• Colds - Causes, symptoms and treatment. MF.

    Cold is the "popular" name for a large group of acute respiratory infections caused by numerous pathogens( viruses, bacteria) that are common and susceptible.

    Most of us think the cold is a minor health disorder that does not require treatment for medical help that does not have consequences. Many seriously associate this "misunderstanding" only with hypothermia. The bulk of workaholics and do suffer a cold "on their feet", preferring to work at home. At the same time, one should not forget that is always the infectious agent at the heart of the common cold - that is, the causative agent, and without it, no symptoms of a cold will simply arise .It must be remembered that any cold in the absence of a regimen and proper care can lead to complications that will require a hospital stay, and sometimes a complex complex of resuscitation measures.

    According to WHO, a person gets colds three times a year, a schoolboy - about 4 times a year, and a preschool child - up to 6 times per year. Mortality with colds varies from 1 to 35-40%, depending on the age of the patients, the type of pathogen and the timing of seeking medical help.

    Cold causes

    More than 90% of all acute respiratory infections are caused by viruses, about 10% are caused by bacteria and other pathogens.

    1. viruses are noncellular lifeforms containing a genetic material-nucleic acid( RNA or DNA) that have the ability to attach to human cells, penetrate inside, integrate into the genome of the cell, multiply through it, and upon the release of a new virion, the cell dies.
    1) family of orthomixoviruses( influenza A viruses( H1N1, H3N2), influenza B virus);
    2) family of paramyxoviruses( parainfluenza viruses of 4x serotypes, respiratory syncytial virus);
    3) family of coronaviruses( 13 types of respiratory and enteral coronaviruses);
    4) a family of picornoviruses( 113 serotypes of rhinoviruses, Coxsackie enteroviruses, some types of ECHO enteroviruses);
    5) family of reoviruses( 3 serotypes of orthoreoviruses);
    6) family of adenoviruses( 47 serotypes of adenoviruses).
    7) herpesviruses( herpes simplex virus - type 1, cytomegalovirus - type 5, Epstein-Barr virus - type 4)
    Some viruses( mainly RNA-containing) have the ability to mutate - to change. Some DNA-containing viruses( adenoviruses) can persist in the body for a long time and cause a chronic infection. Most of the viruses are unstable to high temperatures, they are resistant to freezing and drying.

    2. Bacteria
    1) Conditionally pathogenic flora( representatives of the normal composition of the mucous membranes of the nasopharynx, respiratory system, intestines) - staphylococcus aureus, streptococcus, enterococcus and others.
    2) Pathogenic flora( pneumococcus, hemophilic rod, Staphylococcus aureus, Klebsiella, Escherichia coli)
    Features of bacteria: the ability to cause purulent inflammation of affected systems and organs( nasopharyngeal mucosa, sinuses of the nose, respiratory system).They are extracellular, sensitive to antibacterial therapy.
    3. Other pathogens( legionella, chlamydia)

    Causes of colds

    Source of infection: is more often a patient with symptoms of a cold, sometimes a carrier of a virus( adenovirus, etc.) or bacteria( pneumococcus, hemophilia, staphylococcus).The maximum infectiousness in the first days of the disease, however, the infectious period can begin 1-2 days before the onset of cold symptoms and lasts 1.5-2, and sometimes even more weeks( for example, adenovirus infection).

    The path of infection - airborne( when sneezing and coughing with microparticles of mucus of the nasopharynx, sputum is infected with others).Less common is the contact-household way( in the dried mucus of the nasopharynx and sputum, viruses can last a long time to survive on household items).

    Factors predisposing to the common cold:

    Any cold occurs when the local immunity in the nasopharynx and oropharynx is reduced. This occurs with: frequent colds;hypothermia, which contributes to the creation of a comfortable habitat for colds;stressful situations.

    Risk groups for the occurrence of severe forms of colds: children of early age( up to 3 years);people over 65;persons with chronic diseases;persons with immunodeficiencies( oncological diseases, blood diseases, patients after removal of the spleen, HIV infection).

    Symptoms of a cold

    1. The temperature of is one of the main symptoms of a cold, according to which it is impossible to tell which pathogen caused the disease. The temperature is caused by the action of antigens of pathogens and their toxins on the center of thermoregulation, which is located in the brain( or rather, the hypothalamus).The temperature response depends on the human immune system; in some patients, the temperature is low-grade for the whole period of illness( 37-38 ° C), and in some cases it rises to febrile figures( 38-40 ° C) from the first hours of the disease.

