ARI - what is it? Acute respiratory disease: symptoms of the disease, prevention and treatment. Acute respiratory infections - symptoms, causes, types, treatment and prevention of acute respiratory infections Stages of acute respiratory infections

The diagnosis of acute respiratory disease (ARI) means a wide range of respiratory diseases that can be caused by:

• microbial pathogens (some types of pneumococcus, staphylococcus, Pseudomonas aeruginosa, Legionella, etc.);
• viral pathogens (adenoviruses, enteroviruses, influenza viruses, coronoviruses, etc.);
• mixed pathogens (viral-microbial).

The first signs of acute respiratory infections appear, most often, on the third or fourth day after infection. Sometimes the incubation period of the disease increases to 10-12 days. In adults, symptoms of acute respiratory infections appear smoothly, with a gradual increase:

• runny nose, nasal congestion and sneezing are the most common and striking symptoms;
• lacrimation – present in most cases of the disease;
• sore throat and redness, sometimes a white coating is possible;
• chills and fever;
• enlarged lymph nodes located in the neck and under the jaws.

In addition to these main signs, acute respiratory infections in adults may have the following manifestations:

1. An increase in temperature, despite chills, is most often not observed or is small (37-37.5 degrees).
2. Headache, general weakness, lethargy, aches in muscles and joints - all these characteristic signs of intoxication of the body during acute respiratory infections are weakly expressed at the very beginning of the disease.
3. A cough in acute respiratory disease occurs, in most cases, at the very beginning it is dry and hacking. As the disease progresses, most often, the cough becomes wetter and may continue for some time after other symptoms have disappeared.
4. When infected with an adenovirus, there may be symptoms of acute respiratory infections such as abdominal pain and redness of the eyes.

As a rule, acute respiratory disease lasts for 6-8 days and passes without consequences. Possible complications of acute respiratory infections may include:

• bronchitis;
• pharyngitis;
• pneumonia.

One type of acute respiratory disease is influenza. The manifestations of the disease with this virus are strikingly different from other acute respiratory infections. Influenza is characterized by a sudden onset of the disease with the following symptoms:

• high temperature (up to 39-40 degrees), persisting for 3-4 days;
• pain and pain in the eyes;
• intoxication of the body (eye reaction to light, sweating, weakness, dizziness);
• mild nasal congestion, sneezing.

From the nasopharynx, in the first days of the disease, one can observe hyperemia of the palate and posterior pharyngeal wall without redness. White plaque, as a rule, is absent, and its appearance may indicate the addition of another infection or a sore throat, not the flu.

A cough may be absent or occur on the 2-3rd day of illness and be accompanied by pain in the thoracic region, which is explained by the inflammatory process in the trachea.

Also, a distinctive feature of this type of acute respiratory disease is the absence of enlarged lymph nodes.

Acute respiratory diseases (ARIs) are the general name for a number of clinically similar acute infectious diseases, the causative agents of which (viruses, bacteria, chlamydia, mycoplasmas) enter the body through the respiratory tract, colonize and reproduce mainly in the cells of the mucous membranes of the respiratory system, damaging them, which clinically characterized by syndromes of general infectious intoxication and damage to the respiratory tract.

Prevalence. According to WHO, 40 million people worldwide fall ill with infectious diseases every year, of which 90% are influenza and acute respiratory infections. Each adult suffers from influenza or other acute respiratory infections 2 times during the year, on average, a schoolchild 3 times, a preschool child 6 times. A significant share of acute respiratory infections is evidenced by the fact that even in years of severe epidemics, influenza accounts for 40% of the total incidence of acute respiratory infections in the population, which can cover up to 20% of the country's population during the year.

Etiology. More than 200 etiological agents cause acute respiratory infections. These include:

1. Viruses (influenza viruses of various antigenic types and variants, parainfluenza of 4 types, respiratory syncytial virus, coronaviruses of 4 types, rhinoviruses of more than 100 types, enteroviruses of 60 types, reoviruses of 3 types, adenoviruses of 32 serotypes and adeno-associated viruses, herpes simplex viruses).

2. Bacteria (streptococci, staphylococci, meningococci, legionella).

3. Chlamydia - Ch. psittaci, Ch. pneumonia.

4. Mycoplasmas - M. pneumonie and M. hominis (in laboratory conditions).

Pathogenesis. In the pathogenesis of acute respiratory infections, the following stages can be distinguished: penetration of the pathogen into the body through the upper respiratory tract; cytopathic effect of pathogens on cells of triple tissues; penetration of microorganisms and their metabolites into the internal environments of the macroorganism with the development of local and general reactions in response to infection; inhibition of local and general resistance factors with the possible development of bacterial complications; formation of specific immunity, activation of nonspecific resistance factors, eradication of the pathogen, restoration of damaged structures and functions, recovery.

Symptoms of acute respiratory infections characterized by fever, manifestations of general infectious intoxication, syndromes of respiratory tract damage at various levels and their combination.

Fever in most cases begins with chills or chills. Body temperature already reaches its maximum level on the first day (38-40 °C). The duration of fever varies depending on the etiology of the disease and the degree of severity, but with an uncomplicated course it is always of a single wave nature, with an adenovirus infection it can be recurrent, with chlamydial and mycoplasma infections it can be a long-term low-grade fever.

General infectious intoxication syndrome. Simultaneously with the fever, general weakness, weakness, adynamia, increased sweating, muscle pain, and headache with a characteristic localization appear. Painful sensations appear in the eyeballs, intensifying when the eyes move or when pressing on them, photophobia, and lacrimation. Dizziness and a tendency to faint are more common in adolescents and old people, vomiting is mainly in the younger age group and in severe forms of acute respiratory infections in adults. All patients with severe acute respiratory infections experience disturbed sleep, insomnia, and sometimes delirium.

Rhinitis is felt by patients in the form of a burning sensation in the nose, runny nose, nasal congestion, and sneezing. Rhinoscopy reveals hyperemia and swelling of the nasal mucosa, mucous or mucopurulent discharge in the nasal passages, nasal breathing is disrupted, and hyposmia occurs.

Pharyngitis is manifested by dryness and rawness in the throat, aggravated by coughing, pain when swallowing, and coughing. Pharyngoscopy reveals hyperemia of the mucous membrane of the mesopharynx (posterior and lateral walls of the pharynx), mucous or mucopurulent discharge on the posterior wall of the pharynx, hyperemia, granularity and injection of the soft palate, hyperplasia and/or hypertrophy of lymphoid follicles on the posterior wall of the pharynx, hyperemia and swelling of the lateral folds of the pharynx. Sometimes regional lymph nodes enlarge, less often they become painful.

Laryngitis is characterized by complaints of soreness and soreness in the larynx, which worsens with coughing, hoarseness or hoarseness of the voice, and a rough cough. Laryngoscopy reveals diffuse hyperemia of the laryngeal mucosa, hyperemia and infiltration of the vocal folds, non-closure of the vocal folds during phonation, the presence of viscous mucus and crusts in the larynx. Objectively, in these patients the voice has changed to hypo- or aphonia, and regional lymph nodes may be enlarged.

