Influenza in children

Introduction
Cause
Prevention
Complication
Symptom
Examine
Diagnosis

Introduction

Introduction to Pediatric Influenza Influenza in children mainly refers to influenza (influenza) that occurs in infants and young children. It is a common acute respiratory infection caused by influenza virus. It has strong transmission and is often endemic. When the population is still immune to new influenza virus variants, it can lead to a worldwide pandemic, characterized by sudden onset and rapid spread. The main clinical manifestations are sudden high fever, headache, body aches, fatigue and respiratory inflammation. Cough, sore throat, etc. Infants and the elderly are prone to pulmonary infections, and prevention and treatment cannot be ignored. basic knowledge The proportion of illness: 80% Susceptible people: young children Mode of infection: respiratory transmission Complications: myocarditis, acute tracheobronchitis in children, rhinitis, otitis media

Cause

Pediatric influenza cause

80% to 90% of the colds are caused by viruses, and there are more than 200 kinds of viruses that can cause colds; 10% to 20% of the colds are caused by bacteria. Infants under the age of 1 are more likely to have a cold because the immune system is not yet mature.

Children are prone to catch a cold, first of all related to their physiological and anatomical features, and the immature immune system. The child's nasal cavity is narrow, the mucous membrane is tender, the mucosal gland is insufficiently secreted, it is dry, and it is poorly adapted and resistant to the external environment, and is prone to inflammation. Premature infants, children with congenital defects or diseases, such as cardiopulmonary insufficiency, especially those with congenital immune diseases, may have a cold when they take care of a slight mistake.

Secondly, it is also related to the improper feeding of parents. Because of the rapid growth of children, children who are artificially fed due to lack of breast milk, and children who are too pampered, partial eclipse or anorexia, malnutrition or imbalance may cause different degrees of iron deficiency. Lack of calcium or insufficient intake of vitamins and proteins. Nutrients such as iron, zinc and protein play an important role in the synthesis of various globulins of the immune system and in promoting the maturation and differentiation of immune cells, affecting the resistance of the child's body.

Third, it is related to poor surroundings. Some children have poor family room conditions, dark and humid; some indoor temperatures are too much or too low; some families like to close the doors and windows all day long, the air is not circulating; some family members like to smoke, plus the same room fire, smoke pollution serious. Poor environment, turbid air, and great harm to the respiratory tract are important causes of colds. Some parents dress too much or too little for their children. The result is not sweating or cold, it is easy to induce a cold.

Finally, the cold is also associated with a lack of outdoor exercise. Due to objective conditions or insufficient attention, many children lack outdoor activities. For example, in northern China and in areas with long cold seasons, children spend most of their time indoors and rarely have the opportunity to be outdoors; some parents love children and keep their children in air-conditioned rooms. Once these children are cold, they can't adapt and are prone to colds.

Prevention

Pediatric influenza prevention

Pay attention to rest

The younger the baby is, the more rest and care is needed, and the activity will resume after the symptoms disappear, so as not to relapse due to the failure of the lesion. For those with fever, it is best to rest in bed to reduce the stimulation of the central nervous system.

2. Reasonable diet

A baby with a cold and fever is prone to loss of appetite, nausea, vomiting, abdominal pain and diarrhea. Dietary care is very important. The general principle is to choose digestible food and eat less. If you insist on eating your baby, it will cause your baby's gastrointestinal burden to be heavy, which is harmful to your body and disease recovery. You can eat less food each time, eat more times, and give your baby some fruit juice, such as fresh orange juice. A baby with a fever and a good digestion ability can be thicker. As the baby's condition improves, it usually returns to a normal diet in about 1 week.

3. Environmental suitability

Keep your baby's room airy. For hot babies, fresh air helps the skin to sweat effectively and lowers body temperature. Should avoid direct blowing on the baby, resulting in the baby's skin vasoconstriction, aggravating the condition.

Arrange a good rest environment for the baby, keep the room quiet, do not speak loudly, increase the baby's sleep time as much as possible to reduce energy consumption. You can let your baby lie in bed, tell the baby a soft story or listen to music, help the baby to relax, and promote the recovery of the disease.

4. Effective sweating

Encourage your baby to drink more water. Water can increase the body's cellular metabolism, promote the discharge of toxins in the body, and at the same time effectively sweat, which is beneficial to lowering body temperature.