    The danger of fever is that at hyperpyretic temperature( above 40-41 ° C) one of the most serious complications is possible: neurotoxicosis( in children) and infectious-toxic encephalopathy in adults( cerebral edema with loss of consciousness, hemodynamic disorders-pressure drop). The risk group for this complication is children under 3 years old and elderly patients.
    There is an "unspoken rule": maintaining a high temperature for more than 3 days is either a sign of the development of one of the complications, or a sign of another disease( not a cold).

    How to prevent complications: when febrile fever occurs( 38 ° and above), it is necessary to take antipyretic and follow the dynamics of temperature. If there is no effect( reducing fever or retaining it on previous figures), call a doctor. A terrible symptom is the appearance of marked excitation of the patient at a temperature of 40 ° and above;soon the children may suffer from convulsive syndrome and loss of consciousness.

    2. Symptoms of intoxication with cold - mandatory temperature satellites. This weakness, lethargy,
    dizziness, muscle pain, nausea, decreased appetite, redness of the skin of the face, neck. Myalgia( muscle pain) is a characteristic sign of influenza infection. These symptoms are due to the toxic effect on the tissues of toxins of cold causative agents. The severity of symptoms of intoxication directly depends on the height of the temperature reaction. With a decrease in fever, symptoms decrease. To help yourself at the moment you can follow the diet and drinking regimen( see below).

    3. Nasal congestion and / or rhinorrhea is a symptom of the common cold. Nasal congestion can be both an independent symptom( as in the case of influenza) of colds, and an initial sign that subsequently goes to rhinorrhea( swelling of the mucus of the nose).Causes - swelling and inflammation of the nasal mucosa followed by effusion( the appearance of mucus).Usually at this moment a protective mechanism is triggered - sneezing, with the help of which the nasal cavity is cleansed from mucus with infectious agents and products of their vital activity. Most often, in viral nature, colds from the nose have a mucous, transparent, viscous character. If there is a bacterial component of the infection, a yellowish-greenish tinge of mucus appears. Such a symptom requires a systematic toilets of the nasal passages and the use of vasoconstrictive drugs, and for bacterial reasons - drops with antibiotics.

    One of the unpleasant complications of the common cold is the occurrence of an inflammatory process in the sinuses of the sinuses - maxillary sinus( sinusitis), frontal sinuses( frontal) , etc. In this period there are pains in the affected areas( right and left of the nose, in the nose), nasal voice, nasal congestion becomes pronounced. In this case, it is already pointless to delay the visit to the doctor, since antibiotic therapy is required.

    4. Headache is a common symptom of the common cold. Headache can be local( when the whiskey, frontal region hurt), but can be spilled, intense( at high temperature).With complications( sinusitis, sinusitis, frontalitis), pain can be in the forehead and nose, aching and almost constant. If the pain becomes a character of pulsating pain, then you need to think about another reason for it, not about the common cold( only the doctor can determine). Analgesics and complex antipyretic agents can help with headaches.

    5. Sore throat and perspiration is a sign of oropharyngeal involvement. It does not occur with any cold. Pain can be minor( more often with a viral infection), but can be intense( bacteria).When this symptom appears, the patient can not swallow, food intake causes significant difficulties. When examining the pharynx, reddening of the tonsils, arches, tongue, posterior pharyngeal wall, tonsils usually grow in size, the relief will be smoothed out, looking spherical in appearance. If there is a virus infection, there will not be any overlays on the tonsil surface, if it's a cold caused by bacteria, then you can see whitish-yellowish overlays in the lacunae of the tonsils( like islands), which later merge. If you see any overlap, you must visit a doctor! If this is not done, then the purulent process will spread, there may be swelling of the pharynx and difficulty breathing. If there are no overlaps, the help to the sore throat is reduced to taking anti-inflammatory sprays with a certain periodicity. If there are overlays, then antibiotics are required, which only a doctor will prescribe!

    6. Cough for cold can be as dry without sputum( for example, with influenza, parainfluenza), moist with sputum unproductive( sputum leaves with great difficulty) and productive( well-departed sputum).Sputum when coughing can be transparent, viscous( with viral damage), with a yellowish component( hemophilia rod, pneumococcus) or greenish color( often staphylococcus).Dry cough can be "barking", which indicates the defeat of the larynx( influenza, parainfluenza). In young children( up to 2-3 years of age) with the appearance of such a cough, one of the most serious complications is possible - "false groats" - due to inflammation and edema of the laryngeal mucosa, the laryngeal lumen narrowing, and the child begins to suffocate .This complication usually begins late in the evening or at night, requires resuscitation. Therefore, cough in young children is only necessary under the supervision of a pediatrician!

