The term RS infection determines the acute respiratory viral pathology, which is characterized by preferably damage to the lower structures respiratory tract. She got quite widespread, in the structure of the ORVI (sharp respiratory viral infection) It is up to 20%.

The abbreviation of the RS infection is decoded as a respiratory and synthetic infection. The disease received the greatest prevalence among children under the age of 3 years. Often it amazes premature newborn children under the age of 3 months, and in this case may have a difficult course.

Causes (etiology)

The radios of the RS infection belongs to the paramixirovirus family. It is characterized by tropiness to the cells of the mucous membrane of the lower respiratory tract. As a genetic material, the virus contains RNA (ribonucleic acid). Despite the presence of a protein shell, the virus is quite unstable in the external environment. It quickly dies under the influence of high temperatures (boiling kills the causative agent instantly), as well as disinfectants. A longer than a virus retains its viability at low temperatures, especially if it is in the slopes of the mucus. The causative agent is transmitted by air-drip from a sick person or a virus carrier. It stands out with the smallest droplets of mucus, and then in the form of an inhaled air aerosol falls into the respiratory tract healthy man. The sick person becomes contagious for others before clinical manifestations Diseases.

Development mechanism (pathogenesis)

The virus causative agent of RS infection has tropiness to the cells of the mucous membrane of the respiratory organs. After inhalation of air with the virus, it settles in the upper respiratory tract, embedded in the cells of the mucous membrane and leads to the development of an inflammatory response. He also causes intoxicating the human body by suction to the blood of toxic compounds. After primary reproduction in nasopharynk cells, the causative agent enters small bronchi and lung alveios, where it also causes an inflammatory response. A feature of the PC-infection flow is that the causative agent leads to a change in the morphological and functional properties of the cells of the lower respiratory tract. They acquire significant, gigantic sizes, and also connect to each other. The result of structural changes is the narrowing of small bronchi, impaired drainage function, accumulation of mucus in alveoli with a significant increase in the risk of subsequent attachment of the secondary bacterial infection. After transferred infection, an unstable immunity is formed, so a person can overcome the RS infection several times in life.

Symptoms

First clinical signs Diseases usually appear in 5-7 days after infection ( incubation period). They include unbearable intoxication with headache, subfebrile body temperature up to + 38 ° C, light chills, brushes in muscles and joints, total weakness, deterioration of appetite, disability, as well as conjunctivitis (eye redness, a feeling of burning in them, tear). Then there are signs of the development of an inflammatory response in the respiratory organs. Depending on the preemptive localization of the pathological process, several clinical shapes Diseases:

The difficult course of the RS infection has children under the age of 1. The disease is accompanied by significant intoxication, convulsions, diarrhea and vomiting, as a result of which there is a high risk of fatal outcome. More older children and weakened adults are often accompanied by the development of bacterial complications in the form of inflammation of the middle ear (Otitis), putty sinuses. In this case, the state of the sick person is significantly and rather worsens.

Acute medium otitis (bacterial inflammation of the middle ear) in children is a frequent complication of ARVI. This is due to the fact that Eustachiev pipe connecting the nasal cavity and the drum cavity is shorter and has unbearable bends. This facilitates the penetration of bacteria from the nose into the ear.

Diagnostics

In most cases, the diagnosis of PC infection is established by a infectious disease physician based on clinical symptoms during the epidemiological lifting of morbidity. To reliably detect and identify the pathogen, a tissue study can be used, in which the material was made into the culture of tissues (washing from the nasopharynx, sputum), after which the breeding of the virus in cells is recorded. It is also possible to perform RSK (complement binding reaction), with which the activity (titer) of antibodies to the virus is determined in the blood. These studies are mainly appointed to conduct an epidemiological study in order to identify the source of infection.

Treatment

Antiviral therapy with RS infection is usually not assigned. The uncomplicated course of the disease in adults and older children makes it possible to carry out treatment at home. Applied symptomatic therapy, which includes bedding, diet with large content vitamins, fiber and carbohydrates, abundant drinking (compote from dried fruits, tea, non-carbonated water). If necessary, non-steroidal anti-inflammatory (paracetamol), antihistamine (suprastine, diazoline) preparations that help reduce body temperature, as well as improve well-being. Reception of vitamin C is recommended. Ascorbic acid causes the suppression of the activity of the virus. Children under the age of 1, as well as weakened patients with severe RS infection are subject to hospitalization. In the department, disinfection (intravenous drip administration of saline solutions, vitamins, hormonal means) is carried out, antispasmodics, eufillin, which expand the lumen of the bronchi, facilitate breathing, and also reduce the likelihood of the development of bacterial complications. Additionally, antibacterial agents are often prescribed, especially in the case of a confirmed complicated RS-infection flow.

In general, the forecast for RS infection is favorable. The exception is the development of the disease in weakened people, as well as children under the age of year. To avoid the development of infection, it is important to comply with general preventive measures. Vaccination against RS infection has not been developed.

Respiratory syncitial human virus (English. Human Orthopneumovirus, Previously, HRSV) - type of viruses, infection respiratory tract . Is the main cause of infections of the lower respiratory tract in newborns and children. Treatment is limited to supporting therapy, it is possible to use an oxygen mask.

In countries with temperate climate, annual epidemics occur during the winter months, in countries with tropical climates, diseases caused by Human Orthopneumovirus.As a rule, they are registered during the rain period.