Tracheitis is felt as rawness and burning behind the sternum, aggravated by coughing, which is initially dry, unproductive and therefore painful, not bringing relief to the patient. Over time, sputum appears.

On auscultation, tracheitis is manifested by harsh breathing, single wheezing wheezing, which quickly disappears when coughing up sputum. Bronchoscopy reveals infiltration and hyperemia of the tracheal mucosa, mucous, mucohemorrhagic or mucopurulent discharge.

Bronchitis is manifested by a dry or wet cough with the discharge of mucous or mucopurulent sputum. Auscultation reveals increased vesicular (hard) breathing, dry and moist rales of varying heights and timbres depending on the level of damage: with damage to the proximal parts of the bronchial tree, dry bass and (or) moist coarse bubble rales; in case of damage to the distal parts - dry treble and (or) fine-bubble wet. When a sufficient amount of liquid sputum begins to be released, a small amount of moist, silent rales is heard. On chest x-rays, an increase in the pulmonary pattern due to peribronchitis can be detected.

Bronchiolitis occurs more often in young children and adults when a broncho-obstructive component is attached. This syndrome is characteristic of respiratory syncytial infection. Clinically characterized by shortness of breath, which worsens with the slightest physical exertion and is expiratory in nature. The cough is painful, with difficult to separate mucous or mucopurulent sputum, accompanied by pain in the chest. Breathing is shallow with the participation of auxiliary muscles. Patients are restless, pale skin, acrocyanosis. The box sound is determined by percussion. In the lungs, weakened vesicular breathing and moist fine bubbling rales are heard, increasing on exhalation. When auscultating the heart, an accent of the second tone is noted over the pulmonary artery. On a chest x-ray, the pulmonary pattern is enhanced against the background of significant clearing of the pulmonary fields, bulging of the pulmonary artery arch and expansion of its branches. On the ECG - P-pulmonale. When examining the function of external respiration, ventilation failure and increased airway resistance are noted (more on exhalation than on inhalation).

Most authors consider pneumonia as a complication of acute respiratory infections. However, with adenovirus, PC virus, mycoplasma, and chlamydial infections, pneumonia is one of the clinical manifestations.

Depending on the severity of intoxication of catarrhal syndrome, the presence of complications and emergency conditions during acute respiratory infections, mild (60-65%), moderate (30-35%), severe and very severe forms (3-5%) are distinguished.

The mild form is characterized by an increase in body temperature of no more than 38.0 °C, moderate manifestations of intoxication and catarrhal symptoms.

Moderate form - body temperature within 38.1-40 °C. A syndrome of general intoxication and damage to the respiratory tract at various levels is expressed. Bacterial complications are possible.

The severe form is characterized by an acute onset, prolonged fever above 40 °C or more with pronounced symptoms of general infectious intoxication, multiple lesions of the respiratory tract, and complications. Emergency conditions may develop - infectious-toxic encephalopathy, acute respiratory failure, infectious-toxic shock, acute heart failure.

Extremely severe forms are characterized by a lightning-fast course with rapidly developing symptoms of intoxication without catarrhal phenomena and end in death in most cases. A variant of the fulminant form may be the rapid development of hemorrhagic toxic pulmonary edema and death from parenchymal respiratory and cardiovascular failure.

Complications of acute respiratory infections are characterized by polymorphism. In their clinical diversity, the leading place in frequency and significance is occupied by pneumonia (80-90%), which in most cases is of a mixed viral-bacterial nature, regardless of the timing of occurrence. Other complications (sinusitis, otitis, pyelonephritis, inflammation of the biliary system, meningitis, Reye's syndrome) are observed relatively rarely (10-20%).

Diagnosis of acute respiratory infections based on clinical, laboratory and instrumental criteria. ARIs are distinguished by the localization of respiratory tract damage and a number of epidemiological and clinical manifestations.

Epidemic influenza is characterized by an acute, sudden onset, a predominance of signs of a generalized infectious process (high fever, severe intoxication) with a relatively less severe catarrhal syndrome; among the syndromes of respiratory tract damage, tracheitis and a tendency to leukopenia predominate; There are no inflammatory changes in the blood.

Parainfluenza is characterized by a group incidence, seasonality (late winter, early spring), an incubation period of 2-4 days, the onset of the disease is gradual, catarrhal syndrome occurs early - the predominance of laryngitis syndrome is characteristic, the inflammatory process may spread to the bronchi. Fever often does not exceed 38.0 °C, manifestations of intoxication are mild, the course is sluggish, and in adults it is not severe with a relatively longer total duration of the disease.

Adenovirus infection characterized by group incidence, mainly in the summer-autumn period, both airborne and fecal-oral mechanisms of infection are possible. The incubation period is 5-8 days, the onset of the disease is acute. A characteristic combination of exudative inflammation of the mucous membranes of the oropharynx and eyes with systemic enlargement of the lymph nodes (mainly the neck). The main symptom complex of the disease is pharyngoconjunctival fever above 38.0 °C (rhinopharyngitis, catarrhal follicular or membranous conjunctivitis), characterized by bright hyperemia of the pharynx with the development of acute tonsillitis (rhinopharyngotonsillitis). Manifestations of intoxication are moderate, possible development of diarrhea, enlargement of the spleen, and less often - liver. The course is often not severe and can last up to 7-10 days.

PC infection characterized by group morbidity and the presence of an epidemic focus (PC infection - a highly contagious acute respiratory infection). Seasonality - cold season. The incubation period lasts 3-6 days. Clinically manifest forms occur with damage to the distal parts of the respiratory tract (acute bronchitis, acute bronchiolitis) with a pronounced bronchospastic component. Characterized by a persistent paroxysmal cough, first dry, then productive; manifestations of respiratory failure (expiratory shortness of breath, cyanosis). Fever not higher than 38 °C with severe manifestations of general infectious intoxication; often complicated by viral-bacterial pneumonia. Clinical diagnosis takes into account the predominance of bronchitis symptoms over symptoms of damage to the upper respiratory tract with mild intoxication.

For coronavirus infection group morbidity in children's groups and families is typical; seasonality - mainly winter-spring. The incubation period is 2-4 days. The onset of the disease is acute, the leading symptom complex is intense rhinitis, sometimes signs of laryngotracheitis develop, the fever is not constant, intoxication is moderate. The course of the disease is acute, lasting 1-3 days. Clinically, coronavirus infection is difficult to diagnose, since it does not have a specific symptom complex. Differential diagnosis is often carried out with rhinovirus infection, in contrast to which coronavirus has a more pronounced runny nose and malaise and is less often accompanied by a cough. During outbreaks of acute gastroenteritis, differential diagnosis should be made with other viral diarrheas.

Rhinovirus infection characterized by group incidence, autumn-winter seasonality. The incubation period is 1-3 days. The leading manifestation is rhinitis with copious serous and later mucous discharge. Fever and intoxication are absent or mild. The course of the disease is mild, the total duration is 4-5 days.

Reovirus infection characterized by group morbidity mainly in children's groups. The mechanism of infection is airborne and/or fecal-oral. The incubation period is 1-5 days. A combination of catarrhal syndrome (rhinopharyngitis) with gastroenteritis (nausea, abdominal pain, loose stools) is typical; enlarged lymph nodes and liver are possible. The course of the disease is often mild and lasts 5-7 days.

