Influenza: Diagnosis, Treatment, Prevention - V.D. Moskaliuk 2010

Influenza
Prevention

Immunodeficient states significantly contribute to the onset of Influenza. A reduction in the incidence of influenza can be achieved through seasonal courses aimed at stimulating the body's nonspecific and immunological reactivity: laser irradiation of the nasal passages and Tonsils (5–7 sessions), as well as The Use of interferonogenesis Inducers (amizon, groprinosin, amixin, proteflazid, echinacea).

Inactivated Vaccines are used for active specific immunization.

According to WHO data: "The vaccine is the only socially and economically justified means of combating influenza."

In Ukraine, vaccines such as Influvac, Vaxigrip, Fluarix, and Agrippal are predominantly used. All of the aforementioned vaccines contain the influenza virus antigen. They differ only in the degree of purification. The Influvac vaccine is a trivalent subunit inactivated vaccine containing isolated surface Antigens of Influenza Viruses types A and B. The only contraindication for its use is an allergy to chicken eggs. The protective effect is achieved 10 days after administration and lasts for 1 year. The vaccine is administered to adults subcutaneously at a dose of 0.5 ml. For patients with immunodeficiency, it is advisable to administer two doses of the vaccine (0.5 ml each) at a 4-week interval. The vaccine is updated annually to account for the epidemiologically relevant strains of the current season. Vaccines reduce morbidity by 1.5–2.5 times.

Influenza prophylaxis:

1. Specific active. Live and inactivated vaccines are used.

Live:

✵ egg-derived: prepared through passages in chicken embryos (intranasally, administered twice at an interval of 20–30 days);

✵ tissue-derived: prepared using a chicken embryo Kidney Cell culture (administered orally 3 times at 10-day intervals, 1–2 months before the onset of an outbreak).

Inactivated:

✵ virion — killed, purified (0.2 ml intradermally as a single dose);

✵ subunit — contains Components of the viral particle (viruses are disrupted, separated, antigens are dialyzed and centrifuged);

✵ split — obtained by treating viruses after concentration with detergents (tween-ether, Triton X-100, tri-n-butyl phosphate).

2. Specific passive prophylaxis — gammaglobulin.

Routine nonspecific prophylaxis is carried out using eleutherococcus extract (30–40 drops once daily for 25–30 days), prodigiosan (0.25 ml into each nasal passage twice with a 5-minute interval, in a course of 3 administrations with breaks of 5–7 days), and multivitamins.

For prophylactic purposes, it is recommended to prescribe interferon, which suppresses virus reproduction in the body. Leukocyte interferon should be instilled into the Nose three times a day throughout the entire epidemic period.

For the Prevention of influenza A, remantadine or amantadine can be used at 0.1–0.2 g/day. The drug must be administered throughout the entire disease outbreak. It should be borne in mind that after discontinuing the drug, individuals who received it become susceptible to infection; therefore, combining drug intake with vaccination is necessary. Prophylactic agents that stimulate The production of endogenous interferon (mefenamic acid, dibazol, prodigiosan) are also used. As literature data show, a three-fold oral administration of dibazol for 10 days helps reduce morbidity by more than 3 times.

Features of immunization against current infections

✵ Underestimation of the danger of influenza as a disease.

✵ Public distrust regarding the vaccine's ability to protect against influenza.

✵ New-generation vaccines are currently in use.

✵ Protection against other ARVI throughout the year.

✵ Vaccination should be prioritized for individuals with chronic conditions.

✵ No exacerbations of chronic illnesses or deterioration of the underlying condition have been registered As a result of vaccination.

✵ Pandemic influenza is already resistant to amantadine and remantadine.

✵ Alternative (non-injection) routes of vaccine administration are required (via mucous membranes - intranasal.)

Follow-up care and dispensary observation. Patients whose influenza course was complicated by acute Pneumonia are subject to dispensary registration followed by medical examinations at 1, 3, 6, and 12 months after recovering from the illness. In the presence of residual symptoms following pneumonia, it is recommended to refer patients for convalescence or rehabilitation to a specialized (pulmonology) inpatient facility or the out-patient dispensary department of a polyclinic.