In the United States, up to 60% of infants are infected with a respiratory syncitial virus during the first epidemic season, and almost all children carry infection to the age of two or three years. Among all this virus infected with this virus, only 2-3% arises capillary bronchitis and there are indications for hospitalization. Infection Human Respiratory Syncytial Virus activates the immune protection system, the effectiveness of which decreases with time much faster than in the case of other viral infections, so the person can be infected with this virus several times. Some newborns can be infected several times even during one epidemic season. Heavy infections Much more often found among the elderly.

Respiratory and syncitial human virus since May 2016 refers to the genus Orthopneumovirus. Family Pneumoviridae. The genome contains single-stranded (-) RNA, the protein F on the surface of the virion causes the fusion of plasma membranes of nearby cells and synthetic formation.

Encyclopedic YouTube.

1 / 5

✪ What is flu?

✪ וירוס ה RSV ומחלות של דרכי הנשימה בקרב פגים

✪ וירוס ה RSV וברונכיוליטיס: טיפול ומניעה

✪ וירוס ה RSV ומחלות של דרכי הנשימה בקרב אוכלוסיות בסיכון

✪ Joe Derisi: Hunting The Next Killer Virus

Subtitles

Now you look at this video and I am sure that ever in my life or in the life of someone who you know, you have come to face what it means to hurt the flu, as you feel terribly feeling. Usually people talk about flu in 2 different keys. Now we will analyze both. Sometimes we are talking about influenza, as about the disease, and then we are talking about the symptoms. Sometimes we are talking about influenza as a virus, causing a disease "flu". For clarity, I share the board in this way. First, let's talk about the disease, and then we will turn to the virus. In order not to lose the thread of the conversation. Whenever I hear that someone has fun, I immediately have a number of questions, the answers to which they help make sure that they really have fun, and not something else. Questions that arise in my head usually such: "Is the disease sudden?" Or is it suddenly? " I will write it here: "Is it suddenly?" I ask: "Do you remember exactly what you feel good, and then sharply felt bad?" "Do you remember exactly when it started?" Most people who are ill with influenza can confidently say up to 1-2 days when it started. Another prompt is that the flu usually lasts from 3 to 7 days. If someone says that he got sick with the flu, and after 4 months he felt better, then this is a very strange story. Usually everything goes much faster. Remember, it is from 3 to 7 days. Of course, sometimes the disease lasts a few more days, especially when it comes to such symptoms like cough. But in general, the disease lasts from 3 to 7 days. Then I turn to the symptoms itself. And I want to know exactly what forced patients to feel sick. There are two categories of symptoms. The first is respiratory symptoms. I ask patients about such symptoms. And then I am interested in constitutional symptoms. These are symptoms that are not connected with the "Constitution". Do not think, they belong to the whole body. These are symptoms covering the whole body. We need a little more place on the board. So, first we will analyze respiratory symptoms. Drawing respiratory tract. Air falls inside in two ways. It falls through the nose or through the mouth. After it penetrates inside, it is quickly mixed. Remember, the air from the nose is mixed with the air from the throat and lowers down the air pipe, which we call the trachea. Then, on the bronchum, it enters the right and left lung. Here is the right light. On the other hand, respectively, left. Remember, the left is next to the heart. I will leave a little place for the heart. Here are two lungs, here the air entering them. So, the symptoms are laid out. This is a rather common symptom. It is also called a runny nose. But, no matter how you call it, it respiratory symptomSo associated with air flow into the lungs. Another symptom may be pain in the throat. And here you see how the air goes right through the throat on my way into the lungs. And also a very common symptom that you hear all the time is cough. When I complain about cough, I immediately know that in this case there are almost always lungs. These symptoms are laid nose, sore throat, cough ... you can see, thanks to this drawing, which parts of the body are involved in them. And what really happens? In fact, the virus penetrates the body. Doing inhale, you breathe it. And when it reaches these sites, cell damage occurs. That is what we feel like a laid nose, pain in the throat or cough. All this damaged cells affected by the virus. Go now to another part, to constitutional symptoms. These are symptoms affecting the whole body. That's the whole body. These are hands, here is one, here is another. Bottom of foot. These are symptoms like heat. When we talk about the heat, it is difficult for us to say that some particular part of the body is amazed. Usually they say: "I'm all sorrow." And when you have a heat, you can be very bad. So, the first symptom is a heat. The heat is also often accompanied by chills. Write them together. These are constitutional symptoms. Another symptom - lobby in the body. You lie in bed, because your whole body hurts. You cannot specify one particular place, because pain around the whole body, and this is another constitutional symptom. Another symptom that comes to me in the head is fatigue. In this case, the whole body is also affected. Therefore, when someone talks about the flu, they must have a minimum of these respiratory symptoms and at least one of these constitutional. We have two categories of symptoms. At least one symptom of each category should be. There must be two if someone wants to really convince me that he has flu. But let's go back. Repeat. The disease must be sudden. It should last about 3-7 days. Commier during this time. And there must be a minimum of one respiratory symptom and at least one constitutional symptom. It's all good if we are talking about patients. If we consider the clinical situation in the hospital or emergency room. But what if you are engaged in research? It turns out scientific centers There are many research related to influenza or influencing. They have a definition and I want you to know him. Their definition is followed: a person must hurt the throat or be cough, or all together. And there should be a heat. This definition is very similar to the one I have just given. But this is a definition that is used when research is conducted and represent data. It must be two things: pain in the throat or cough and heat. This is the definition of flu-like disease. Abbreviated GPB. Influense disease. This is the definition used by the Centers for Disease Control. And if you hear this name, you will understand what is meant in the flu-like disease. And there is an interesting question here. That is why I made a distinction between the disease and the virus. So, I turn to the virus. Just keep in my head the concept of flu-like disease. And now, with regard to the virus. I will make a green sketch of how the flu virus looks like. This is us a flu virus. Inside this virus there is RNA. RNA will be here. I will sign: RNA so you have seen. I will use two colors. Purple here. And it is also important to know about RNA what it is broken into small pieces. I draw them. There are purple pieces. And there are yellow pieces. This RNA is a genetic material. She encodes squirrels. There are proteins, several proteins on the surface. You can imagine that the source of these yellow proteins are these yellow segments. And there are still purple proteins. Here. Several lilac proteins. I paint a few lilac proteins here. Purples Let's call, say, H. And I call yellow, for example, N. Here you see several important parts of the influenza virus. You know now that it is inside there is RNA with torn slices, and outside, on the surface, there are proteins. The most important of them are those that we for brevity called H and N. in more detail in another video. This is a flu virus. The question is if you have it. If my friends say that they suddenly fell ill, and the disease lasted 6 days, and they had a heat and cough, in this case it sounds like the definition of flu-like disease. And if I rent the tests to check it out ... For example, I will take a smear from the nose and surrender. You can expect that flu will be detected. In most cases, I really detect flu. But not always. And this is a very important point. Want to believe, you want no, but there are small imitative viruses. I will write here: imitator viruses. Draw two of them. In fact, they are more. This, of course, an arbitrary presentation of how they look. Sign them. One is called "rinovirus". Rinovirus. You may know that Reno means the nose. And, in fact, rinovirus loves to strive his nose. Therefore, it was called Rinovirus. Another virus imitator. It looks a little different, slightly stretched to the sides. It is called RSV. Full name - respiratory syncytial virus. Respiratory synthetic virus. We will talk about it another time. The idea is that these are imitator viruses. And it is very interesting. They actually can make us think that we are dealing with the flu. Because some symptoms that rinovirus causes, and which causes RSV, it turns out, very similar to the symptoms of influenza. Sometimes they are pretty difficult to distinguish. Sometimes you just may have something that is called a cold, not a flu. I shifted a little drawing and free space. I will write a cold and flu. How to distinguish one of the other? When you have influenza, you usually have respiratory symptoms. Put a tick. And some constitutional symptoms. But if you have a cold, an ordinary cold, you will have only respiratory symptoms. It usually does not happen heat, the body will not lie and there is no fatigue. This is a simple I. fast way Distinguish flu from cold. And I usually ask your patients, whether they have a body and whether they have fatigue. And when I hear in the answer "No", I think: "So, a person has a cold." But, of course, this is not exactly, this method is not perfect. Sometimes it happens that people are misleading, and they have one of these imitator viruses, rinovirus or RSV, or adenovirus. There are still many other viruses. And they are actually a flu-like disease. They have a sore throat, there is a heat, lomit body. It is important to remember that whenever we clinically determine flu, it does not necessarily mean that patients really have a flu virus. Subtitles by The Amara.org Community