    Such a symptom as a cough requires the appointment of expectorant and anti-inflammatory drugs. Preparations that suppress cough, take without a doctor's appointment is strictly not recommended! Their use can lead to stagnation of the inflammatory process, the "lowering" of inflammation in the lower parts of the lungs and the development of pneumonia.

    The addition of a bacterial component in the common cold and the appearance of a cough with yellowish-greenish sputum requires mandatory doctor intervention and the administration of specific antibiotics.

    7. Chest pain ( more often with coughing).Minor pain in coughing can be associated with intercostal muscles. However, if there is pain in the depth of the chest with coughing, deep inspiration, this may be due to pneumonia, which requires an urgent call to the doctor. A sharp pain in the chest can appear with inflammation of the lung tissue and complication with pleurisy( inflammation of the pleura).Any severe pain in the chest - an occasion for treatment to the doctor.

    8. The rash on the body of is rarely seen with colds. These can be minor hemorrhages, pinpoint hemorrhages( petechiae). Such a rash indicates the attachment of the vascular component for colds( often this is the case with the flu) and requires the call of a doctor .

    So, summarizing all of the above, the reason for going to the doctor for a cold should serve:

    1) the early child's age of the patient( up to 3 years, especially nursing infants);
    2) non-buoyant temperature over 38 ° for more than 3 days;
    3) intolerable headache, pulsating local headache;
    4) the appearance of a rash on the trunk and extremities;
    5) the appearance of a bacterial component of secretions( yellowish and greenish color of mucus from the nose, phlegm, severe pain in the throat), barking cough;
    6) the appearance of severe weakness and pain in the chest when coughing;
    7) elderly patients over 65 years of age;
    8) persons with chronic bacterial foci( chronic bronchitis, sinusitis and others);
    9) people with concomitant diseases( onco-, hematological patients, hepatic, renal pathology).

    Children with cold may have abdominal pain, but since this symptom can also indicate life-threatening conditions - it is urgent to see a doctor!

    Help with cold before calling a doctor

    You can not treat colds for certain symptoms, but the recommended drugs for a particular symptomatology will be given below. Treatment includes:

    1. Therapeutic regimen, correct high-grade medical food, and also reception of multivitamins.

    Hospitalizations in the hospital are subject to children and elderly people with moderate and severe forms of the disease, adults with severe forms of cold. In other cases, the home treatment regime, when cold symptoms appear, go to work and to other places of congestion is not recommended to avoid infection of others. The whole feverish period at home is a bed rest. The well-known commandment: "The cold should be lying in bed" is actual and to this day.

    Diet therapy for colds is reduced to a full-fledged diet with the goal of strengthening immunity, the prompt removal of toxins from the body, for which food should be taken in a warm form with the exclusion of fatty, fried, spicy dishes. Should be observed drinking regime to reduce intoxication( berry fruit drinks, dog rose, lemon and honey water).
    Vitamins( baby vitrum, junior, kids, teenager, complex, multitabs immuno diet from 4 years of multtabs immuno plus from 12 years, jungle, biovital kidsnapravit for colds, complim, supradin and others).

    2. Etiotropic therapy( antiviral chemotherapeutic and biological agents, antibacterial drugs) .
    In the case of a viral cold, the following antiviral agents are prescribed( Tamiflu, Relenza, Imixin, Kagocel, Remantadine, Ingavirin, Vovironum, Viferon), immunomodulating agents( arbidol, ocilococcinum, immunal, derinat, anaferon, aflubin, influicide).
    For a cold of bacterial etiology, antibacterial preparations of various groups( amixiclav, augmentin, azithromycin, fluoroquinolones depending on the affected area, the age of the patient, concomitant diseases), and also immunostimulants( immunon, IRS-19).

    The vast majority of antiviral and antibacterial drugs are prescribed exclusively by the doctor after the examination of the patient. Self-medication in this case threatens more pronounced immunodeficiency and the development of complications.

    Of the relatively safe immunomodulators for colds, one of the following drugs is recommended:

    • Anaferon is an adult and children's one-month-old tablets for resorption( activate local protection in the oropharynx): 1st day - first 2 hours every 30 minutes, then 3 morereception at regular intervals, from 2 days 1 tab 3 times a day 8 hours before complete recovery. To small children to dissolve a tablet in 1 item of l.water.

    • Grippferon drops to adults and children from birth( contains highly active interferon 2nd generation, which significantly affects the immunity of the patient) 2 drops in each nasal passage to children up to 3 years 3 times a day, from 3 to 14 years - 4 times a day,adults - every 3-4 hours before the disappearance of cold symptoms.

