influenza nostras: Description, Causes and Risk Factors:
Influenza, usually of a less severe type, occurring with some degree of regularity during the winter season, especially in larger Cities.
Influenza nostras is a disease resembling in its general pandemic influenza but is usually of less severe type, occurring with more or less regularity during the cold season especially in larger Cities. One thing is sure, once it starts in any country, it takes a Global tour.
The two types of Influenza nostras viruses capable of causing significant illness are termed influenza A &B
. Both these virus types are able to cause annual winter epidemics of varying size and severity, but only Influenza nostras A viruses have the ability to cause a pandemic. Influenza A & B viruses are continually altering through a process of random mutation, every few year this can result in significant epidemic. Influenza A can change substantially leading to a new subtype with the potential to cause a pandemic. This can be as a result of re-assortment of genes between differential influenza viruses, or though direct transmission of an avian virus to humans.
Affecting persons are usually between age of 15 and 40. It has been found that in pandemics the disease is usually more severe in young and otherwise healthy adults than in infants and the aged. It attacks both the sex and incubation period is 1-5 days. Mode of infection is droplet.
Although no figures exist in many parts of the world, the pandemic is estimated to have infected 50% of the world's population; approximately 25% suffered clinical infection and the total excess mortality was between 40-50 million. There are reports of people walking up well in the morning, but dying by the nightfall.
In many cases recovery is not always complete within a few days; many patients exhibit a rather marked "post-infection asthenia" characterized by weakness, dizziness, easy fatigue, palpitations, and anorexia.
- Muscular pain.
- Loss of appetite.
- Coated tongue.
- Pulse is rapid.
- Cough - harsh, unproductive, and dry.
After short incubation say one or two days, at the most three, there is a felt of sudden malaise, headache, pain in the back and limbs, anorexia, and may be there is nausea and vomiting. Fever is usually 39 C - remits for two or three days with chills and shivering but there is seldom any rigor. Face is flushed, conjunctivae is suffused and hyperemic fauces - with very prominent lymphoid follicles.
During an endemic influenza, diagnostic virology laboratories will have a major role to play in patient management and surveillance, especially in the early phases of the endemic. Preparation to meet this demand has been under way for some time. The infrastructure that will allow the laboratories to provide same-day diagnosis for a greatly increased number of specimens is being developed and is expected to be able to meet the needs of the province in the event of an endemic. Once an endemic occurs, the diagnostic process, from collecting specimens to reporting results, will continue to be refined as the endemic strain of the virus and its clinical impact become better characterized, and ongoing coordination at the International level will keep the laboratories up-to-date on any new tests and algorithms that will require implementation.
Testing for endemic Influenza nostras will be determined in response to the phase of the endemic. Conventional immunospecific tests such as immunofluorescence microscopy and point-of-care tests are appropriate in the absence of specific risk factors. Isolation in cell culture continues to be performed by virology laboratories unless there are strong risk factors such as travel from an endemic country and direct contact with poultry or persons infected with the Influenza nostras virus. If risk factors are present, isolation in cell culture must be performed in a high containment biological safety level 3 (BSL-3/P3) laboratory. Nucleic - acid-based tests such as RT-PCR are considered ideal for the diagnosis of influenza, its differentiation into types A and B, and determination of the serotype. For patients with risk factors for having acquired the H5 virus, the diagnosis of influenza and determination of its H-type (H1, H3, H5, H7) can readily be accomplished in 1 day. In general, a preliminary discussion with a medical health officer is required for such cases.
Antiviral treatment should be based on clinical judgement. It should especially be considered: - early for patients with influenza who are at higher risk of severe outcomes, including pregnant women or recently pregnant women, people with underlying medical conditions, very young children (under 5), and people with morbid obesity; or - for patients with more severe influenza or whose condition begins to deteriorate. In adult cases in the community, antiviral treatment should begin within 48 hours of the onset of symptoms, or after discussion with an Infectious disease, respiratory or general physician. For hospitalized cases this policy may be varied on a case-by-case basis. For children aged five years or less, treatment can be initiated up to five days from the onset of symptoms.
Tamiflu™ is the first line antiviral treatment. The first dose should be given with food to reduce the incidence of nausea and vomiting. The standard adult (treatment) dose is 1 x 75 mg capsule twice daily for five days. RelenzaSM
should be used only where Tamiflu cannot be taken or cannot be tolerated, or the case or contact has renal impairment. The standard adult (treatment) course is 2 x 5 mg blisters (two inhalations) twice a day for five days.
Other Preventive Measures:
Symptomatic measures may afford relief.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
- Steam inhalations give relief.
- Cough syrup with or without codeine or morphine are often given.
- Bed rest is primary importance, the sooner, the better.
- In order to avoid complications like pneumonia the patient should under all circumstances be protected from a draught of air. However, the room should be well ventilated.
- Diet should be liquid - hot and sweetened. Hot milk, fruit juice, and nourishing soup.
- The patient should not be given bath since it causes further chilling, particularly the chest and head.
- To avoid droplet infection, all the expectorations should be received in a pot and the excretions should be incinerated.