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Updated: May 03, 2023
- Influenza virus belongs to the genus Influenzavirus, type A virus can infect humans and some animals, types B and C multiply only in humans.
- Influenza viruses are characterized by high antigenic variability (highly developed in type A and B viruses, less in C).
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- Antigenic polymorphism contributes to frequent epidemics, multiple morbidity during the season, and also does not allow developing a sufficiently reliable group-specific prophylaxis.
- The influenza virus is unstable, easily dies when the temperature rises to 50-60 degrees, under the influence of chemical disinfectants.
- The reservoir and source of infection is a sick person (with obvious clinicalsevere manifestations or an erased form of infection).
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The maximum isolation of the virus occurs in the first 5-6 days of the disease, the contagiousness depends on the severity of catarrhal symptoms and the concentration of the virus in the secretion of the mucous membrane of the respiratory tract.
Updated: May 13, 2023
Influenza A virus is also isolated by sick pigs, horses and birds. One of the modern theories suggests that migratory birds play a certain role in the spread of the influenza virus on a global scale, mammals serve as a reservoir of infection and contribute to the formation of new strains that can subsequently infect humans. The mechanism of transmission of influenza is aerosol, the virus spreads by airborne droplets. Excretion occurs with saliva and sputum (when coughing, sneezing, talking), which in the form of a fine aerosol spreads in the air and is inhaled by other people. In some cases, it is possible to implement a household contact route of transmission (mainly through dishes, toys).
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Human natural susceptibility to the influenza virus is high, especially for new serotypes. Immunity is type-specific, its duration reaches 1-3 years in type A influenza, 3-4 years in type B. Breastfed babies receive antibodies from the mother, but often this immunity does not protect against infection. The prevalence of the influenza virus is ubiquitous, epidemics regularly break out, often on a global scale. The incubation period of influenza usually ranges from several hours to three days, the onset is predominantly acute, the course can be mild, moderate, severe, with or without complications.
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The development of intoxication syndrome begins from the first hours of the disease, body temperature can rise up to 40 degrees, chills, headaches and dizziness, general weakness are noted. There may be moderate myalgia and arthralgia, convulsions, impaired consciousness. The intensity of the intoxication syndrome determines the severity of the course of uncomplicated influenza and can vary widely, from moderate malaise to an intense febrile reaction, central vomiting, convulsions, confusion and delirium.
The clinical picture of influenza is represented by three main symptom complexes. intoxication, catarrh and hemorrhage. The fever often proceeds in two waves, the symptoms usually begin to subside by the 5th-7th day of illness. When viewed during a febrile period, hyperemia of the face, hyperthermia and dry skin are noted, tachycardia is detected, and some decrease in blood pressure is possible. Catarrhal symptoms appear soon after the development of intoxication (sometimes it is weakly expressed or may be completely absent).
Patients complain of dry cough, discomfort and soreness in the throat and nasopharynx, runny nose.
The clinic of laryngitis and bronchitis can be shown. hoarseness of voice, rawness behind the sternum with a dry, growing in intensity, straining cough. On examination, slight hyperemia of the pharynx and posterior pharyngeal wall, tachypnea are sometimes noted. In 5-10% of cases, influenza can contribute to the development of a hemorrhagic symptom. In this case, small hemorrhages in the mucous membrane of the oropharynx, bleeding from the nose join the catarrhal phenomena.
With the development of severe hemorrhage, it may progress to acute pulmonary edema. Influenza is usually not accompanied by symptoms from the organs of the abdominal cavity and small pelvis, if such a clinic takes place, then it is predominantly neurogenic in nature.
Intestinal disorders in influenza in young children are associated with intoxication syndrome. Diarrhea with influenza in adults most likely indicates the presence of chronic diseases of the digestive system, provoked by an exacerbation of the infection. The duration of the flu on average does not exceed 3-5 days, then sometimes general asthenia persists for several days. Cases of an atypical course of influenza, mild, erased forms, as well as an infection combined with other viruses have been noted.
Influenza can be complicated by a variety of pathologies both in the early period (usually caused by an attached bacterial infection) and later. Severe complications of influenza usually occur in young children, the elderly and debilitated individuals suffering from chronic diseases of various organs.
Quite rarely, with extremely severe intoxication, influenza is complicated by a severe, life-threatening condition - acute hemorrhagic pulmonary edema. At the same time, there is a sharp increase in difficulty breathing, and cyanosis, bloody foamy sputum is released. The result of acute hemorrhagic pulmonary edema is progressive respiratory failure and hypoxic coma, often leading to death.