Description

The genome of the virus contains 10 genes that encode 11 proteins, gene M2 contains two open reading frames. Proteins NS1 and NS2. Inhibit the activity of interferon type I. gene N. encodes a nucleocapsid protein that binds genomic RNA. Gene M. encodes a matrix protein required to build virions. SH, G and F proteins form capsid. Glycoproteins F. (English Fusion - Merge) and G. It is necessary to penetrate the virus into the cell and cause the immune response, are antigens. M2. It is the second protein of the matrix and is also required for transcription, encodes the elongation factor M2-1 and the transcription regulator M2-2, M2 contains CD8 epitopes. L. encodes RNA polymerase. Phosphoprotein P. is a cofactor L. The nuclear structure of proteins has been decrypted N. and M. The virus gene is transcribed sequentially from the ns1 gene to L, while the expression level of the respective genes is reduced.

Symptoms of Disease

Most people have an infection with a respiratory syncitial virus causes only weak symptoms, often indistinguishable from other respiratory diseases. Centers for the control and prevention of US diseases call this virus most frequent cause Bronchipolitis and pneumonia in children under 1 year in the United States. Some children Human Orthopneumovirus. It may cause bronchiolite and then heavy respiratory diseases leading to hospitalization, and, in rare cases, to death. Other symptoms of infection in children include weakness, lethargy, weak or lowered appetite and sometimes raising the temperature.

Treatment

The authors group believes that in the treatment of bronchiolite caused by respiratory syncitial virus in newborns, it does not help anything, except for oxygen, and adrenaline, broutine, steroids and ribavirin do not give any real benefit.

Treatment is to support therapy, recommended abundant drinking and oxygen supply through a mask. In the case of bronchial spasms, albuterol is prescribed. To reduce the efforts needed for breathing, an increased flow of moisturized air is supplied through the nasal cannulas.