Enterovirus infection is characterized by a group incidence, summer-autumn seasonality (the so-called “summer flu”), airborne and (or) fecal-oral infection mechanism. The incubation period is 2-4 days. The onset of the disease is acute with fever above 38 °C, intoxication (characteristic muscle pain). Catarrhal syndrome - nasopharyngitis is poorly expressed. Other forms of enterovirus infection are often detected (exanthema, myalgia, herpangina, serous meningitis), lymphadenopathy, enlargement of the liver and spleen are possible. The acute period lasts 2-4 days. The course of the disease is often mild and lasts up to 7-10 days.

Respiratory mycoplasmosis characterized by group incidence, lack of seasonality (registered all year round). The incubation period is 7-14 days. The onset of the disease is acute with high fever and severe intoxication. Catarrhal syndrome is characterized by the predominant development of nasopharyngitis and tracheobronchitis. An inflammatory leukocyte reaction and an increase in ESR are often absent. The course of the disease can drag on for up to 14 days.

For acute respiratory infections chlamydial etiology An epidemiological history is characteristic - contact with birds, group occupational morbidity or the occurrence of a family outbreak. The transmission mechanism is airborne and/or airborne dust. The onset is acute (flu-like) with fever (up to 38-39 °C) and intoxication with the simultaneous development of acute tracheobronchitis, less often - gradual. Pneumonia develops on the 2-4th day of illness, is predominantly interstitial in nature and tends to have a protracted course. Characterized by enlargement of the liver and spleen; in the blood - absence of leukocytosis with a sharp increase in ESR.

Bacterial acute respiratory infections characterized by predominant development in individuals with chronic focal pathology of the respiratory tract and association with cold factors or with previous viral acute respiratory infections. Catarrhal syndrome in the form of nasopharyngitis (runny nose with mucopurulent discharge from the first day of illness, coughing quickly turns into a productive cough). In primary bacterial acute respiratory infections, the onset is gradual, the course is torpid, fever and intoxication are mild. In case of secondary bacterial acute respiratory infections, complicating viral acute respiratory infections, the course is severe with a second febrile wave, the development of inflammatory foci of different localization (sinusitis, otitis media, pneumonia, lymphadenitis). Inflammatory leukocyte reaction of varying severity.

Differential diagnosis of acute respiratory infections must be carried out with other infections characterized by the predominance of catarrhal symptoms in the initial period of the disease - a localized form of meningococcal infection (acute meningococcal nasopharyngitis), measles, a flu-like variant of the initial (pre-icteric) period of viral hepatitis, with a group of typhoid paratyphoid diseases.

Structure and examples of diagnosis. Due to the fact that the clinical manifestations of acute respiratory infections are so similar that it is extremely difficult to clinically make an etiological diagnosis of the disease, especially sporadic cases, and express diagnostic methods do not have sufficient sensitivity, the preliminary diagnosis is noso-syndromic in nature and reflects:

1) nosological form - “acute respiratory disease”;

2) the predominant syndromes of damage to the respiratory tract - such as rhinitis, nasopharyngitis, laryngotracheobronchitis;

3) probable etiology of the disease;

4) the period of illness (prodromal, height, early convalescence, convalescence), according to which treatment tactics are determined;

5) the day of illness (for the prodromal period and the peak period) must be indicated to determine the indications for the prescription of antiviral drugs and their various regimens;

6) the severity of the patient’s condition (mild, moderate, severe or extremely severe);

7) complications (pneumonia, sinusitis, otitis media, myocarditis);

8) emergency conditions (indicated in an extremely serious condition) requiring intensive care measures;

9) concomitant diseases that can worsen against the background of acute respiratory infections, aggravate acute respiratory infections (determine the development of emergency conditions and complications), lead to a protracted course of acute respiratory infections, require treatment of concomitant diseases and adjustments in the treatment of the underlying disease.
The clinical diagnosis of “influenza” is valid only during periods of epidemic outbreaks of influenza infection based on clinical signs, especially when group diseases with similar symptoms occur. The etiological diagnosis is made retrospectively after laboratory confirmation.

The next stage of diagnosis is to determine the nature of the inflammation (viral, bacterial) based on an assessment of a clinical blood test. Acute respiratory infections of viral origin are characterized by leukopenia and a tendency to lympho- and monocytosis. The presence of leukocytosis with neutrophilia and/or a shift of the leukocyte formula to the left indicates the bacterial nature of acute respiratory infections or a bacterial complication (pneumonia, sinusitis, otitis).
Etiological diagnosis of acute respiratory infections includes methods of express and serological diagnosis, as well as isolation of pathogens.

Express diagnostic methods allow you to get a preliminary answer within a few hours from the moment the samples arrive at the laboratory. For this purpose, immunofluorescence reaction (RIF) and enzyme-linked immunosorbent assay (ELISA) are used. To detect some pathogens (adenoviruses, reoviruses, chlamydia), nucleic acid hybridization methods and polymerase chain reaction (PCR) are used.

To isolate pathogens of acute respiratory infections, cell cultures, chicken embryos and laboratory animals are infected, and they are also inoculated on nutrient media. Then they are identified on the basis of a complex of morphological, tinctorial, cultural, biochemical and antigenic (in RIF, RTGA) characteristics.

Serological testing is relatively simple and available to most laboratories. These methods are based on the detection of an increase in titers of specific antibodies in the dynamics of acute respiratory infections using various immunological reactions - the complement fixation reaction (CFR), the hemagglutination inhibition reaction (HAI), the neutralization reaction (RN), and enzyme-linked immunosorbent assay (ELISA). A fourfold or more increase in the titer of specific antibodies to the infectious agent in the RTGA, RSK has diagnostic significance.

Treatment of patients with acute respiratory infections includes basic, etiotropic, pathogenetic, symptomatic therapy, physiotherapy, intensive care of emergency conditions, rehabilitation and medical examination of those who have recovered.

Mode. Patients with a serious condition, emergency conditions, complications, or aggravated premorbid background are subject to hospitalization (the presence of uncompensated chronic diseases of the lungs and cardiovascular system requires hospitalization even in moderate forms of the disease). According to epidemiological indications, patients from organized, closed groups (military personnel, boarding school students, students living in dormitories) are hospitalized if it is impossible to isolate them from others at their place of residence and undergo constant medical supervision. According to provisional indications, patients with severe manifestations of laryngitis or laryngotracheitis who are not vaccinated against diphtheria are hospitalized. Treatment for mild and moderate forms of influenza is carried out at home, for severe and complicated forms - in an infectious diseases hospital.

An indispensable condition is compliance with bed rest during the entire febrile period and intoxication, as well as until complications are eliminated. 3 days after normalization of body temperature and disappearance of intoxication, semi-bed rest and then ward rest are prescribed.

A complex of vitamins is prescribed (multivitamins, Revit, Hexavit, Undevit 2 tablets each, Decamevit 1 tablet 2-3 times a day), ascorbic acid up to 600-900 mg/day and vitamin P up to 150-300 mg/day.