    • Immunal drops to adults and children from 1 year( extract of echinacea stimulates the defenses of the body) - from 1 year to 6 years - 1ml 3 times a day, from 6 to 12 years - 1.5 ml 3 times a day;with 12 years and adults - 2.5 ml 3 times a day. The course of treatment is 14 days. Also appeared immunall in tablets from 4 years of age: 4-6 years - 1 tab 2 times a day, 6-12 years - 1 tab 3 times a day, from 12 years and adults - 1 tab 4 times a day. The course is the same as the drop.

    • Aflubin drops and tablets( homeopathic preparation) has immunomodulatory, antiviral, antipyretic effects. It is prescribed: 1-2 days of illness - before meals for children up to a year - 1 drop or ½ tab.3-8 times a day;from 1 year to 12 years - 5 drops or ½ tab.3-8 times a day;adults -10 drops or 1 tab.3-8 times a day. From the 3rd day of the illness the same dosages but 3 times a day for 10 days.

    Patients with chronic bacterial foci( chronic sinusitis, sinusitis, tonsillitis, bronchitis, otitis) are recommended bacterial immunostimulants:

    • Immudone( activates local defense against bacteria in the oropharynx) in tablets from 3 years of age: 6 tablets are taken per day at intervals of2 hours for all ages( tablets are absorbed).The course of treatment is 20 days. Children from 3 to 6 years absorb tablets under the supervision of adults!

    • IRS-19( the goal is activation of local immunity against bacteria in the nasopharynx) in the form of a spray from 3 months of age: 1 injection in each nostril 2 times a day for all ages for 2 weeks.

    3. Pathogenetic therapy ( correction of protective functions of the body, desensitizing treatment, bronchodilators, anti-inflammatory drugs).Treatment is appointed by a doctor and mainly in a hospital.

    4. Symptomatic treatment of ( decrease in the severity of cold symptoms)
    With temperature and headache take combined antipyretic analgesic effect:
    - koldreks( tablets, powders, syrup) from 12 years: 1 pack after 6 hours,that is, no more than 4 times a day. Course - 1-3 days. Coldrex junior from 6 to 12 years: 1 packet after 6 hours. Course 1-2 days. Tablets from 6 years: 6-12 years for 1 tab, from 12 years - 2 tablets 4 times a day. Course 1-2 days. Syrup koldreks nayt from 6 years: 6-12 years 10 ml, from 12 years - 20 ml at night. The course is 3 days.
    - teraflu sachets from 15 years: 1 packet 3 times a day. Course 1-3 days.
    - similar action and doses have powders: fervex, influoflu, collamation, lemsyp, rinsasip.
    - panadol tablets from 12 years( 2 tab 4 times a day), efferlangan effervescent tablets from 15 years( 1-2 tablets 4 times a day);
    Children are recommended: - Panadol syrup with 3 months: a detailed dosage table by months in the instructions. The course is not more than 3 days.; - Efferalgan syrup from 6 months: 6-12 months - ½ scoop 3 r / d, 1-3 years - 1 l.lozhka 3 r / d, 3-6 years - 1 l.lozhka 4 r / d. The course is 1-3 days.; - Nurofen syrup from 6 months: a detailed table of the dose by months in the instructions. During the day no more than 3 times! Course 1-3 days.

    If the rhinitis and / or congestion of the nose is pronounced, vasoconstrictive drops in the nose are recommended:
    - Nazel - spray is comfortable, 2-3 r / day is applied;
    - Nasol Advance - convenience in the form of a spray, contains essential oils, applied 2 r / day;
    - Nazivin - comfortable forms for adults, babies;
    - Tysin - drops, contain essential oils, effective with viscous nasal discharge.
    - Lazolvan spray nasal( dilutes the mucus of the nose).
    - Pinosol( oily solution) drops and spray.
    The peculiarity of taking vasoconstrictive drops in the nose: the course should not exceed 5-7 days, otherwise the drugs will cease to function, and the nasal mucosa atrophies.
    Recommendations of pediatricians: for children under 18 months( 1.5 years), it is desirable to use saline solutions instead of vasoconstrictive drops: aqua-maris, otrivin sea, saline, baby alkaline, quix.after a year you can take a baby.

