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

General information about influenza and other ARVIs
Relevance of the problem

Acute respiratory viral infections are the most common infections in Ukraine, affecting 10 to 25% of the population annually, and up to 90% during major epidemics (B.P. Bohomolov, 1990; O.O. Bobylova, S.P. Berezhnov, L.M. Muharska et al., 2002). ARVI accounts for 60 to 96% of all registered infectious diseases (Zh.I. Vozianova, O.A. Podoliuk, O.A. Holubovska, 2002; L.L. Hromashevska, 2006).

According to WHO experts, recent years have seen a steady upward trend in the incidence of ARVI. This phenomenon is primarily driven by social factors associated with global urbanization, closer human contact across virtually all Regions of the globe, and intensified migration processes (N.I. Lvov, 2003; L.S. Shcheholeva et al., 2004; I.S. Freidlin, 2005). To date, most fundamental challenges in combating respiratory infections remain unresolved from a scientific, methodological, and practical standpoint. The main reasons for this include the polyetiology and clinical diversity of ARVI, the presence of numerous serological variants and strain specificities of pathogens, their frequent variation, uneven distribution across various climatic and geographical zones, as well as the serotype-specific nature of Immunity (K. Jakeman, H. Smith, C. Sweet, 1989; A.F. Frolov, V.M. Frolov, 2004; H. Jonuleit et al., 2001).

With the exception of Influenza, specific prophylaxis and etiotropic Treatment are virtually nonexistent for almost all of these diseases (A.P. Mironenko, H.S. Khmelnytska, O.V. Komohorov, P.M. Ostapchuk, 2002).

In the etiological Structure of acute respiratory infections (ARIs), Viruses account for the largest share. However, due to the lack of specific diagnostic Methods for the etiological deciphering of each case, it is impossible to determine the true prevalence of both viral ARIs and those of other etiologies (legionellosis, mycoplasma, coccal, rickettsial, and many others) (A.F. Frolov et al., 2000; M.D. Chemych et al., 2004; I.I. Balabolkin et al., 2005). At the same time, It is important to distinguish between viral ARIs and those caused by other microorganisms, since specific antiviral drugs may be used to treat the former (as discussed below), whereas the latter require antibacterial treatment In addition to standard pathogenetic and symptomatic therapy.

Adult susceptibility to infection is influenced by fatigue, emotional stress, allergic rhinopharyngitis, hormonal status, etc. The severity of ARVI and its outcomes depend on climatic conditions, season, patient age, the specific respiratory tract lesion syndrome, and the standard of medical care provided (A.P. Kendall, 1997; Yu.V. Lobzin et al., 2000, 2001; L. Nosach, 2004).

Today, influenza is ranked first as a problem that lacks a radical solution, primarily due to the genetic resources of the virus itself (R. Kierszenbaum, 1982; V.M. Kozko et al., 2006).

Despite widespread anti-influenza preventive measures, the incidence of ARVI remains high (B.P. Bohomolov et al., 1996; E.I. Burtseva et al., 2000; D.E. Levy, 2002). During influenza seasons, the mortality rate rises, particularly among risk groups (R. Kumar et al., 1992; E.N. Amosova et al., 2000; R. Deonarain et al., 2000; E.P. Selkova et al., 2003; V.D. Moskalyuk, 2006). Influenza Viruses, which affect various Organs and systems, cause severe hypertoxic forms in 5% of patients (T.P. Salazar et al., 2002; V.A. Isakov et al., 2002; V.D. Moskalyuk et al., 2006).

Virtually all epidemics of influenza and other ARVIs are complicated by The Development of Pneumonia, Bronchitis, meningitis, meningoencephalitis, acute cardiovascular failure, etc. (E. Lupulescu et al., 1994; S. Ludwig et al., 1995; B.P. Bohomolov, 2000; V.M. Kozko et al., 2001; V.D. Moskalyuk, 2004).

The hazard of the disease is compounded by the fact that the influenza virus can suppress the body's immune responses, thereby increasing the severity of existing chronic conditions and causing their decompensation (Z. Lu et al., 1995; A.M. Naiikhin et al., 1997; K. Krishnan et al., 1998; K.I. Grigoryev et al., 2002).

Complications developing from influenza B and C remain poorly studied, and those associated with other ARVIs are practically unstudied.