It is shown that the hypertensive 3% saline solution supplied with inhalations is inexpensive and effective way the treatment of newborns hospitalized with viral bronchipolitis of moderate gravity, for example, in the case of viral bronchipoly caused by Human Orthopneumovirus. .

see also

Notes

1. Taxonomy of viruses (eng.) On the website of the International Committee on Virus Taxonomy (ICTV).
2. ICTV TAXONOMY HISTORY: Human Orthopneumovirus. On the ICTV website (eng.) (Checked March 23, 2017).
3. Pinevich A. V., Sirotkin A. K., Gavrilova O. V., Potekin A. A. Virology: tutorial. - St. Petersburg. : Publisher of St. Petersburg University, 2012. - P. 393. - ISBN 978-5-288-05328-3.
4. Glezen W. P., Taber L. H., Frank A. L., Kasel J. A. (1986). "Risk of Primary Infection and Reinfection with Respiratory Syncytial Virus". Am. J. DIS. Child. 140 (6): 543-546. PMID.

Respiratory Syzitial Virus enters a group of acutely occurring infections affecting a sufficiently large number of population mainly early age. One year old children occupy the main place among infected. If adult disease passes superficially, the kids may develop serious complications.

Definition

This is a virus that causes respiratory infections. Cunning is that it is difficult to diagnose, as it can be easily confused with a simple cold. At the moment, the vaccine has not yet been developed, so the disease sometimes ends with a fatal outcome. Hospitalized provokes the appearance of bronchitis, whistles and asthma.

Etiology

The respiratory syncitial virus focuses in the cytoplasm, after ripening begins to reconnect into the membrane. It belongs to the Paramyxoviridae family and is the only representative of this group that can provoke a serious illness. Although a variety of stamps have some antigenic heterogeneity, the variations relate mainly to 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 syncytia.

The reasons

The respiratory synticial virus of a person refers to a little gland, which is transmitted by air-droplet. They are able to infect both sick people and carriers. Collective and family outbreaks are characteristic, and cases are often registered in pediatric hospitals. Distribution is widespread and around the clock most often in the winter-spring time. The greatest susceptibility is celebrated at the children from 4-5 months to 3 years. At an early age, most of the kids transfers this disease, since further immunity is observed, there are quite often repeated cases of the disease, only in an over-erase form. However, after a complete disappearance of antibodies (IGA), a respiratory syncytial virus may appear again.

Approaches close contact with infected. It was analyzed and revealed that if the sick person sneezes, then bacteria are easily distributed by 1.8 m. This group of pathogens can survive on hand to 30 minutes, and on items - for several hours.

The pathogenesis of infection is very similar to the mechanism of the development of influenza and paragrippa, as is associated with the movement of the disease to the epithelium of the respiratory tract. For penetration, the respiratory tract is served, and the primary reproduction begins in the nasopharynx cytoplasm and after it applies to bronchi. At this moment, hyperplasia of affected cells and symplasts occurs. Such phenomena are accompanied by hypersecretion and narrowing bronchiole, which further leads to the blockage of their thick mucus. The development of infection is then determined by the degree of intake of flora and respiratory failure.

Symptoms

Respiratory and sycitial virus, whose microbiology is complex and is difficult to diagnose, is an early spring and winter disease.

To date, it was not revealed why the lower airways are affected by the kids and the top in adults.

In kids, the disease begins with fever, severe throat pain and a cold. Soon other symptoms that resemble asthma are connected. The infection is characterized by the following features:

- (more than 40 breaths per minute);
- Blue skin shade (cyanosis);
- sharp and frequent cough;
- heat;
- intermittent and uneven breathing;
- bruboral seals;
- piercing breaths and wheezing;
- Difficult exhalations.

Infectilation of the lower respiratory tract appear when bronchioles swell. If at this moment the patient is experiencing problems with the supply of oxygen, then it is necessary to consult a doctor for immediate medical help. Such ailments most often appear in children for up to one year, and they are quickly exacerbated.

Classification

There are a large number of factors for which you can characterize the respiratory syncytial virus, namely:

- typical - rhinitis, laryngitis, pneumonia, rinofaring, bronchilitis, bronchitis, segmental pulmonary edema and otitis are developing;
- atypical - erased or asymptomatic course of the disease.

There are 3 main forms of illness.

1. Easy, it occurs more often in adults and school children. It is manifested as moderate noodopharyngitis, respiratory failure is not observed. Most often, the body temperature remains normally either slightly rises, but literally a few degrees. No signs of intoxication are completely absent.

2. Medium-heavy, you can observe the symptoms acute bronchitis or bronchiolitis, accompanied by obstructive syndrome and respiratory failure. The patient has oral cyanosis and swelling. If a child fell ill, then it can be too restless, drowned, excited or sluggish. Often there is a small increase in liver or spleen. The temperature is often elevated, but sometimes normally. There is a moderately pronounced intoxication.

3. HeavyAt this moment bronchiolite and obstructive bronchitis are developing. There is a strong insufficiency of air at which only the oxygen mask for breathing can help. Sweets and noises are traced, there is a pronounced intoxication and a strong increase in liver and spleen.

The criteria of gravity most often include such characteristics:

The presence of local changes;
- Difficult breathing failure.

By the nature of the flow:

Smooth - no bacterial complication;
- Non-smooth - the appearance of pneumonia, sinusitis and purulent otitis.

History

Respiratory syncitial virus, whose symptoms can be confused with other diseases was detected in 1956 by Dr. Morris. He, watching the chimpanzee, which found rhinitis, found a new infection and called it CSA - ChimpanzeEcoriragent (Cauditoger Rubber Chimpanzee). At the time of examination of the sick employee, who cared for a monkey, an increase in antibodies was noticed, very similar to this virus.