Don't over-thick your baby's clothes and bedding. Wear loose pants for effective sweating and heat dissipation. Do not give the baby a lot of clothes and cover the thick bedding, otherwise it will lead to high fever, and even induce febrile seizures! After taking the antipyretics, the baby will sweat a lot, and the clothes should be replaced after being wet. Suffering from the cold and aggravating the condition.

5. Physical cooling

Pediatric influenza drugs

Baby fever should be the preferred physical cooling, especially for small babies. When the physical cooling is invalid, use a small amount of antipyretics to cool the drug. Physical cooling methods include: local heat dissipation, warm bath or warm water bath, cold salt water enema, etc. Among them, the local heat dissipation method is the easiest and most convenient for families.

Local heat dissipation method

Head cold wet pack or head ice pack: This is the most common method. The cold and wet compress of the head (that is, the cold wipes applied to the baby's forehead) is the most accepted. Some babies do not want to put the ice pack on their heads, and they can be applied with cold wipes. Care should be taken to replace the ice pack or cold wipes frequently. Ice packs in the neck, underarms, and groin: These areas have larger blood vessels, and it is better to place the ice packs in these places. Warm bath or warm water bath: It can receive good cooling effect, but it is difficult to implement in winter.

Experts remind: to closely observe the changes in the baby's condition, pay attention to the horror of the fever, and watch out for the occurrence of febrile seizures. A baby who has had a fever and convulsions should take "Lumina" under the guidance of a doctor to prevent recurrence of febrile seizures. If you find a baby with a herpes in your mouth or a rash on your skin, you should see your doctor promptly.

Complication

Pediatric influenza complications Complications Myocarditis Children Acute tracheobronchitis Rhinitis Otitis

Infants and young children have frequent infections and lower respiratory tract, especially those with pneumonia. Pneumonia can be caused by influenza virus, or secondary bacterial infection, caused by influenza bacillus, Staphylococcus aureus, pneumococci, streptococci. Irritable, often see high fever within 48 hours, continue to retreat; a few moderate fever, gradually increased after 2 to 3 days, often accompanied by severe wheezing and cyanosis, even after heat retreat, there is still asthma, occasionally grass yellow pleural cavity Liquid, often vomiting, diarrhea, etc., when spit coffee, or accompanied by intestinal bleeding, are severe manifestations, sometimes early can occur convulsions, coma, neck rigidity, etc., cerebrospinal fluid pressure increased, the number of cells can be normal, protein is normal Or a slight increase, hemiplegia can occur in the course of the disease, but the recovery is faster, early X-ray examination, spotted or flocculated irregular shadows on both sides of the hilum, and then merged into small pieces or block shadows, the course of pneumonia is as short as 1 week It can be more than a month long, with an average hospitalization of about 3 weeks. The body temperature fluctuates and the lung signs disappear slowly.

Others can be complicated by rhinitis, angina, otitis media, laryngitis, tracheobronchitis, myocarditis, encephalitis, mumps, etc., influenza B can be complicated by Reye's syndrome, occasionally septic arthritis, peritonitis, neuritis , nephritis and calf pain in the calf and so on.

Symptom

Pediatric influenza symptoms Common symptoms Children with fever after a fever, chills, children, nasal congestion, runny nose, sore throat, dry cough, dizziness, sleepiness, high fever

1. Incubation period: about several hours to 1-2 days.

2, clinical symptoms: the clinical symptoms of children with influenza often have different characteristics due to different ages, the symptoms of older children are similar to adults, mostly manifested as common cold type, rapid onset, high fever, chills, headache, back pain Sore limbs, fatigue, etc., soon there will be sore throat, dry cough, runny nose, conjunctival congestion, tearing, and local lymphadenopathy, lungs may appear rough voice, occasionally complain of abdominal pain, diarrhea, abdominal distension and other digestive tract manifestations, In infants and young children, the clinical manifestations are similar to other respiratory viral infections. They are difficult to distinguish. The inflammation involves the upper respiratory tract, the throat, the trachea, the bronchi, the bronchioles and the lungs. The condition is more serious. Japanese scholars reported that the lower respiratory tract infection during the influenza epidemic. One-fourth of the hospitalized children were confirmed to be caused by influenza virus, which was several times higher than that caused by respiratory syncytial virus or adenovirus in the same period. The sick child often had high fever, with symptoms of systemic poisoning and clearing of nasal discharge, often accompanied by vomiting. Diarrhea, etc., occasionally rash and nasal discharge, body temperature fluctuates at 38 ~ 41 ° C, can have febrile seizures, young babies can have severe throat, trachea, bronchitis with sticky Sputum, and even respiratory obstruction, neonatal patients often have drowsiness, refusal to eat and apnea, and even need to use artificial respirator, the clinical manifestations of influenza B are similar to the type A, but more common nose, eye symptoms and signs, As well as myalgia caused by acute benign myositis, mainly seen in the lower limbs, especially in the lower leg gastrocnemius muscle, and systemic poisoning such as dizziness, fatigue, etc. are mild, most of the influenza C manifested as mild upper respiratory infection, no Complications of flu fever usually last for 3 to 4 days, and the symptoms of systemic poisoning are relieved after heat withdrawal, but dry cough and physical weakness can last for 1 to 2 weeks.

