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  • Rinovirus infection - Causes, symptoms and treatment. MF.

    Rhinovirus infection is an acute infectious disease caused by viruses that primarily affect the nasal mucosa, with a weakly intoxicating.

    The causative agent is attributed to the family of picornaviruses( Spanish pico-small, with English RNA-RNA) because of its small size, the presence of RNA and the absence of an outer shell. The latter fact makes it relatively unstable in the external environment and rapidly amenable to inactivation under the action of adverse factors. There is no general group antigen, as for example in parainfluenza, each serotype( type of virus from this family) has its virus neutralizing and complement-binding antigen( ie for each type of virus, the body tries to isolate its type of antibodies).

    Relatively unstable in the external environment, especially rapidly inactivated in the acidic environment of the stomach, quickly die with heating / drying / disinfectants, but are stable at minus temperatures and for a long time, ie, closer to 0 ° C, they are more destructive than negative temperatures, alsoresistant to ethers.

    Causes of rhinovirus infection

    Source - sick person or virus carrier. The transmission path is airborne, contact( direct contact) or contact-household( through household items).Outbreaks develop during the cold and damp season( autumn and spring), and therefore have a two-wave character and occur more often in small closed collectives, such as the family, kindergartens. Susceptibility is high, all age groups become ill. Also, the height of susceptibility will depend on the premorbid background, that is, the presence of risk factors, the immune status of the patient in contact, and the duration of contact.

    Symptoms of rhinovirus infection

    The incubation period( from the moment of introduction of the virion, to the first clinical manifestations) is 1-5 days. The entrance to the virion is the nasal mucosa, and it is there that the inflammatory focus is formed, accompanied by catarrhal manifestations after the expiration of the incubation period and the onset of the prodromal period: a gradual onset with a rise in temperature to 38 ° C, cognition, edema of the nasal mucosa, hypersecretion( abundant discharge from the nose first mucous, and a few days later - more dense) and the growing symptoms of intoxication, followed by a weak current.

    Also, as with other SARS, from the first hours there are catarrhal phenomena: sneezing, choking in the throat and difficulty in nasal breathing. The wings of the nose are hyperemic( red) and the skin is macerated( scaly), especially on the threshold of the nose. There is an injection of conjunctival vessels and a sclera, that is, small vessels appear on the belly of the eye, like after a long sitting behind the monitor), accompanied by lacrimation.

    In summing up: the main target tissue for rhinovirus is the nasal mucosa, therefore, hyperemia, swelling of the mucosa with copious discharge, hyperemia of the wings of the nose and flaking of the skin on the threshold of the nose will come to the fore;and because of the anatomical connectivity of the nasolacrimal canal with the inferior nasal concha, the virus quickly penetrates the external structures of the eyes, therefore a response occurs from the sclera and conjunctiva.

    Diagnosis of rhinovirus infection

    1. Objectively and as a result of the survey - pronounced rhinitis, with moderate intoxication( ie moderate malaise, low temperature).
    2. A virological method with taking a material from a nose wash collected in 1 day or no later than 5 - in these biological materials reveals an infectious agent.
    3. Serological methods - neutralization reaction( RN) - detection of qualitative and quantitative determination of the causative agent and counteracting factors( antibodies, antitoxins)
    4. general assays( OAB and OAM) are poorly informative and will only indicate the inflammatory picture( OAK) orcomplications / decompensation of the renal-tuberculosis system( OAM)

    Usually, rhinovirus infection is not differentiated with other ARVI, that is, they diagnose ARVI and treat as well as other ARVI.

    Treatment of rhinovirus infection

    Because of similar symptoms with other acute respiratory viral infections, the choice is made in favor of broad-spectrum virocidal drugs, narrow-spectrum can and should be used only after confirmation of the alleged diagnosis. In all respiratory infections( influenza, parainfluenza, RSI, rhinovirus, adenovirus, enterovirus and coronavirus infections), the principle of treatment is the same.