In 1957, R. Chenok allocated a similar pathogen from the fallen children and determined that it was he who was responsible for the excitement of bronchitis and pneumonia. After that, until today, scientists are unsuccessfully trying to develop a vaccine.

Diagnostics

The clinical definition of the disease is problematic due to the similarity of it with other ailments. Adults most often prevail the symptoms of bronchitis and pneumonia. During laboratory studies, which allow you to identify the titer of antibodies. If there is a need, the doctor prescribes radiography and specific laboratory tests, for example, virological test of nasopharynx wasches.

Therapy

Patients who have revealed a respiratory syncytial virus, treatment is appointed complex, in order to strengthen the body. Bed regime is recommended for the entire exacerbation period. Hospitalization is shown to children, with a severe form of the disease, the babies of preschool age with the middle severity and persons who have complications. The prerequisite is the presence of a diet of the appropriate age. It should include mechanically and chemically gearous food, full of various microelements and vitamins.

Is also carried out for which the use of such drugs as leukocytarian human interferon, "Anaferon", "Grippferon" and "Viferon". In severe forms, it is recommended to take "immunoglobulin" and "Ribavirin", the price of it varies from 240-640 rubles, depending on the dosage. Perfectly helps to prevent the appearance of the consequences at the Bronchitis preparation "SINAGIS". If a bacterial complication is found, antibacterial therapy is shown.

Broncho-abstructive syndrome is well removed symptomatic and pathogenetic treatment. In this case, an oxygen mask for breathing is applied, it facilitates heavy symptoms And simplifies air supply.

Required during complications. After pneumonia, it is recommended to conduct inspections after 1, 3, 6 and 12 months before complete recovery. Preventive diagnosis is necessary after recurring bronchitis and is appointed after the year of the amendment. If necessary, consultation of an allergist or a pulmonologist is visited, as well as laboratory surveys.

Treatment of children

The kids are always more difficult, and the consequences are much more serious than in adults, therefore therapy should be thorough and intense.

Antiviral:

- "Ribavirin", the price of this drug, as described earlier - is available, so he will not hit the pocket of parents strongly;
- Also, "Arbidol", "Inosine", "Tilorane" and "Pranobex" is often prescribed.

Syndrome therapy is required in accordance with the relevant protocols for the treatment of acute respiratory failure, bronchitis and cereal syndrome.

Basic antigomotoxic therapy:

- "Influenza heel", "Enhistol" (the initiating scheme is used);
- "Euphorbiumcomposites with" (nasal spray);
- Lymphomyosis.

Additionally:

- "Viborol" ( rectal candles);
- "Echinacea composites with" (ampoules);
- "Angine Hieel C";
- "Tumel with" (tablets).

All these tools are perfectly helping to overcome the respiratory syncytial virus in children.

First actions

In order to quickly defeat the disease, it is necessary to respond correctly to the symptoms that appeared in order to obtain the necessary assistance in case of need.

1. To consult a doctor is required when the SMI symptoms appear at a small child, namely the sore throat, runny nose and severe wheels.
2. necessarily called ambulanceIf there is a high temperature, intense noises, difficulty breathing and a common serious condition.

It is required to refer to such doctors as the therapist and infectiousist.

Complications

A negative impact on the respiratory departments has a respiratory syncytial virus. The consequences of this disease are solids, as the secondary bacterial flora can join and cause such ailments as:

Sinusitis;
- otitis;
- bronchitis;
- pneumonia;
- Bronchiolitis.

Prevention

All viral diseases are difficult to treat, since their symptoms are often hidden. One of the measures is to identify the disease and isolating patients to full recovery. During the periods of the outbreak of such an infection, special attention is required to pay sanitary and hygienic measures. In children's teams and hospitals, wearing a wearing gauze bandages for staff. The kids are necessarily and systematically disinfected by hands using alkaline solutions.

Emergency prevention measures in foci of infection include the use of such drugs as "Anaferon", "Viferon", "Immanal" and various inductors of endogenous interferon.

Immunoprophylaxis includes such means as "Motavizubam", "Revision" and "Palivizubam".

Vaccine

To date, they have not yet developed a component that will prevent this disease. The creation is carried out quite actively, the experiments began to be held since 1960, after which the substance was inactivated by formalin and besieged by the alum. Such a vaccine caused a pronounced formation of serum antibodies, although as a result of use, the tests developed even more serious disease. Live attenuated components cause not very pleasant symptoms or turn into the same virus, only wild type. To date, we consider the method of cleansing subunit antibodies against one of the surface proteins or attenuated elements, and then try to adapt them to cold.

The reasons

Respiratory and sycitial infection is widespread; According to various data, the proportion of cases of infection in the structure of the general incidence of ORVI is from 3 to 16%. Despite the fact that the child can get sick, and the adult, the virus is extremely dangerous for young children. Observations have shown that when an infected child appears in the team of children's institutions, all other children under the age of 1 year are ill.

Most high rates The incidence is observed in the winter and spring months, but the registration of the case of infection is possible at any time of the year. The forms of the disease can be different - occur both lesions of the upper respiratory tract, typical of uncomplicated ARVI and heavy bronchiolites, pneumonia. Older children and adult patients most often easily tolerate the disease - unlike children of the first 6 months of life.