    When coughing , the following drugs are recommended:

    a) Combined preparations( anti-inflammatory, expectorant, suppressive cough) - with dry cough:
    - tussin [syrup] - for trachitis - adults and>12 years - 2-4 tsp.3-4 p / d;2-6 l - 0.5-1 tsp3 r / d, from 6-12 years - 1-2 tsp. The course is 7 days.; tussin plus syrup - 6-12 years - 1 tsp, from 12 years - 2 tsp.every 4 hours. The course is 7 days.
    - stoptussin - with a dry, irritating, difficult-to-repel cough;It is convenient in application in the form of drops, with 2хмес.Appointed by a doctor after the examination!
    - gedelix extract of ivy leaves, in syrup and drops, from 6 months of age;up to 1 year - 2.5 ml per day, 1-3 years - 2.5 ml 3 times / day, 4-10 years - 2.5 ml 4 times / day, from 10 years and adults - 5 ml 3 r /e. The course is 7 days. B) sputum-thinning medications:
    - ACTS-exists in several forms for convenience - powders, tablets, prolonged tablets, prescribed for children from 2 years( granulate for the preparation of syrup): doses for all forms - 100 mg( 1 h.l.) 2-3 az per day from 2 to 5 years, 3 r / d - from 5-14 years, adults 200 mg - 3 times a day. ATSTS long( 600 mg) - 1 tab per day( adults only).The course is 7 days.
    - lazolvan syrup and tablets: adults 1-2 tablets.3 r / d, the course is 14 days;syrup from 1 year: 1-2 years - 2.5 ml 2 r / d, 2-6 years - 2.5 ml 3 r / d, 6-12 years 5 ml 3 r / d, from 12 years - 10 ml3 r / d, the course is 14 days.
    - ambroben( ambroxol, ambrohexal) tablets from 6 years old, syrup from year( doses are the same as lazolvan).
    d) To improve the drainage function of the bronchi and increase the evacuation of mucus and sputum, warm, moist inhalations containing soda and solutions for inhalation( lazolvan special solution - from 2 years old), herbs. Inhalation is carried out up to 15 min 2 r / day for 4 days.

    c) protivokashlevye central action( sinecode, kodelak, terpinkod) have a pronounced antitussive effect, are prescribed only by a doctor!

    For sore throat and perspiration( anti-inflammatory pills): falimint, pharyngosept, hexoral, antiangin - are prescribed 1 tablet 3-4 times a day for 5-7 days. Also shown are anti-inflammatory sprays( hexoral, gum, tertum verde spray, bioparox) - one to two injections 3-4 times a day are prescribed.

    Pregnant women in case of a cold are recommended the following drugs: panadol at a temperature, aquamaris, pinosol for a cold, gedelix with a cough, solutions for rinsing - chamomile, eucalyptus.

    5. Folk remedies for colds: drinks from rose hips, cranberry cockles, linden with raspberries, raspberry with honey, propolis, fir oil, radish, garlic and honey - all these substances help to remove toxins from the body, prompt recovery.

    Severe complications of the common cold:

    1) Neurotoxicosis or infectious-toxic encephalopathy( cerebral edema, falling blood pressure) - at high temperature in the early stages - the second-third day of the disease;
    2) Infectious-toxic shock( at high temperature) - due to toxins of pathogens, hemodynamic disorders appear in the patient - lowering of blood pressure, faster pulse, hemorrhages on limbs;
    3) Meningitis, meningoencephalitis( damage to the shell of the brain and the brain itself);
    4) "False groats" - with a barking cough mainly in children up to 2-3 years old.
    5) Inflammation of the lungs( both in viral and bacterial colds), the nature of which can only be determined by a doctor.
    6) Purulent foci - sinusitis, sinusitis, frontalitis, otitis and others.
    7) With pneumonia - the development of pleurisy( inflammation of the membrane covering the lung).

    Cold prophylaxis

    I. Specific:( vaccination) is used for influenza( influenza plus, influywak, vaksgripp), pneumococcal infection( Prevenar 13 and Pnevmo 23), with hemophilic infection( Act-HIB).Immunological layers of people who are not susceptible to cold can be created only during vaccination.

    Barrier protection: oxolin ointment;nazaval plus spray( the so-called "invisible mask" from viruses and bacteria) is used from birth, in pregnant and lactating women - 1 injection 3-4 times a day - during the period of activation of cold infections;means for washing the nasopharynx( aqualor, physiomer, dolphin, otrivin sea, aquamaris, quix, marimer) - wash in the morning and in the evening.
    For emergency chemoprophylaxis of cold( immediately after contact with the patient) use:
    - remantadine at 100 mg 1 r / day during an epidemic outbreak,
    - arbidol 100 mg 2 r every 3-4 days for 3 weeks,
    - amixin1 table 1 time per week,
    - dibasol for ¼ table 1 p / day.

    Doctor infectious disease Bykova N.I.