Etiotropic therapy for acute respiratory infections, depending on the pathogens that cause them, can be antiviral (for acute respiratory infections of viral etiology), antibacterial (for acute respiratory infections of bacterial, mycoplasma or chlamydial etiology), complex (for viral-bacterial infections, viral infections with bacterial complications).

Antiviral therapy includes biological (interferons and immunoglobulins) and chemotherapeutic agents. The success of antiviral therapy for acute respiratory infections cannot be separated from compliance with the mandatory conditions: emergency use; regularity of intake; compliance of drugs with the etiology of acute respiratory infections.

Universal antiviral drugs are preparations of human leukocyte interferon. It is instilled into the nasal passages, 5 drops at least 5 times a day for 2-3 days.

Immunoglobulins. Anti-influenza donor gamma globulin (immunoglobulin) is most effective against influenza. For adenoviral, PC-viral and parainfluenza infections, targeted immunoglobulins are used. In the absence of specific immunoglobulins, normal human immunoglobulin is used. Immunoglobulins are prescribed in the first 3 days of illness.

Remantadine (0.05 g) is prescribed only for influenza in the early stages of the illness, especially on the first day, when it gives a pronounced effect, according to the scheme: 1st day of illness, 100 mg 3 times a day after meals (a single dose of up to 300 mg is possible mg), 2nd and 3rd days of illness - 100 mg 2 times a day after meals, 4th day of illness - 100 mg 1 time a day after meals.
Neuraminidase inhibitors (zanamivir, oseltamivir) are used for influenza A and B during the first 5 days of the disease, 2 times a day.

For adenoviral infection with conjunctivitis, keratitis, keratoconjunctivitis, deoxyribonuclease (0.05% solution, 1-2 drops in the conjunctival fold), poludan (powder in ampoules of 200 mcg) in the form of eye drops and (or) injections under the conjunctiva are indicated.

For herpes viral acute respiratory infections, acyclovir is prescribed orally at a dose of 100-200 mg 5 times a day for 5 days. For herpetic meningitis and meningoencephalitis, acyclovir solution is prescribed intravenously.

Antibacterial therapy is indicated for acute respiratory infections of mycoplasma, chlamydial and bacterial etiology, secondary (bacterial) complications of viral acute respiratory infections, activation of a chronic bacterial infection against the background of a viral acute respiratory infection. The choice of antibiotic depends on the expected etiology of acute respiratory infections, bacterial superinfection, the results of bacteriological examination of sputum and determination of the sensitivity of isolated microorganisms to antibiotics.

Pathogenetic treatment of all forms of acute respiratory infections is aimed at detoxification, restoration of impaired body functions, and prevention of complications.

Detoxification therapy. In the febrile period with mild and moderate forms, drinking plenty of fluids containing vitamins C and P (5% glucose solution with ascorbic acid, tea - preferably green, cranberry juice, infusion or decoction of rosehip, compotes, fruit juices, especially grapefruit and chokeberry ), mineral water.

Antihemorrhagic therapy consists of prescribing ascorbic acid, calcium salts (chloride, lactate, gluconate), rutin. In severe forms, antihemorrhagic therapy is limited to the treatment of DIC syndrome.

Treatment of DIC syndrome is carried out taking into account coagulogram parameters. In the hypercoagulation stage, protease inhibitors - contrical (trasylol 10,000-20,000 units) in combination with heparin (5000 units at once, then 500-1000 units every hour) are administered intravenously. Treatment is also carried out with fresh frozen plasma, warmed to 37 °C. With each transfusion, 2500 units of heparin per 400 ml of plasma should be administered to activate antithrombin-III. Chimes and aspirin are also used.

With the development of acute hemostatic insufficiency (hypocoagulation phase), intravenous jet injection of fresh frozen plasma is carried out, and proteolysis inhibitors are prescribed. Heparin and antiplatelet agents are discontinued.

Improving microcirculation can be achieved both by normalizing hemodynamics in the pulmonary circulation (respiratory analeptics - camphor, sulfocamphocaine, cordiamine), and by normalizing systemic hemodynamics. In case of a significant decrease in the contractility of the left ventricle (with the development of infectious-allergic myocarditis, complicating the course of severe acute respiratory infections), the use of cardiac glycosides is possible. One should remember the hypersensitivity of the inflamed myocardium to cardiac glycosides and prescribe them intravenously in small doses (for example, 0.3 ml of a 0.05% strophanthin solution).

Bronchodilators are indicated for the development of bronchospasm syndrome. They use aminophylline, theophylline, including extended action (teopek, theolep), less often (in adults and in the presence of bronchial asthma) - symptomatic (ipratropium bromide, salbutamol, berotec, bricanil) and other pathogenetic agents.

Desensitizing agents - H1-histaminolytics: diphenhydramine, diprazine, diazolin, tavegil, suprastin, fenkarol, bicarfen, astemizole, pheniramine maleate, peritol.

Normalization of the function of the ciliated epithelium, microcirculation, the production of surfactant, lysozyme, interferon, secretory immunoglobulin A, the function of alveolar macrophages and the bronchopulmonary immune system - the population of T- and B-lymphocytes is achieved by using bromhexine (8-16 mg 2-3 times a day ), ambroxol, which stimulate the formation of surfactant.

Symptomatic treatment. For a runny nose, vasoconstrictor nasal drops are recommended - sanorin in the form of a 0.1% solution or emulsion, galazolin, naphthyzin, 1-2 drops into the nasal passages 3-4 times a day.

Antitussives are prescribed in the first days of the disease, when the cough is unproductive, dry, painful, painful, causing suffering to the patient, often depriving him of sleep. Narcotic antitussives (opium alkaloids), codeine (methylmorphine), codeine phosphate, dionine (ethylmorphine) and combination drugs (codterpine) are addictive and can depress the respiratory center and are therefore used in short courses, often once at night. Non-narcotic drugs glauvent (glaucine hydrochloride), ledin and tusuprex are not addictive and do not depress the respiratory center, and therefore are preferable to narcotic drugs for long-term systematic use. Antitussives with predominantly peripheral action (libexin, bithiodine, baltix, sinecode, falimint) selectively act on the nerve endings of the respiratory tract and are also used as long-term therapy.

Expectorants are prescribed when sputum appears to improve its discharge by stimulating the cough reflex (expectorants themselves) and/or improving the rheological properties of sputum (mucolytics).

Antipyretics and analgesics are represented by nonsteroidal anti-inflammatory drugs (NSAIDs). When choosing an analgesic and antipyretic drug, preference is given to drugs with minimal anti-inflammatory effect - Coldrex or aspirin upsa with vitamin C, dissolving a tablet of these drugs in 100 ml of warm water.

It should be remembered that fever is one of the most important protective mechanisms in the fight against an infectious disease, therefore the abuse of antipyretic drugs does not contribute to a faster recovery of patients. Many antipyretics and analgesics have a significant effect on the immune system and significantly suppress phagocytosis. In this regard, antipyretics, in particular acetylsalicylic acid (no more than 0.5 g once), should be taken only at high body temperatures, reaching 39.5 ° C or more in adults and 38.5 ° C in children and the elderly individuals when elevated temperature turns from a protective factor into a pathogenic one.