A provocateur respiratory-sycitial infection - a virus belonging to the Paramyxoviridae family. It is called a RS virus, a RSV infection and are attributed to the ARVI causative agents group (acute respiratory viral infections) in children and adults. It is sensitive to the effects of the external environment, is quickly inactivated at a temperature of about 55 ° C (on average in 5 minutes). Contains ribonucleic acid (RNA), determines the formation of syncytium tissue culture, or pseudogagant cells.

The respiratory-sycitial virus is transmitted by air-drip (during coughing, sneezing), a contact-domestic way (with handshake, the use of any objects that have become infected - for example, toys).

The source of infection is a sick person, and the "entrance gate" - the epithelial cells of the upper departments of the respiratory tract.

The risk factors of the hard flow of the RS infection are determined:

In children under the age of 1 year, the respiratory syncytial virus causes a defeat of the lungs with the episodes of apnea (respiratory stop).

Pathogenesis

The penetration of the PC-virus into epithelial cells leads to their death. Pathological changes also include:

• outlet, thickening of the walls of the bronchi;
• necrosis tracheobronchial epithelium;
• blockage of lumen of bronchi mucous lumps, epithelium;
• the formation of atelectasis;
• the formation of immune complexes.

The process is characterized by rapid progression, the high probability of distribution to the lower respiratory system.

The RS virus is able to suppress the activity of the interferon system, which slows down the formation of an immune response. Secondary immunodeficiency leads to the weakening of immune protection and increase in the risk of attachment of bacterial infection.

Symptoms

The incubation period in the infection of respiratory syncytial viral infection lasts from 3 to 6 days. The course of the disease largely depends on age. Adults endure the RSV infection easily in the form of classical ARVI without pronounced intoxication. Patients are concerned:

• weakness, lethargy of a moderate degree;
• headache;
• increase body temperature up to 37.5-38 ° C;
• nasal congestion;
• sore throat;
• dry bakery cough;
• dyspnea.

The unproductive cough passes in a few days in wet. Even after the disappearance of fever can persist for 3 weeks - this is one of the typical signs of PC infection. With the deterioration of the state, the patients complain about shortness of breath, a feeling of gravity in the chest.

Bronchiolitis is an inflammatory disease of the lower departments of the respiratory system, characterized by the defeat of small bronchi and bronchiol. Children are ill under the age of 2 years, although in the overwhelming majority of cases bronchiolitis is registered in patients not over 9 months. One of the most likely provoking etiological agents is a respiratory syncitial virus. Symptoms usually appear a few days later from the start of the ARVI (runny nose, an increase in body temperature), in the clinical picture there are:

1. Strong weakness, lethargy or excitement.
2. Painful headache.
3. Disruption of appetite.
4. Fever (37.5-38.5 ° C).
5. Spastic cough, runny nose, pharyngitis.

Sometimes vomiting occurs, the disorder of the chair - as a rule, in the first day after the appearance of bright symptoms. Breathing in patients frequent, short, whistling with difficult exhalation; accompanied by the participation of auxiliary muscles. The bloated is noted chest, gray-cyanotic shade of skin, lips sinusiness. With auscultation of lungs, you can hear dry whistling and wet wheezing on both sides. Cough first dry, hoarse; After purchasing a productive nature, the sputum is separated with difficulty.

Diagnostics

Quickly confirmation of diagnosis requires, as a rule, only respiratory synthetic infection in children. Adults transfer it as ordinary ARVI without the need to hospitalize in the hospital and deciding on the tactics of urgent events. Used:

• general analysis blood;
• radiography of the chest organs;
• pulse oximetry;
• linked immunosorbent assay;
• immunofluorescent method;
• polymerase chain reaction.

The choice of research is carried out by the attending physician.

Treatment

Treatment of patients is carried out on outpatient conditions or in a hospital. Hospitalization requires:

• children under the age of 6 months;
• children with episodes of apnea;
• patients with signs of respiratory failure;
• patients with the need for permanent respiratory sane;
• in the presence of heavy concomitant pathologies.

It is also recommended to hospitalize children in the hospital who identified signs of malfunction, difficulty feeding. Social readings are important - the absence of persons who can care for the patient during the disease period, the patient's stay in constant contact with other children in the children's homes.

When infecting respiratory syncitial virus, the treatment includes the following activities:

1. Hydration, that is, abundant drinking, the introduction of glucose-salt solutions intravenously, through a naughty probe.
2. Inhalation of B2-agonists of short action (Salbutamol).
3. Purification of the nose from mucus.
4. Oxygen therapy according to indications.

Antibacterial therapy applies only with the proven presence of a bacterial infection in a patient.

Without the appointment, the doctor cannot be used by mucolyts (ambroxol), since the volume of the bronchial secret increases and the phenomena of respiratory failure are exacerbated. In addition, the secret is liquid, and it is not necessary to ignore it.

The appropriateness of the use of glucocorticosteroids is discussed - both inhalation and systemic. The bronchipoly therapy scheme is not recommended to include vibration massage due to low efficiency.

With severe respiratory failure, the APNEE is used by IVL ( artificial ventilation lungs). The need to appoint ribavirin as antiviral drug Determined by the doctor.

Prevention

• preservation breastfeeding at least during the first 6 months of life;
• prevention of passive smoking;
• reducing the frequency and time of staying in places of cluster of people;
• restriction and avoidance of contact with persons who have the symptoms of ARVI;
• frequent washing hands, rejection of touching with your eyes to the eyes, nose and mouth to hygienic procedures.

Children belonging to the risk risk group of the RS-infection, the immunization of palivizumab (monoclonal antibodies to the RS virus) is carried out.