3, blood: the total number of white blood cells decreased, the average is about 4 × 109 / L, neutrophil reduction is significant, lymphocytes are relatively increased, large mononuclear cells can also increase, this special blood picture is very early in the first few days of the disease Significantly, often lasting 10 to 15 days, the total number of white blood cells may be greatly reduced when pneumonia occurs, as low as 1 to 2 × 109 / L, the blood sedimentation rate is generally normal, and the condensation test is mostly negative.

Examine

Pediatric influenza check

(1) Virus isolation: take the acute phase of nasopharyngeal cavity lotion, pharyngeal sputum or throat swab in the preservation solution, preferably inoculated immediately into the chicken embryo amniotic cavity or allantoic sac, or inoculated in sensitive In the cell culture of human embryonic kidney and the like, the influenza virus is isolated, and if necessary, the virus is isolated from the experimental animal, and the specimen is preferably taken within 3 to 5 days of onset, and the positive rate of late delivery is lowered.

(2) Hemagglutination and hemagglutination inhibition test: The influenza virus has the ability to agglutinate guinea pig red blood cells (or chicken and human "O" type red blood cells), and the early nasopharyngeal cavity washing (washed with physiological saline) and guinea pig red blood cells Mixed, agglutination is positive, only indicates the presence of virus, this reaction is less sensitive, such as pre-added specific anti-influenza virus serum for hemagglutination inhibition test, positive indicates that the sample contains influenza virus, and can be further applied by this method For typing identification.

(3) Fluorescent anti-staining test Nasal mucosa cells: Rotate the nasopharyngeal swab several times in the nasal cavity, so that the swab is stained with mucous membrane exfoliated cells, applied to the slide, dried and then fluorescent antibody (anti-influenza virus specific serum) Staining, seeing multiple cells with apple green fluorescence under fluorescent microscope is positive, pay attention to identify non-specific fluorescent spots, positive ones have a positive meaning, negative ones can not be completely excluded, this method is fast (completed within 2 hours).

(4) Serum antibody detection can be used.

1 Hemagglutination inhibition test.

2 neutralization test.

3 Complement binding test, the serum antibody titer in the recovery period is more than 4 times the initial titer has diagnostic value, the positive rate is generally 60% to 80%.

Diagnosis

Diagnosis of pediatric influenza

diagnosis

Because the performance of the flu is very similar to that of the common cold and upper respiratory tract infection, there is no obvious feature. Therefore, the initial cases are not easy to diagnose, and it is necessary to comprehensively diagnose according to epidemiological history, clinical symptoms and signs and pathogenic tests.

1. Epidemiological history: There is flu epidemic information in the local area, which is most helpful for diagnosis. In the flu epidemic season, the same symptoms in the surrounding population should raise the alert and the disease.

2, clinical diagnosis: sudden onset, fever, cold, headache, limb muscle soreness, fatigue and fatigue, gradually appearing respiratory symptoms have cough, sore throat, eye conjunctival congestion, cheek flushing, and catarrhal symptoms are not as good as ordinary colds Obviously, sore throat, pharyngeal redness and tonsil signs are not as serious as acute tonsillitis. It is a clinical feature of influenza. The surrounding white blood cell counts are mostly low or normal, and neutrophils are significantly reduced. It is clinically suspected of influenza, and infants are clinically The performance is less likely to be differentiated from other upper respiratory virus infections, and pathogenic diagnosis should be performed as soon as possible.

3. Pathogen diagnosis:

(4) Serum antibody detection can be:

1 hemagglutination inhibition test,

2 neutralization test,