Physiotherapeutic treatment is aimed at improving coughing up sputum, draining the airways and restoring bronchial patency. Aerosol therapy begins on the first day of admission of the patient to the infectious diseases department. The most effective are warm, moist inhalations. They are carried out for 15 minutes 2 times a day for 4 days. When performing the procedure, the patient takes deep breaths and exhales. Bronchodilator aerosols that enhance the evacuation of mucus and sputum are used.

Prevention of acute respiratory infections includes isolation, regime-restrictive and sanitary-hygienic measures. Certain prospects have recently been associated with antiviral drugs for emergency prevention, as well as stimulants of immunity and general resistance.

Public prevention comes down to isolating patients with acute respiratory infections at home or in a hospital and limiting visits by sick people to public places (clinics, pharmacies). Persons serving patients should wear 4-6-layer gauze masks and use intranasal interferon.

To prevent influenza, mass vaccination of the population is carried out in the pre-epidemic period. According to epidemiological indications, vaccine prophylaxis is carried out to persons at “high risk” of influenza disease - schoolchildren 7-14 years old, children in closed organized groups. According to clinical indications, to prevent the adverse consequences of influenza, vaccination is administered to adolescents who often suffer from acute respiratory infections or chronic somatic diseases.

Clinical examination. Persons who have suffered uncomplicated forms of acute respiratory infections are not subject to dispensary observation. Those who have suffered complicated forms of influenza and acute respiratory infections are subject to medical examination for at least 3-6 months by appropriate specialists (general practitioner, ENT doctor, neurologist).

Expertise. Adolescents who have suffered acute respiratory infections and do not present any complaints, who do not have chronic diseases, as well as functional disorders of individual organs and systems, belong to the 1st group of health and dispensary observation (D-1). Practically healthy teenagers who have suffered from acute respiratory infections such as acute bronchitis with obstructive manifestations, as well as those who often suffer from acute respiratory infections, whose functional indicators periodically deviate from the norm, physiological reserves are reduced, but there is no obvious clinical manifestations, constitute the 2nd group of health and dispensary observation (D- 2). Adolescents in this group are examined at least twice a year using functional diagnostic methods (ECG, pneumotachometry, spirography) with stress tests.

Adolescents who often suffer from acute respiratory infections for a long time are classified into the 3rd group of health and clinical observation (D-SH). These adolescents are called in for examination 2-4 times a year, depending on the nosological form and nature of the main and concomitant diseases.

The criterion for the effectiveness of dispensary observation is a decrease in the frequency of acute respiratory infections, the severity of acute respiratory infections, and the absence of a complicated nature of the acute respiratory infections.

Groups for physical education. During the period of early convalescence, patients with acute respiratory infections can engage in exercise therapy group, where classes are conducted using special methods in an outpatient clinic or in a medical physical education clinic.

Adolescents who have had acute respiratory infections are exempt from physical education for 1-2 weeks. Then, until 1 month after suffering an acute respiratory infection, they study in a preparatory group. In the absence of contraindications, 1 month after acute respiratory infections, adolescents are transferred to the main group.

When conscripted for military service, citizens with temporary functional disorders after severe acute respiratory infections are given a deferment from military service until the outcome is determined.

Symptoms and treatment

What are acute respiratory diseases (ARI)? We will discuss the causes, diagnosis and treatment methods in the article by Dr. P.A. Aleksandrov, an infectious disease specialist with 12 years of experience.

Definition of disease. Causes of the disease

Acute respiratory diseases (ARI)- a group of acute infectious diseases, the pathogens of which enter the human body through the respiratory tract and, multiplying in the cells of the mucous membrane of the respiratory tract, damage them, causing the main symptom complex of the disease (syndrome of respiratory tract damage and general infectious intoxication). The use of the term ARVI (in the absence of a laboratory-confirmed etiological decoding) is incorrect.

Etiology

ARI is a polyetiological complex of diseases, the main types of pathogens:

• bacteria (staphylococci, streptococci, pneumococci, Haemophilus influenzae, Moraxella catarrhalis, etc.);
• viruses (rhinoviruses, adenoviruses, respiratory syncytial virus, reoviruses, coronaviruses, enteroviruses, herpesviruses, parainfluenza and influenza viruses);
• chlamydia (Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis);
• mycoplasma (Mycoplasma pneumoniae).

Viruses, as the causative agent of acute respiratory infections, have a predominant position in the structure of morbidity, so it is not unreasonable to use the term ARVI (acute respiratory viral disease). Recently, the term ARI (acute respiratory infection) has sometimes been used.

Epidemiology

Mainly anthroponosis. They are the most numerous and common group of human diseases (up to 80% of all diseases in children) and therefore pose a serious problem for the health care of various countries due to the economic damage they cause. The source of infection is a sick person with pronounced and erased forms of the disease. Susceptibility is universal, immunity to some pathogens (adenoviruses, rhinoviruses) is persistent, but strictly type-specific, i.e., you can get an acute respiratory infection caused by one type of pathogen (but different serotypes, of which there can be hundreds), many times. The incidence increases in the autumn-winter period, can take the form of epidemic outbreaks, and affects countries with cool climates. Children and people from organized groups get sick more often (especially during the adaptation period).

The main transmission mechanism is airborne droplets (aerosol, to a lesser extent airborne dust), but contact and household mechanisms can also play a role (contact - through kissing, household - through contaminated hands, objects, water).

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of acute respiratory diseases (ARI)

The incubation period is different and depends on the type of pathogen; it can vary from several hours to 14 days (adenovirus).

Each causative agent of acute respiratory infections has its own specific features of the course of the disease, but they are all united by the presence syndromes of general infectious intoxication (SOIS) and damage to the respiratory tract, to varying degrees.

We present respiratory tract syndrome - SPRT(the main syndrome for these diseases), starting from the upper sections:

• rhinitis (nasal congestion, decreased sense of smell, sneezing, nasal discharge - first transparent mucous, then mucopurulent - denser, yellow-green in color, this occurs as a result of the addition of secondary bacterial flora);
• pharyngitis (soreness and pain of varying intensity in the throat, dry cough - “throat”);
• laryngitis (hoarseness, sometimes aphonia, cough and sore throat);
• tracheitis (painful, predominantly dry cough, accompanied by rawness and pain in the chest);
• bronchitis (cough with or without sputum, dry wheezing, rarely coarse wheezing on auscultation);
• bronchiolitis (cough of varying intensity, wheezing of various sizes).

Separately, we should highlight the syndrome of lung tissue damage - pneumonia (pneumonia). In the context of acute respiratory infections, it should be considered as a complication of the underlying disease. It manifests itself as a significant deterioration in the general condition, a pronounced cough that intensifies with inspiration, with the sound of crepitus on auscultation, moist fine rales, sometimes shortness of breath and pain in the chest.

Additional syndromes may include:

• exanthema syndrome (rashes on the skin);
• tonsillitis (inflammation of the tonsils);
• lymphadenopathy (LAP);
• conjunctivitis;
• hepatolienal (enlarged liver and spleen);
• hemorrhagic;
• enteritis.

