Winter Diseases

Winter diseases spread very widely among children and aged people. Children have less developed resistance against virus and bacteria while old people resistance is broken by aging process.

There are two most common diseases in winter.

Influenza & its symptoms

Influenza is a viral respiratory infection causing fever, coryza, cough, headache, and malaise. Mortality is possible during seasonal epidemics, particularly among high risk patients (eg, those who are institutionalized, at the extremes of age, have cardiopulmonary insufficiency, or are in late pregnancy); during pandemics, even healthy, young patients may die. Diagnosis is usually clinical and depends on local epidemiologic patterns.

The incubation period ranges from 1 to 4 days with an average of about 48 h. In mild cases, many symptoms are like those of a common cold (eg, sore throat, rhinorrhea); mild conjunctivitis may also occur. Typical influenza in adults is characterized by sudden onset of chills, fever, prostration, cough, and generalized aches and pains (especially in the back and legs). Headache is prominent, often with photophobia and retrobulbar aching.

Respiratory symptoms may be mild at first, with scratchy sore throat, substernal burning, nonproductive cough, and sometimes coryza. Later, lower respiratory tract illness becomes dominant; cough can be persistent, raspy, and productive. GI symptoms may occur and appear to be more common with the 2009 pandemic H1N1 strain. Children may have prominent nausea, vomiting, or abdominal pain, and infants may present with a sepsis-like syndrome.

High-risk patients, their caregivers and household contacts, health care practitioners, all people over 50 yr, and all children aged 6 mo to 18 yr should receive annual influenza vaccination. Antiviral treatment reduces the duration of illness by about 1 day and should be specifically considered for high-risk patients.

Influenza refers to illness caused by the influenza viruses, but the term is commonly and incorrectly used to refer to similar illnesses caused by other viral respiratory pathogens. Influenza viruses are classified as types A, B, or C by their nucleoproteins and matrix proteins. Influenza C virus infection does not cause typical influenza illness and is not discussed here.

Prevention

Influenza infections can largely be prevented by annual vaccination. Sometimes chemoprophylaxis (ie, with antiviral drugs). Prevention is indicated for all patients, but is especially important for high-risk patients and health care practitioners.

Vaccines

Vaccines are modified annually to include the most prevalent strains (usually 2 strains of influenza A and 1 of influenza B). When the vaccine contains the same HA and NA as the strains in the community, vaccination decreases infections by 70 to 90% in healthy adults. In the institutionalized elderly, vaccines are less effective for prevention but decrease the rate of pneumonia and death by 60 to 80%. Vaccine-induced immunity is decreased by antigenic drift and is absent if there is antigenic shift

Lung Infection

Pneumonia caused by bacteria and virus which are often clinically indistinguishable from pneumonias with other causes. Common viral agents include respiratory syncytial virus (RSV), adenovirus, influenza viruses, metapneumovirus, and parainfluenza viruses. Bacterial superinfection can make distinguishing viral from bacterial infection difficult.

Pneumoniae is commonly responsible for outbreaks of respiratory infection within families, in college dormitories, and in military training camps. It causes a relatively benign form of pneumonia that infrequently requires hospitalization. Chlamydia psittaci pneumonia (psittacosis) is rare and occurs in patients who own or are often exposed to birds.

A host of other organisms cause lung infection in immunocompetent patients, although the term community acquired pneumonia is usually reserved for the more common bacterial and viral etiologies.

Common fungal pathogens causes pneumonia in patients who have HIV infection or are immunosuppressed.

Symptoms and signs Symptoms include tiredness, cough, difficulties with breathing, and chest pain. Cough typically is productive in older children and adults and dry in infants, young children, and the elderly. Dyspnea usually is mild and exertional and is rarely present at rest. Chest pain is pleuritic and is adjacent to the infected area. Pneumonia may manifest as upper abdominal pain when lower lobe infection irritates the diaphragm. Symptoms become variable at the extremes of age, infection in infants may manifest as nonspecific irritability and restlessness, in the elderly, as confusion and obtundation.

Signs include fever, galloping heart beats, crackles, bronchial breath sounds.

Treatment

Best treatment is available in the form of antibiotics

Last modified on 2023-11-15 15:12:00






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