Accession of infection during the course of influenza most often contributes to the development of pneumonia, the lungs are affected mainly by streptococcal and staphylococcal flora, pneumonia of this etiology proceeds with a tendency to destruction of the lung tissue, can be complicated by pulmonary bleeding, edema, provoke infectious toxic shock. After neAfter pneumonia, residual effects in the form of bronchiectasis and pneumosclerosis often persist. Influenza can contribute to the development of otitis media, as well as be complicated by sinusitis, sinusitis, frontal sinusitis.
On the part of other organs and systems, nephritis, pyelocystitis, myositis, inflammation of the heart sac (pericarditis) can be noted. Complications of the heart with influenza is considered to be the cause of an increase in the frequency of myocardial infarction during the epidemic, the development of acute cardiovascular insufficiency. In pregnant women, influenza can cause spontaneous abortion or fetal death. Preliminary diagnosis is carried out on the basis of the clinical picture and rapid diagnostic data of RNIF or ELISA (detection of influenza virus antigen in swabs taken in the nasal cavity), serological diagnostic methods serve as confirmation of the diagnosis. an increase in antibody titer is determined using RTGA, RSK, RNGA, ELISA. More than a fourfold increase has diagnostic value.
If pneumonia is suspected, a patient with influenza may need to consult a pulmonologist and have an X-ray of the lungs taken.
Influenza is treated mainly on an outpatient basis, hospitalizing only patients with severe and complicated forms of infection. In addition, children from orphanages and boarding schools are subject to hospitalization. For the period of fever, patients are recommended bed rest, plenty of fluids, a balanced, complete diet, and vitamins. As a means of etiotropic therapy in the first days of the disease, rimantadine is prescribed (has contraindications. age up to 14 years, pregnancy and lactation, pathologies of the kidneys and liver), oseltamivir. Late appointment of antiviral agents is ineffective. Interferons may be recommended. In addition to antiviral therapy, vitamin C, calcium gluconate, rutin, antipyretic, antihistamines are prescribed.
With the development of complications from the ENT organs, an examination by an otolaryngologist with oto- and rhinoscopy is necessary. The severe course of influenza often requires detoxification measures (parenteral infusion of Hemodez solutions, rheopolyglucin) with forcing diuresis. Eufillin, ascorbic acid, diphenhydramine are often added to detoxification solutions. With developing pulmonary or cerebral edema, the dosage of saluretics is increased, intravenous prednisone is prescribed, and the necessary intensive care measures are taken. Developing cardiovascular insufficiency is an indication for the appointment of thiamine pyrophosphate, sulfocamphoric acid with procaine, potassium and magnesium preparations. At the same time, the necessary correction of the internal acid-base homeostasis is carried out, the airway patency is controlled.
Forecast and prevention of influenza. Mostly the prognosis of influenza infection is favorable, recovery occurs in 5-6 days. The deterioration of the prognosis causes a severe course in young children, the elderly, the development of life-threatening complications. The prognosis of the course of pregnancy is unfavorable - the flu quite often provokes its termination. Currently, measures have been developed for the specific prevention of influenza, which is carried out in relation to the most common strains.
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The multiantigenic structure of influenza epidemics does not allow vaccination to completely eliminate the possibility of influenza, but the sensitized organism tolerates the infection much easier, the risk of developing severe complications in immunized children is significantly reduced. It is advisable to get vaccinated against influenza a few weeks before the predicted epidemic period. Anti-influenza immunity is short-term, it is desirable to immunize every year.
General prevention during periods of mass epidemics includes the usual measures to prevent the spread of infections transmitted by airborne droplets. Personal prevention consists in avoiding contact with patients, crowded places, wearing a gauze mask that covers the respiratory tract, taking prophylactic antiviral drugs in case of a risk of infection, as well as measures aimed at strengthening the immune properties of the body. The article was prepared by a specialist for informational purposes only. We urge you not to self-medicate. When the first symptoms appear, consult a doctor.
For most people, flu symptoms resolve within a week without medical attention. But the flu can lead to severe illness and death, especially in people at risk. According to WHO estimates, annual influenza epidemics lead to 3-5 million cases of severe illness and 390-650 thousand deaths. Only in Russia every year doctors register about 27 million sick people. The recovery period is 7-15 days.
Periodically spreads in the form of epidemics and pandemics.
Influenza is an acute respiratory infection caused by the influenza virus. Included in the group of acute respiratory viral infections (ARVI). Type A (has subtypes A1, A2). Almost all known epidemics, influenza pandemicsa are caused by the type A influenza virus. It has many serotypes that can infect humans and animals. A variety of subtypes cause bird and swine flu. The DNA of the virus can change rapidly, so each season there are flu strains that differ from those previously known.