Algorithm for recognizing acute respiratory infections of various etiologies:

There are differences in the initial period of influenza and other acute respiratory diseases, expressed in the earlier onset of SOIS in influenza (delay of SPRT) and the opposite situation in relation to acute respiratory infections of other etiologies.

A typical acute respiratory infection begins with a feeling of discomfort, soreness in the nose and throat, and sneezing. Over a short period, the symptoms increase, the soreness intensifies, a feeling of intoxication appears, the body temperature rises (usually no higher than 38.5℃), a runny nose and a mild dry cough appear. Depending on the type of pathogen and the properties of the microorganism, all of the listed acute respiratory infections syndromes may sequentially appear in various combinations and degrees of severity, and symptoms of complications and emergency conditions may develop.

Pathogenesis of acute respiratory diseases (ARI)

The entrance gate is the mucous membrane of the oropharynx and upper respiratory tract.

The first stage of colonization of the human body is the adsorption of the infectious agent on the surface of cells that have specific receptors for each type of pathogen. This function is usually performed by one of the surface proteins of the pathogen's envelope, for example, the fibril glycoprotein in adenoviruses, the hemagglutinin spikes in paramyxo- or orthomyxoviruses, and the S-compound protein and glycolipids in coronaviruses. The interaction of a pathogenic agent with cellular receptors is necessary not only for its attachment to the cell, but also for the launch of cellular processes that prepare the cell for further invasion, i.e. the presence of appropriate receptors on the surface of cells is one of the most important factors determining the possibility or impossibility of the occurrence of infectious process. The entry of a pathogen into a host cell triggers a flurry of signals that activate a range of processes by which the body attempts to rid itself of it, such as an early protective inflammatory response, as well as cellular and humoral immune responses. An increase in cell metabolism, on the one hand, is a protective process, but on the other hand, as a result of the accumulation of free radicals and inflammatory factors, the process of disruption of the lipid layer of cell membranes of the epithelium of the upper respiratory tract and lungs is started, the matrix and barrier properties of intracellular membranes are disrupted, and their permeability increases. and disorganization of the cell’s vital activity develops until its death.

The second stage of infection will be marked by the virus entering the blood and spreading throughout the body - viremia, which, together with an increase in the activity of protective mechanisms and the appearance of cell breakdown products in the blood, causes intoxication syndrome.

The third stage is characterized by increased severity of immune defense reactions, elimination of the microorganism and restoration of the structure and function of the affected host tissue.

Classification and stages of development of acute respiratory diseases (ARI)

1. According to clinical form:

• typical;
• atypical

a) acatarrhal (no signs of respiratory tract damage in the presence of symptoms of general infectious intoxication);

b) erased (mild clinical picture);

c) asymptomatic (complete absence of clinical symptoms);

2. Downstream:

• uncomplicated acute respiratory infections;
• complicated acute respiratory infection;

3. By severity:

• light;
• average;
• heavy.

Complications of acute respiratory diseases (ARI)

Diagnosis of acute respiratory diseases (ARI)

In widespread routine practice, laboratory diagnosis of acute respiratory infections (especially with a typical uncomplicated course) is usually not carried out. In some cases the following may be used:

• a detailed clinical blood test (leukopenia and normocytosis, lympho- and monocytosis, with the accumulation of bacterial complications - neurophilic leukocytosis with a shift to the left);
• general clinical urine analysis (changes are uninformative and indicate the degree of intoxication);
• biochemical blood tests (increased ALT with certain systemic pathogens, for example, adenovirus infection, CRP);
• serological reactions (retrospective diagnosis using RSK, RA, ELISA methods is possible - rarely used in practice. Currently, PCR diagnostics of fingerprint smears is widely used, but its use is limited mainly to hospitals and research groups).

If complications are suspected, appropriate laboratory and instrumental studies are carried out (x-ray of the paranasal sinuses, chest organs, CT).

Treatment of acute respiratory diseases (ARI)

Due to the extreme occurrence and, to a greater extent, the presence of forms of mild and moderate severity of the disease, patients with acute respiratory infections are treated at home, severe diseases (with the risk of development and developed complications) should be treated in an infectious diseases hospital (until the process normalizes and trends towards recovery appear). At home, acute respiratory infections are treated by a therapist or pediatrician (in some cases an infectious disease specialist).

One of the most important components in the treatment of acute respiratory infections is a favorable indoor microclimate: the air should be cool (18–20°C) and humid (air humidity - 60–65%). Accordingly, the patient should not be wrapped in fur blankets (especially at elevated body temperatures), but dressed in warm pajamas.

Food should be varied, mechanically and chemically gentle, rich in vitamins, low-fat meat broths are recommended - thin chicken broth, etc. is ideal), drink plenty of fluids up to 3 l/day. (warm boiled water, tea, fruit drinks). Warm milk with honey, tea with raspberries, and a decoction of lingonberry leaves have a good effect.

Drug therapy for acute respiratory infections includes etiotropic (i.e., affecting the causative agent of the disease), pathogenetic (detoxification) and symptomatic (alleviating the patient’s condition by reducing disturbing symptoms) therapy.

Etiotropic therapy makes sense only when prescribed in the early period and only with a limited range of pathogens (mainly influenza). The use of “highly effective” drugs from the domestic pharmaceutical industry (Arbidol, Kagocel, Isoprinosine, Amiksin, Polyoxidonium, etc.) has absolutely no proven effectiveness and can only have an effect as a placebo.

The following groups of drugs can be used as symptomatic therapy:

Forecast. Prevention

The leading role in preventing the spread of acute respiratory infections (excluding influenza) is:

• isolation separation of sick and healthy;
• during the epidemic season (autumn-winter), limiting visits to crowded places and the use of public transport;
• washing hands and face with soap after interacting with sick people;
• wearing masks by people with signs of acute respiratory infections;
• walks in the open air;
• healthy eating, multivitamins;
• hardening;
• frequent ventilation of the room;
• vaccine prophylaxis (Hemophilus influenzae, pneumococcus).

The main manifestations of acute respiratory infections are lesions of all parts of the respiratory tract - from the nasopharynx to the bronchi and lungs.

Respiratory infections affect all groups of the population from newborns to the very old. These are seasonal diseases that occur when the seasons change - in the autumn-winter period and early spring.

Acute respiratory infections often cause epidemics that become widespread. These infections are most severe in newborns and weakened people. A feature of acute respiratory infections is the frequent combination of mixed flora (microbes combined with viruses or protozoa), which complicates the diagnosis and treatment of these infections.

Based on the type of pathogen, there are three large groups of acute respiratory diseases: viral, microbial, caused by protozoa, and mixed infections (viral-microbial, microbial-microbial, viral-protozoan).

Causes

More than 200 types of viruses can cause acute respiratory infections:

All of them belong to certain groups: rhinoviruses, adenoviruses, coronaviruses, enteroviruses, parvaviruses, influenza viruses, respiratory sentiential viruses, etc.

In addition, respiratory infections are caused by such common microbes as Haemophilus influenzae, several strains of pneumococcus, meningococci, several types of streptococci, staphylococci, legionella, and Pseudomonas aeruginosa.