    1. Etiotropic therapy( directed against the causative agent):
    - Arbidol( inhibits the fusion of viruses with epithelial cells).It is shown from 2 years, from 2-6 years on 2 tablets a day before meal, from 6-12 years on 4 tablets, from 12 years - on 8 tab. Take before meals for 5 days.
    - Ribavirin( virazol).It is prescribed for children over 12 years in a dose of 10 mg / kg / day, for 5-7 days
    - Isoprinosin.50 mg / kg and the divided dose divided into 3 receptions within 10 days, taken after meals.
    - For topical application Oksolinovaja ointment intanazalno( in a nose), Bonafton, Lokferon.

    2. Interferons are immunomodulators that have universal virocidal properties, because they suppress the reproduction of viruses, and also stimulate the immunological reactions of the body.
    - Interferon-α 5 drops every 30 minutes for 4 hours, in the following days - 5 times a day for 5-7 days.
    - Viferon in candles - 2 candles per day.

    3. Interferonogenesis inductors - immunostimulants.
    - Cycloferon. From 4-6 years, 1 tablet, 7-11 years - 2 tablets, adult 3 tablets.
    - Anaferon. Assign to children from 6 months of age: in the first day 4 tablets, after - 1 tablet 3 times a day. Course 5 days.

    4. Symptomatic treatment:

    • antipyretic drugs( Ibuprofen, Nurofen),
    • antitussives are prescribed taking into account the nature of the cough and its localization( with laryngitis at the time of parainfluenza - Sinecod, Stoptusin, Tusuprex, if the process descended lower and the cough acquired a different character, then appointexpectorants, mucolytics),
    • anti-inflammatory - Erespal,
    • from the common cold are washed with AquaMaris or weak saline solution,
    • to remove puffiness - Pinosol or Xylen.

    If the treatment does not give positive dynamics for 3 days and the temperature continues to rise, reaching critical figures, then after consultation with a doctor, they switch to antibiotic treatment.

    Treatment with folk remedies

    Antimicrobial and anti-inflammatory drugs: St. John's wort, chamomile, sage, eucalyptus, calendula. Antiviral / antibacterial: garlic, onion, raspberries, blackberries, Echinocice, grenade puppies( the strongest antibacterial properties to which there is no stability).Sweating / antipyretic: linden, raspberry, mother and stepmother. Expectorants: mother and stepmother, quince, oregano, licorice, breast-feeding №1.Spasmolytic effect on the bronchi: chamomile, dill, breast collection number 1.

    Treatment of herbs for preschool children without doctor's supervision is unacceptable. Especially dangerous is the complication, such as the development of the croup - the triad of symptoms, the leading of which is asphyxiation, in which case immediate hospitalization is necessary.

    Complications:

    Complications are rare and are associated with exacerbation of chronic or attachment of secondary bacterial flora with further development of sinusitis, frontalitis, etmoiditis, otitis, and angina. In young children, the risk of spreading to the mucous membrane of the trachea and bronchi is high, with the development of tracheobronchitis, a mixed viral-bacterial infection is more common than in adults, the intoxication syndrome is more severe.

    Prevention of rhinovirus infection

    Drugs used for treatment, but in preventive dosages.

    • Arbidol with 2-6 years for ½ tablets 30 minutes before or after meals, up to 12 years - 1 tablet, after 12 years - 2 tablets. The course of admission is 2 weeks.
    • Interferon-α.Ampoule dilute warm water to the mark and dial with a pipette, then 2-3 times a day dig in the nose, trying to get to the back of the pharynx, there is the concentration of lymphoid tissue, and not on the back of the nose.
    • Cycloferon, Echinocice - the same immunal, but cheaper. Add a few drops to the tea.

    Also patients should be isolated for 7-14 days. Two-time wet cleaning with disinfectants is carried out. For the patient, separate dishes are allocated. A good prevention of viral and bacterial diseases is a full breakfast, because thus the antibodies are activated and there is a slight sensitization of the organism to foreign agents. Specific prevention in the form of vaccination - no.

    Therapist doctor Shabanova I.Е.