Respiratory and syncytial infection is assigned first place. With a relatively easy course in adults, in the children's age group, this infection can lead to the development of severe pneumonia and may cause an adverse outcome.

Respiratory and syncitial infection (RS infection) - acute infectation viral disease With airborne transmission caused by the Virus of the Paramixoviridae family, which is characterized by the preferably defeat of the lower respiratory tract (bronchitis, bronchiolites, pneumonia).

RSI, target organ

PS-infection pathogen Opened in 1956 (Morris, Savage, Blont) in the cultivation of material from chimpanzees during the episode of numerous rhinitis among primates. A person has a similar virus allocated in 1957 (Chanock, MyrsRizman) when examining children with bronchiolites and lung inflammation. With its name, the virus is obliged to one feature of its pathological impact, namely: the ability to form synthetia - a network-shaped cell structure with cytoplasmic processes among themselves, as well as tropiness to the cells of the respiratory tract. Thus, the virus was called a "respiratory syncytial virus" (hereinafter referred to as RSV).

Causes of RS infection

Pathogen - Respiratory-Syzitial virus (RSV) - RNA-containing virus from the Pneumovirus Pneumovirus family. Currently, 2 serological strains of RSV (Long and Randall) have been allocated, which do not have clear delimitation by properties, therefore, are attributed to one serotype. The size of the virion ranges from 120 to 200 nm, the RSV is distinguished by polymorphism. RSV has several antigens:
- nucleocapsid to-antigen or complement-binding antigen (promotes the formation of complement-binding antibodies),
- Surface A-antigen (contributes to the development of virus antibodies).

Respiratory Syncitial Virus

The composition of the virus has M-protein (membrane protein), which is necessary for communication with the membranes of infected cells, as well as the GP-protein F-proteins (attaching proteins), which contribute to the attachment to the virus target cell with the subsequent replication of the RSV.

RSV is not much resistant to the external environment: already at a heating temperature of 55-60 ° C inactivated for 5 minutes, when boiling instantly. When freezing (minus 70 °) retains its viability, but it does not withstand repeated freezing. Virus sensitive K. disinfectants - solutions of acids, ether, chlorine. Sensitive to drying. On the skin of the hand, the virus can be maintained in a viable state for 25 minutes, on the subjects of the environment - clothes, toys, tools in fresh selections can be saved from 20 minutes to 5-6 hours.

In the human body, as in the cell culture in laboratory conditions, the RSV has a cytopathogenic effect - the appearance of pseudogagant cells due to the formation of syncytium and symplast (the network formation of cells with cytoplasmic bridges between them, that is, the absence of a clear boundary between cells and their specific fusion).

Source of RS infection Is a sick person and a virus monitor. The patient becomes contagious 1-2 days before the appearance of the first symptoms of the disease and remains as such for 3-6 days. The virus carrier can be healthy (without signs of the disease) and reconmarkscence after suffering from the disease (that is, after recovery, allocate the virus).

Mechanism of infection - Aerogenic, transmission path - Air-drip (with sneezing and cough, splashing aerosol with viral particles in 1.5-3xmeter surroundings from the patient). The air-dust path has a slight value due to the low stability of the virus to dry. For the same reason, it has a slight value to the transfer of contact-household through the objects of the environment.

Susceptibility to infection is universal and high, more often the children's population is sick. The disease is highly contagious, the non-hospitality flashes of infection in children's hospitals are described. Winter-spring seasonality has been revealed, but sporadic cases are recorded year-round. By virtue of "passive immunity", breast-age children (up to 1 year) are rarely ill, the exception is premature babes. Until 3 years of age, almost all children are already overwhelmed by RS infection. For one season outbreak of PC infection lasts from 3 to 5 months.

Immunity after transferred RS infection Unstable, short-term (no more than 1 year). Repeated cases of infection in another epidemic season, which can flow either, with residual immunite, or manifesto in the absence of such are described.

Pathological effect of RSV in the human body

The entrance gate of the infection is the nasophaling and the rotogling. Here, RSV multiplies in the epithelium of the mucous membrane. Next occurs in its lower airway departments - bronchi small caliber and bronchioles. It is here that the main pathological effect of the RSV is the formation of sycithiyev and symplasts - pseudogagant cells are formed with cytoplasmic partitions. In the focus of the lesion, there is inflammation and migration of specific cells - leukocytes and lymphocytes, swelling of the mucous membrane, mucus hypersecretion. All this leads to the blockage of the respiratory tract of the secret and development of various kinds of violations of the lungs of the lungs: violates the exchange of gases (O2, CO2), there is a lack of oxygen. All this is manifested by shortness of breath and the frequency of heart rate. The development of emphysema, atelectasis is possible.

Also, the RSV is able to cause immunosuppression (inhibition of immunity), which affects the cellular immunity, and in humoral. Clinically, this can explain the greater frequency of secondary bacterial foci with RS infection.

Clinical symptoms of RS infection

The incubation period lasts from 3 to 7 days. Symptoms of the disease are combined into 2 syndrome:

1) Infectious toxic syndrome. The beginning of the disease can be sharp or subacted. The patient has a body temperature from 37.5 to 39 ° and above. The temperature response lasts about 3-4 s days. Fever accompany the symptoms of intoxication - weakness, driers, lethargy, headaches, chills, sweating, capriciousness. Immediately appear symptoms of Noodopharygitis. The nose is laid, the skin is hot to the touch, dry.

