of general weakness. While with the flu, headaches are more complex. Due to the general intoxication of the body, the patient experiences a severe migraine.
6. Deterioration of general condition (lethargy, weakness) - such symptoms are observed in both the first and second diseases. With a cold, discomfort persists throughout the illness, at that time with the flu only at the time of its resolution.
7. Muscle pains are characteristic of influenza infection. The patient complains of a strong ache in the body, pain in flexing the limbs.
8. Nausea and vomiting - the presence of such symptoms can cause difficulties in diagnosing. And it's not surprising how such symptoms are characteristic of severe poisoning. With a cold, intoxication is not observed, but for the flu, characteristic gastrointestinal disorders.
9. Painful sensations in the eyeballs - because of the pronounced intoxication of the body during influenza infection, the eyes are very watery and there are pains in the eye sockets.
10. Recovery period - the cold passes and is treated faster than the flu, the course of the disease is sluggish. Influenza is treated for a long time and often causes severe complications.

How to treat the flu in 2018?

Treatment of influenza infection, like any other disease begins with a comprehensive diagnosis. How to treat the flu of 2018 will depend entirely on the results of the research. Particular attention is given to differentiation with other acute respiratory infections:

Paragripp:

• Characterized by a slow onset, differing from influenza with mild intoxication and subfebrile body temperature.
• Painful sensations in the larynx. Possible development of laryngitis: dry cough, hoarseness.
• The mucous membrane of the oropharynx is slightly hyperemic, while the flu is characterized by pronounced hyperemia.

Adenoviral infection:

• Increased regional lymph nodes and other symptoms of tonsillitis.
• Moderate coughing attacks.
• Pronounced sputum discharge during cough.
• Asymmetrical conjunctivitis.
• Dyspeptic phenomena.
• Feverish period is more than 10 days.

Treatment of influenza consists of such basic stages:

1. Antiviral and antipyretic therapy - is conducted for both children and adults from the first days of the disease. Patients are prescribed oral, injection and inhalation forms of drugs. Also, the intake of vitamins is recommended.
2. Physiotherapy - to improve the drainage function of the bronchi and increase the excretion of phlegm, conduct warm inhalation with bronchodilators, and also appoint mucolytics for oral administration.
3. Hospitalization - is indicated in a severe course of the disease with such symptoms as: severe hyperthermia 40-41 ° C, nausea and vomiting, blue skin, arrhythmia, meningeal syndrome, risk of complications.

Particular attention is paid to non-drug treatment. Patients are shown strict bed rest for 5-7 days. During this period it is not recommended to read, work at a computer or watch TV. Recommended abundant drink - a day at least two liters of water, drinks, enriched with vitamin C, tinctures of rose hips, mors. Also shown is a gentle diet with a predominance of food rich in vitamins.

How to prevent the flu in this season 2017-2018?

The most effective way to prevent infection with a viral infection is a set of preventive measures. Let's consider in more detail how to prevent the flu in this season 2017-2018:

Strengthening the immune system

• First of all, you should not allow viruses to enter the body. To do this, minimize contact with infected people and observe personal hygiene.
• Full nutrition, rich in proteins, fats, carbohydrates and vitamins.
• Active lifestyle and regular exercise.
• Compliance with sleep and rest.
• Minimization of stress and overstrain.
• Refusal from bad habits (smoking, alcoholism, drug addiction), negatively affecting the resistance to infectious diseases.

Vaccine prophylaxis

Every year influenza vaccines undergo strain updates. The vaccination is carried out with the help of viruses that circulated in the previous season. The effectiveness of this method of preventing infection depends on how much the viruses are similar to these. With repeated vaccinations, the effectiveness increases. To date, these types of vaccines that contain two strains of type A and one strain of type B:

1. Trivalent inactivated (TIV)

• Split vaccines
• Subunit
• Whole-virion

Only TIV are licensed for children under two years of age, pregnant and patients older than 50 years. The vaccine is in multi-dose and single-dose vials. The drug is intended for intramuscular injection into the deltoid muscle or anterolateral surface of the thigh. TIV are considered the safest, although they can cause temporary allergic reactions at the site of administration.

2. Live attenuated influenza (LAIV)

There is a trivalent lyophilized vaccine, which is based on live attenuated viruses adapted to the cold. The vaccine is derived from a donor strain of subtype A virus that is recombined with seasonal strains A (H1N1) and A (H3N2). Due to the sensitivity to temperature, vaccine viruses multiply perfectly in the cold environment of the nasopharynx, but poorly at body temperature in the lower respiratory tract.

Vaccination should be in advance, that is, before the epidemic, better in September. The vaccination can be carried out during the epidemic, but it should be borne in mind that the immunity is formed within two weeks. Also, do not forget about the risk of adverse reactions. Most often, redness occurs at the injection site, fever, general malaise, muscle pain, allergic reactions.

Emergency prevention

It is performed during an outbreak in a closed group. Vaccination is not used, as for the formation of protective properties of the immune system, at least 2 weeks are needed. Recommended intake of rimantadine, oseltamivir or Tamiflu. Also, it is not superfluous to receive a specific anti-influenza immunoglobulin.

Flu 2018, like the virus diseases of previous years, requires comprehensive prevention. With timely vaccination and strengthening the protective properties of the immune system, there are all chances that the body cope with the seasonal problem and will not cause serious complications.