Influenza in children

Influenza is a widespread infection with epidemic and pandemic morbidity. In the interepidemic period, morbidity is maintained by sporadic cases and local outbreaks. During an epidemic/pandemic, natural immunization of the majority of the population and a decrease in the susceptible population occur, which leads to a rapid decrease in morbidity. The most widespread diseases are associated with type A virus, type B virus usually causes local outbreaks, and type C virus - sporadic cases. Influenza epidemics occur almost annually and are caused by the emergence of new virus strains due to antigenic drift. Influenza pandemics are relatively rare, occurring every 10-20 years or more, and are associated with a change in the virus subtype due to antigenic shift.

ICD-10 code

• J10 Influenza due to identified influenza virus.
• J10.0 Influenza with pneumonia, influenza virus identified.
• J10.1 Influenza with other respiratory manifestations, influenza virus identified.
• J10.8 Influenza with other manifestations, influenza virus identified.
• J11.0 Influenza with pneumonia, virus not identified.
• J11.1 Influenza with other respiratory manifestations, virus unidentified.
• J11.8 Influenza with other manifestations, virus unidentified.
• G 00.0 Influenza meningitis.

Reasons

Influenza pathogens are RNA-containing viruses from the orthomyxovirus family, 80-120 nm in diameter. They have a lipoprotein membrane formed by the glycoproteins neuraminidase (N) and hemagglutinin (H). According to the nucleoprotein (NP) and matrix (M) protein, influenza viruses are classified into 3 antigenically independent types A, B and C. According to the antigenic variants of glycoproteins H and N, subtypes of influenza A virus are distinguished. Currently, 16 subtypes of hemagglutinin (HI-H16) and 12 subtypes of neuraminidase (N1-N12) are known; virus strains are usually designated by a short antigenic formula: H1N1, H2N1, H3N2, etc.

What causes the flu?

Classification

There are typical and atypical cases of influenza, among which the following forms are distinguished according to the severity of symptoms.

• Typical:
  • light;
  • moderate;
  • heavy;
• Atypical:
  • hypertoxic;
  • erased;
  • inapparent.

The severity of influenza is determined by the severity of the intoxication syndrome (hyperthermia), neurological symptoms (headache, loss of consciousness, convulsions, meningeal symptoms), hemorrhagic syndrome, and cardiovascular disorders.

Symptoms

The incubation period of influenza ranges from several hours to 2 days for influenza A and up to 3-4 days for influenza B. The disease begins acutely, with a rise in body temperature to high values (39-40 ° C), accompanied by chills, general weakness, fatigue, muscle and joint pain. The fever reaches its maximum by the end of the first, less often on the second day of the disease. By this time, all the symptoms of influenza are expressed to the maximum. Children complain of headaches, usually in the temples, forehead, superciliary arches, eyeballs; they lose their appetite, sleep worsens, nausea, vomiting are possible, and in severe cases - delirium and hallucinations. Catarrhal symptoms are usually weakly expressed and are represented by coughing, congestion and scanty mucous discharge from the nose, sore throat, especially when swallowing. In severe cases, nosebleeds, convulsions, short-term loss of consciousness, meningeal symptoms (stiff neck, weakly positive Kernig's sign) are possible.

Symptoms of flu

Diagnostics

Influenza is clinically diagnosed when a typical form of the disease is detected in patients during an epidemic rise in morbidity.

For laboratory confirmation, an express method is used, which is based on the detection of viral antigens in the epithelium of the mucous membrane of the upper respiratory tract using RIF. The result can be obtained in 3 hours.

Diagnosis of influenza

Treatment

Treatment of children with influenza is carried out mainly at home.

Hospitalization is carried out according to clinical, epidemiological and social indications.

• Clinical indications:
  • severe and hypertoxic forms of influenza;
  • complicated course of influenza (meningitis, encephalitis, pneumonia, etc.);
  • neonatal period, regardless of the severity of the disease; hospitalization of infants is also advisable.
• Epidemiological indications:
  • the child’s stay in a closed institution or in an organized group (orphanage, children’s home, health camp, etc.).
• Social indications:
  • the inability to organize treatment and adequate care in an outpatient setting due to social, technical or other reasons;
  • the lack of possibility to organize “hospital care at home” if necessary;
  • antisocial family;
  • homeless and neglected children.

Treatment of flu

Prevention

To prevent influenza, organizational and anti-epidemic measures (exposure prophylaxis) are important:

Vaccination plays a leading role in influenza prevention.

The following flu vaccines are approved in Ukraine:

• Grippol (influenza polymer-subunit vaccine, Russia);
• Influvac (subunit vaccine, Netherlands);
• Vaxigrip (split vaccine, France);
• Fluorix (split vaccine, England);
• Agrippal S1 (subunit, Germany).

How to prevent flu?

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