Influenza, which we forgot about in the summer, reminding us that the winter season is coming. It can be distinguished from common cold diseases by the sudden onset of fever, headache, malaise and common muscle aches-symptoms in children. It has also caused him to call it the "rag disease" among the people because of the "feeling like a rag" in which the captured people felt so weak that they could not do their daily work. Patients who feel the need to rest because of the obvious weakness and muscle pain caused by the disease may have difficulty in getting out of bed. If we do not count the plague epidemics of the 13th century, influenza is one of the ancient enemies that caused the most mass loss of mankind. Therefore, an endless war has been going on between healthcare workers and influenza virus for hundreds of years.
There are 3 types of viruses in the influenza family according to their surface antigens; A,B,C type. Large outbreaks are caused by types A and B, while type C sporadically causes mild influenza-like illness in children. Vaccines contain both A and B type antigens. Seasonal influenza can also be differentiated as pandemic influenza.
Seasonal influenza can be seen between November and March every year, with peaks in December and February. If more than one strain is epidemic, the season can last as long as 4-5 months. Generally, A type peak season is experienced in December-January and type B peak season from February. A part of the population may be immune to seasonal influenza that occurs every year.
Pandemic influenza occurs with type A. In order for this to happen, it must undergo a large mutation, different from the mutation that occurs every year in the surface antigens Hemagglutinin and Neuraminidase proteins. This has happened 3 times in the 20th century, it is said to have caused states to stop the first world war (1918-1958 and 1968 pandemics). Such a virus catches the vast majority of people without immunity and causes a severe clinic. Finally, the pandemic in 2009 occurred with the H1N1 subtype and showed itself with high pediatric patient involvement. or resulted in the loss of people between 150 thousand and 450 thousand. Among the victims were the elderly, healthy babies, pregnant women, morbidly obese, neurology patients, immunocompromised individuals and individuals with organ failure. For example, H3N2 outbreaks often present a season with high fever and severe clinical findings.
School-age children and their families in contact with them are on the target board. Transmission begins one day before symptom and is high for the first 3 days. The incubation phase is 1 – 4 days. Droplet, contact with contaminated surfaces and prolonged time spent in closed crowded environments facilitate the spread of the virus.
The disease may cause severe clinical symptoms that require hospitalization in children younger than 2 years old. Symptoms last for 7-8 days, and the rate of antibiotic prescription increases in all age groups in these 7-8 days.
There are rapid antigen tests that can be done from upper respiratory tract swab to diagnose influenza in the outpatient setting. In the treatment of influenza, antiviral drugs and treatments for fever, malaise, runny nose and cough, called symptomatic treatment, are used. In severe disease, antiviral treatment can be started without waiting for results after hospitalization. Antiviral therapy is more effective when started within the first 48 hours. Generally, a two-dose 5-day treatment scheme is applied. If the symptoms of children who received antiviral treatment and were considered not contagious 24 hours after the fever subsided, there is no problem in terms of public health if their symptoms have subsided. A daily dose of 10-day antiviral drug protection (prophylaxis) can be started for individuals who may develop severe illness in the family. Let's be
2-Let's wash our hands frequently and regularly
3-Let's not touch our eyes, nose and mouth with our hands
4-Let's not get together with sick individuals
5-Let's stay at home on days when we don't feel well and prevent the spread of the virus
6-If there are individuals with a risk of severe disease in the family, these individuals should be given prophylaxis with antiviral treatment for 10 days before the disease starts.
For protection, vaccines can be given; Influenza vaccines are vaccines that have been used in millions of doses for years. It can be applied to babies older than 6 months. It is an inactive vaccine, it may contain particles of type A and B viruses and a small amount of egg protein. Children who still have egg allergy should be vaccinated under surveillance in health centers where the necessary conditions are met. The vaccine is expected to become operational in 10-14 days. Especially school-age children who have been vaccinated will not get the disease while their friends are sick, and will not infect their siblings and parents at home. Since the disease can progress severely in children with immune system deficiency, chronic heart and lung disease, and neurologically disadvantaged children, both these children and their family members who are in contact should be vaccinated.
Dr.Fatih Binboğa
Private Acıbadem Bakırköy Hospital- Pediatrics Clinic
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