In addition, acute respiratory infections can be caused by pathogens such as mycoplasmas and chlamydia of various types.

The pathogen penetrates through the upper respiratory tract, fixes on the mucous membranes and multiplies, damaging the mucous membranes. In this case, the primary signs of acute respiratory infections appear - swelling and inflammation in the nose and throat. With reduced immunity, the pathogen quickly spreads down the respiratory tract. Usually, after an illness, a strong immunity is formed, but due to the abundance of pathogens of acute respiratory infections, you can get sick repeatedly and to varying degrees of severity.

Symptoms of acute respiratory infections

The entire clinical picture of acute respiratory infections can be divided into two large categories: catarrhal respiratory manifestations, general infectious symptoms.

Respiratory manifestations of acute respiratory infections include:

• runny nose,
• dry or wet cough,
• manifestations of acute tonsillitis,
• sore throat, sore throat, redness,
• manifestations of false croup,
• voice changes - hoarseness, hoarseness,
• manifestations of conjunctivitis,

Common infectious manifestations include:

• fever,
• malaise, headaches,
• loss of appetite, refusal to eat,
• enlargement of the liver and sometimes the spleen,
• enlarged lymph nodes,
• signs of toxicosis - anemia, pallor, nausea.
• pain in muscles, joints,
• skin rash.

Diagnostics

The basis for the diagnosis of acute respiratory infections is the clinical picture, supplemented by data from a general blood test with signs of microbial or viral inflammation.

With a microbial acute respiratory infection there will be leukocytosis, with a viral one - lymphocytosis.

To determine the type of microbial pathogen, it is necessary to inoculate mucus from the nose and throat, as well as serological diagnosis - determination of the antibody titer, which increases several times, or the DNA of the pathogen.

Additional diagnostic methods are chest x-ray and ultrasound of internal organs.

Treatment of acute respiratory infections

Treatment methods largely depend on what pathogen is causing the acute respiratory infection. Common activities include:

• drinking plenty of water,
• diet - warm, pureed food,
• bed rest.

If these are viral acute respiratory infections, only symptomatic treatment is necessary; for microbial acute respiratory infections, a prerequisite is the prescription of broad-spectrum antibiotics (penicillins, cephalosporins), and for chlamydial and mycoplasma infections - specific treatment (macropen or rulide).

Otherwise, the principles of treatment are similar for all types of acute respiratory infections:

• antipyretics (nurofen, paracetamol - for children, aspirin in soluble form is acceptable for adults),
• anti-inflammatory sprays, lozenges, tablets (Tantum Verde, Strepsils),
• antitussives, expectorants (Sinekod, ACC, Ascoril),
• cold remedies (salin, acalor, pinosol),
• vitamin C, multivitamins,
• traditional medicine (linden blossom, tea with honey, milk with butter).

For most acute respiratory infections, the prognosis is favorable and complete recovery occurs. Specific prevention methods have been developed for certain types of acute respiratory infections:

• flu vaccine,
• vaccine against Haemophilus influenzae infection (Act-HIB),
• pneumococcal vaccine (Prevenar or Pneumo-23),
• vaccine against meningococcus (meningo A+C).

Acute respiratory diseases are almost the most common in the world. According to statistics, every adult gets acute respiratory infections up to three times a year. To date, over two hundred types of viruses have been registered that cause diseases of the throat, nasopharynx and upper and lower respiratory tract. Colds are contagious and are transmitted by airborne droplets, i.e. You can catch it anywhere: in transport, a store, an office, a dining room, and even at home if someone close to you “brought” the virus.

Acute respiratory infections are often confused with the flu. To distinguish these completely different diseases, you need to know:

• The flu immediately manifests itself with acute symptoms. A cold develops gradually.
• With the flu, the temperature rises to 38 degrees on the first day and does not decrease until five days. With acute respiratory infections, such an increase occurs in rare cases.
• If you have the flu, the intoxication of the body is pronounced: the patient feels chills, pain in the eyes and temples, dizziness, and aching joints. In acute respiratory infections, intoxication is mild.
• The cough with influenza is paroxysmal, painful, and begins on the second or third day. With a cold, it is moderate, in most cases dry, but begins on the first day of the disease.
• A runny nose with the flu is not severe and appears within two days. When you have a cold, it is immediate and very strong.
• With the flu, a sore throat does not always appear. For a cold, this is the main symptom.
• Redness of the eyes with the flu is very common. For a cold - subject to the addition of a bacterial infection.

We’ve figured out how to distinguish acute respiratory infections from influenza, now let’s figure out how to treat acute respiratory disease. But it is worth warning that in any case the diagnosis must be made by a doctor! Because influenza is a very dangerous disease that can cause life-threatening complications in vital organs.

First, a few mandatory rules

• Bed rest, at least for the first two days of the disease, in a ventilated room.
• If your body temperature does not rise above 38 degrees, you should not bring it down.
• Do not take antibiotics unless prescribed by your doctor. They are powerless against viruses. Their main strength is antibacterial.
• When body temperature rises above 37.5 degrees, thermal procedures are prohibited! May harm the heart and blood vessels
• Don't get carried away with vasoconstrictors. By drying out the nasal mucosa, it opens the way for viruses.
• Do not take expectorants and cough suppressants together. They stop each other's action.

There is a joke among people: “If you treat a cold, it will go away in seven days. Do not treat – within a week.” Jokes aside! Don't risk your health, you only have it! Trivial, as many believe, acute respiratory infections can lead to serious complications if left untreated. But you can overcome acute respiratory infections with remedies prepared at home, without harming your body or wallet. This requires several days and a necessary (and most importantly accessible to everyone) set of products. So, when we detect the first symptoms of an acute respiratory infection, we act immediately: we cannot waste a single minute of precious time.

Drinking plenty of fluids during acute respiratory infections

• Rosehip is a record holder for vitamin C content - what is needed for this disease. Pour one hundred grams of dried rose hips into a half-liter thermos and pour boiling water over it. After six hours, strain, mix with half a liter of pomegranate juice and drink a glass several times a day.
• Oatmeal-viburnum drink will improve immunity. Bring a quarter kilogram of unpeeled oats and half a glass of dried viburnum berries to a boil in one and a half liters of water. Remove from heat, cover with a thick towel and leave for three hours. Strain, add fifty grams of honey. You can drink it either warm or cold.
• Rowan is an excellent antitussive remedy. Brew fifty grams of dried rowan berries with half a liter of boiling water. Cover the dish with a warm cloth and leave to steep for eight hours. Drink fifty milliliters up to five times.
• Raspberries are a great remedy for colds. Make fruit drinks and infusions from them. Drink as much as you want. Here's the simplest recipe. Leave one hundred grams of dry raspberries in three glasses of boiling water for half an hour.