2) Respiratory tract syndromeFirst of all, the cough is manifested. Cough in patients with RS infection appears on 1-2 day of the disease - dry, painful, stubborn and long. Along with the cough, the number of respiratory movements is gradually increasing, for 3-4 days from the moment of the beginning of the disease, signs of expiratory breath are observed (exhalation is difficult, which becomes noisy whistling and audible at a distance). Due to the fact that patients more often are children of early age, then the attacks of suffocation are often accompanied by the child's concern, the poverty of the skin, the pestoznost and the swelling of the face, nausea and vomiting. More older kids impose complaints of painful pain.

In case of inspection - hyperemia (redness) of the throat, the arms, the rear wall of the pharynx, the increase in submandibular, cervical lymph nodes, the injection of the spool vessels, and with auscultation of the patient, hard breathing, scattered dry and wet wipes, dulling the percussion sound. Rinitis renital Little and characterized by small mucous secretions. Possible complications Respiratory syndrome, and with severe form - manifestations, are croup syndrome and obstructive syndrome.

The severity of manifestations has a direct dependence on the age of the patient: the younger child is, the harder the disease flows.

Light form characterized by a low temperature reaction (up to 37.50), weakly pronounced
symptoms of intoxication: small headaches, total weakness, dry cough. Easy form is more often registered in older children.
The medium-heavy form is accompanied by a febrile temperature (up to 38.5-390), moderate symptoms Inxication, stubborn dry cough and moderate shortness of breath (DN 1 degree) and Tachycardia.
A severe form is manifested by pronounced infectious-toxic syndrome, pronounced, stubborn, long coughing, pronounced shortness of breath (DN 2-3 degrees), noisy breathing, circulatory disorders. With auscultation, the abundance of small-pushed wheezes, it is hears the attitudes of the lungs. Heavy form is most often observed in children of the first year of life, and the severity is more connected with the phenomena of respiratory failure, rather than with the severity of intoxication. In rare cases, pathological hyperthermia and convulsive syndrome are possible.

Duration of the disease from 14 to 21 days.

The analysis of peripheral blood is observed leukocytosis, monocytosis, the appearance of atypical lymphomonocytes (up to 5%), neutrophilic shift to the left when the secondary bacterial infection is attached, an increase in ESO.

Features of symptoms in newborns and premature children: perhaps a gradual beginning, a pronounced fever, against the background of congestion, a stubborn cough appears, which is often confused with cough. Children are restless, sleeping little, they eat badly, lose weight, quickly grow symptoms of respiratory failure, inflammation of the lungs develops quite quickly.

Complications and forecast of RS infection

The complications of the RS infection may be diseases of ENT organs, more related to the addition of secondary bacterial flora - otitis, sinusites, pneumonia.

Forecast with typical uncomplicated RS infection favorable.

Diagnosis of PC infection

The diagnosis of respiratory synthetic viral infection is placed on the basis of:

1) clinical and epidemiological data. Epidemiological data includes contact with ORVI patients, presence in public places, places of great crowding. Clinical data includes 2x syndromes - infectious and toxic and respiratory, and most importantly - feature of the respiratory syndrome in the form of bronchipolite development (see description above). The presence of the aforementioned signs under the age of 3 years. Differential diagnosis need to be carried out with the whole group of sharp respiratory viral infections, laryngitis, tracheitis various etiology, inflammation of the lungs.

2) laboratory data - a general blood test: leukocytosis, monocytosis, an increase in ESP, detection of atypical lymphomonocytic cells (5%), possibly neutrophilic shift to the left.

3) tool data - chest radiography: amplification of the pulmonary pattern,
seal of lung roots, places emphysematous sections of the lung.

4) Specific laboratory data:
- virological study of naso-cell flippers with reef, express methods;
- Serological examination of blood on antibodies to RSV using the neutralization reaction, RSK, RTGA in paired serums with an interval of 10-14 days and detecting an increase in antibody titer.

Treatment of RS infection

1) Organizational and regime measures: hospitalization of patients with a medium-heavy and severe form of the disease, bed regime for the whole fevering period.

2) Medical therapy includes:

Etiotropic therapy:
- antiviral tools (Isoprosin, Arbidol, Anaferon, Cycloferon, Inhavirini Others), depending on the age of the child;
- Antibacterial agents are appointed with the proven attachment of a bacterial infection, the attachment of pneumonia and only a doctor.

Pathogenetic treatment:
- antitussive, expectorant and anti-inflammatory syrups (Erispal, Lazolyvan, Bromgexin, synecode, medicine with the root of Altea, with thermopsis);
- Antihistamines (Claritin, Zirtek, Zoda, Zetrin, Suprastin, Erius and others);
- Local therapy (Nazol, Nazivin and Other for the nose, Faliment, Faringosept and Other for the throat).

Inhalation therapy - steam inhalations with herbs (chamomile, sage, oregano), alkaline inhalation therapy, the use of drug nebulizers.
- If necessary, the purpose of glucocorticosteroids.

PC-infection prevention

Specific prophylaxis (vaccination) No.
Prevention includes epidemiological measures (timely insulation of the patient, timely start of treatment, wet cleaning of the room, antiviral prevention of contact - arbidol, anaferon, flu and other drugs); Hardening of children and propaganda healthy image life; Prevention of hypoints in the epidemic season of infection (winter-spring).

Doctor Infectiousist Bykov N.I.