• Herbal tea for high fever. Pour half a liter of boiling water over a spoonful of linden flowers, chamomile and thyme. After five minutes, strain. Drink half a glass several times a day.
• Elderberry flower infusion improves immunity and fights fever. Brew one spoonful of flowers in a glass of boiling water. After ten minutes, drink the resulting infusion. Prepare it three times a day and drink it fresh.
• A decoction of currant leaves will relieve fever. Boil two tablespoons of currant leaf in a liter of water for five minutes. Drink a glass of the cooled and strained broth every hour.
• The infusion, the recipe for which we will give below, should not be given to pregnant women and children! Pour two tablespoons of sage into a liter of boiling water. After about five minutes, chop four cloves of garlic and add to the infusion. After half an hour, add the juice of half a lemon and finely chopped lemon zest. Leave for another half hour. Drink the entire amount of the resulting product within two hours.
• Make syrup from green pine cones; it is also good for lowering body temperature. Finely chop ten cones and pour two liters of boiling water. Reduce over low heat to half the liquid. Add one glass of sugar, stir and boil for twenty minutes. Cool and strain the syrup. Every two hours, drink two spoons.
• An infusion of parsley roots will quickly relieve high fever. Pour 250 grams of chopped parsley root with half a liter of boiling water. After five hours, squeeze the juice from one lemon. If the temperature is very high, drink 400 ml of the product at once. Usual intake: 100 ml up to six times a day.
• Foot wrap reduces temperature. Add a little vinegar to cold water, soak two towels in the solution and wrap them around your calves, up to the knees. On top - dry cloth. Keep the compress for ten minutes.
• Cold compresses are a well-known remedy. Keep bottles or heating pads filled with water in the refrigerator. To reduce the temperature, you should apply them to your armpits, knees or elbows, to your temples or forehead. The temperature will begin to drop before our eyes.

Gargling

• The simplest recipe is to dissolve one spoon of sea salt in two glasses of warm water.
• Rinsing with salt, soda and iodine will relieve inflammation. Dissolve a large spoonful of salt, tea soda and four drops of iodine in a glass of warm water.
• You can gargle with a regular soda solution, but not more than four times a day. To prepare it, dissolve a spoonful of baking soda in a glass of warm water.
• Rinsing with calendula infusion is comparable to an antiseptic solution. Brew two spoons of calendula flowers with a glass of boiling water. After fifteen minutes, strain and use for rinsing.
• You can gargle and take it orally with milk in which carrots have been boiled. Boil four medium carrots in a liter of milk until soft. Cool slightly and strain. Apply the milk decoction of carrots to your throat and drink the decoction little by little throughout the day.
• Taking beet juice and adding apple cider vinegar or a decoction of sage and chamomile makes a very effective gargle. Add a little vinegar or herbal infusion to beet juice, heat slightly and apply.

• It is recommended to rinse your nose every half hour. For the procedure, use an aqueous solution of salt and soda, the recipe for which is described above.
• Propolis tincture will help get rid of a runny nose. Lubricate the nasal passages with cotton swabs soaked in the tincture. Or place two or three drops in each nostril.
• Add a drop of eucalyptus oil and honey to the beetroot juice that has just been prepared. Mix thoroughly and drop into both nostrils. After instillation, it is advisable to lie down for about fifteen minutes.

Rubbing

It is most convenient to carry out the rubbing procedure before bedtime.

• For rubbing, mix one spoon of gum turpentine with two spoons of warm camphor alcohol. Rub the product into your chest, wrap yourself up and go to bed.
• Badger fat does not smell very pleasant, but it helps one hundred percent! Leave the fat at room temperature for a while until it becomes soft. Rub into chest and back until absorbed.
• Goat fat will help not only with acute respiratory infections, but also with bronchitis. Melt half a liter of fat, add 20 ml of alcohol tincture of propolis to it and place in a water bath until the alcohol evaporates. Pour the product into a jar and keep it in the refrigerator. Use a small amount of fat for rubbing.
• The easiest and most accessible method for rubbing is honey. Rub honey on your chest or back, apply fresh cabbage leaves, secure with a warm bandage and go to bed.

Inhalations are a very popular remedy among traditional healers. Let's list some of them.

• Chamomile is an essential ingredient in many traditional medicine recipes. Pour one spoonful of flowers into a glass of boiling water and place in a water bath for half an hour. Add boiling water to a volume of one liter. Cool slightly and breathe over the steam for a quarter of an hour.
• The following recipe is a little complicated to prepare, but very effective. A quarter of a briquette of pine concentrate, two spoons of eucalyptus leaf, a spoon of menthol oil, 15 drops of menthol alcohol, a spoon of chopped onion or garlic. Place all ingredients in a liter of boiling water, cool slightly and breathe over the steam for 10 minutes.
• You can inhale volatile emissions from onion or garlic pulp. In the first quarter of an hour they are most active and kill all types of viruses.

For oral administration

We can’t do without prescriptions from traditional medicine for internal use.

• Hot milk with honey should be drunk for general malaise and to reduce fever.
• Onion milk helps to cope with cough. Peel the onion and cut it into rings. Pour in milk and bring to a boil. Remove, cool slightly and strain. Drink before bed.
• Squeeze the juice from one lemon. Add a spoonful of cognac and a spoonful of honey to it. Stir and leave for a day. Take one spoon three times a day.
• A tasty and equally healthy drink can be prepared from linden flowers and dried raspberries. Take 25 grams of raw material, pour two glasses of boiling water and leave for half an hour. Drink a quarter glass three times a day.
• Vegetable juice is a good way to maintain body tone. Extract the juice from beets, carrots and black radishes. Measure it in equal proportions and mix. Take one spoonful of vegetable juice before each meal.
• It is easy to prepare medicine from sea buckthorn. Crush one spoonful of fresh or defrosted berries, pour in two hundred ml of boiling water, cool slightly and add a spoonful of honey. Drink before bed.
• St. John's wort infusion is recommended for acute respiratory infections, sore throat and flu. Pour two tablespoons of herbs into a thermos and pour in a glass of boiling water. After two hours, strain and add honey to taste. Drink half a glass warm three times a day.
• Pine buds make a good expectorant. Pour one spoonful of buds into a glass of boiling water and place in a water bath for half an hour. Cool slightly, strain and drink a third of a glass three times a day.
• But the most interesting remedy is rowan berry tablets. They remove mucus from the bronchi well. Grind the rowan berries, add water twice as much as the volume of crushed berries. Place on low heat for 5 hours. Strain and put on the fire again to evaporate until viscous. Remove, cool and form the resulting mass into tablets. Take six homemade pills a day.

Prevention of acute respiratory infections

It is easier to prevent any disease than to treat it for a long time. By following simple rules, you can avoid infection.

• Clean hands are the key to health. Wash your hands after returning home, before eating, after caring for a sick person, even if it is your beloved child...
• If you are sick, cover your mouth when you sneeze or cough. This way you will protect your loved ones from infection.
• Use only disposable handkerchiefs and throw them in the trash immediately.
• During illness, provide separate cutlery for yourself or a sick family member. Wash and store them separately.
• Avoid close contacts with people with obvious signs of acute respiratory infections.
• Ventilate your apartment or office space.
• Take vitamin complexes.
• Include enough vegetables and fruits in your diet. Drink fermented milk drinks every day, eat cottage cheese and eggs, chicken, fish, lean beef. Eat small, frequent meals.

By following these very simple rules, you will avoid acute respiratory disease.

Video - How to quickly cure acute respiratory infections at home?