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Influenza, influenza virus infection

Influenza virus infections, influenza (ICD-10: J10, J11), are among the most common infectious diseases. Influenza is caused by highly contagious airborne viruses that cause acute febrile illness and result in varying degrees of systemic symptoms, from mild fatigue to respiratory failure and death. These symptoms contribute to significant loss of working days, mortality, and morbidity. The word “influenza” comes from the Italian language and means “influence,” as it was attributed to unfavorable astrological influences in the age of superstition.

Although most common influenza circulating strains in the annual flu cycle represent significant public health concerns, many more deadly strains of influenza appeared periodically. These deadly strains caused three global pandemics in the last century, the worst of which occurred in 1918. called the Spanish flu (although most cases occurred in the United States and elsewhere in Europe before Spain), and the pandemic killed between 20 and 50 million people.

In addition to humans, the flu also affects various animal species. Some of these influenza strains are species-specific, but new strains can spread from other animal species to humans. So that, e.g., the term “avian influenza” is used to denote zoonotic human infections by a strain of influenza that primarily affects birds.

Types of flu

Swine flu refers to infections with strains derived from pigs.

The flu’s signs and symptoms overlap with many other signs of the virus upper respiratory tract infections. Viruses such as adenovirus, enterovirus, and paramyxovirus can initially cause influenza symptoms.

The standard for diagnosing influenza A and B is a viral culture of nasopharyngeal or throat samples. However, this process can take 3-7 days, which is usually longer than the patient’s stays in the clinic, office, or emergency room and after a time when the therapy can be effective. Recently, PCR laboratory techniques have become available that require less than 24 hours and have good sensitivity. However, due to the cost and availability of tests, clinicians most often diagnose influenza only based on clinical criteria, which we will describe later.

As with other diseases, flu prevention is the most effective strategy. Every year, a vaccine is made that contains the antigens of the strains that are most likely to cause infection during the winter flu season. The vaccine provides good protection against immunized strains, becoming effective 10-14 days after administration. Antiviral medications that can prevent some flu cases are also available; if given after the development of the disease itself, they can reduce the duration and severity of the disease.

Influenza epidemiology

In the tropics, influenza occurs year-round, but in the northern hemisphere, the group season typically begins in early fall, peaks in mid-February, and ends in late spring of the following year. The duration and severity of a flu epidemic vary, depending on the virus’s causative strain.

In the 2006/2007 flu season, as representative of the “typical flu season,” nearly 180,000 respiratory samples tested positive for influenza. Data for the United States say that in 2006. This epidemic caused 849 deaths (608 in people over the age of 75) and in 2007—411 deaths (216 in those over 75 years of age). Combined with pneumonia, influenza claims 36,000 lives a year in the United States alone.

Unlike the typical flu season, the 2009/2010 season. It was marked by the H1N1 virus (swine flu), where the disease was more severe among people younger than 65 years than in non-pandemic seasons, with significantly higher pediatric mortality and higher hospitalization rates of children and young adults.

As for bird flu, as of March 2011. 532 cases were reported, with 315 deaths, with most East Asia cases. Cases were reported in all age groups ranging from 3 months to 75 years of age, with a mean age of 20. Most cases and the highest mortality rate (79%) were observed in persons aged 10-19.

Primary risk factors for human H5N1 influenza virus infection (“ bird flu “) is direct contact with an infected person or dead birds infected with it. Contact with the feces of infected birds or contaminated water surfaces is also considered an infection mechanism. Other specific risk factors are not known.

Pathophysiology of influenza

influenza vaccination
Influenza vaccination

Influenza viruses A and B belong to the family orthomyxovirus (This group of viruses also includes influenza C, which is not medically important, although epidemics of influenza C have been reported, especially in children), spherical enveloped viruses with a segmented single-stranded negative RNA coil. RNA consists of 8 genetic segments surrounded by 10 (in the influenza A) or 11 (influenza B) protein. Immunologically, the most important surface proteins are hemagglutinin (H) I neuraminidase (N).

Hemagglutinin and neuraminidase

Hemagglutinin and neuraminidase are the most important virulence factors and are the main targets of neutralizing antibodies of acquired immunity to influenza. Hemagglutinin binds to respiratory epithelial cells, enabling cellular infection. Neuraminidase cleaves the bond that holds newly replicated virions on the cell surface, allowing the infection to spread.

Virus identification

Influenza A identification is made by identifying both N and H. Sixteen N and 9 H types have been identified so far. Different combinations of HINs result in 144 combinations and potential virus subtypes. The most common subtypes of human influenza viruses identified today contain hemagglutinins 1, 2, and 3 and neuraminidases 1 and 2. These variants are responsible for species specificity due to receptor utilization differences (particularly sialic acid, which binds hemagglutinin and is cleaved by neuraminidase when the virus leaves the cell).

For example, influenza A subtype H5N1 expresses hemagglutinin 5 and neuraminidase 1.

H3N2 and H1N1 are the most commonly prevalent influenza A subtypes affecting humans. Each year, the vaccine used contains influenza A strains H1N1 and H3N2 and an influenza B strain.

Viral RNA polymerase does not have a mechanism to check for replication errors, so year-to-year variations are sufficient to provide a significant number of susceptible hosts. Also, the segmented genome can reorganize genomic segments from different strains of influenza in a co-infected host.

Animal flu

In addition to humans, influenza also infects various animal species. More than 100 types of influenza A infect most birds, pigs, horses, dogs, and seals. Some of these strains of influenza are species-specific. Species specificity depends in part on the ability of hemagglutinin to bind to various sialic acid receptors on airway epithelial cells. In humans, the influenza virus binds to alpha-2,6-sialic acid receptors.

In this context, the term avian influenza (“bird flu”) refers to a zoonotic human infection with an influenza strain that primarily infects birds. Swine flu refers to infections with strains that primarily affect pigs.

Influenza A is a genetically labile virus, where the frequency of mutations is almost 300 times higher than the frequency of mutations in other microorganisms.

Clinical picture

Symptoms

Presentations of influenza virus infection vary. Patients with influenza who have been previously immunized may have milder symptoms. Sudden onset of the disease is common. Many patients can give the time when the disease started. [/simptom]Fever can have wide variations, where some have a lower fever (around 37.5 degrees Celsius), and some develop up to 40 degrees Celsius. Some patients report a feeling of fever and chills.

Sore throat

The sore throat can be severe and can last for 3-5 days. A sore throat can be a significant reason why patients seek medical help. Myalgia is common and varies from mild to severe myalgia.

Frontal/retroorbital headache

Frontal/retroorbital headache is common and usually severe. Ocular symptoms develop in some patients with the flu, such as photophobia, a burning sensation, and pain when performing movements.

Some patients with influenza develop rhinitis of variable severity, but this is generally not the main symptom.

Weakness and severe fatigue

Weakness and severe fatigue can prevent patients from performing normal activities. Sometimes with flu patients, activities become difficult, and they may need bed rest.

Cough

Cough and other respiratory symptoms may be initially minimal but often progress as the infection progresses. They may report unproductive cough, pleurisy chest pain associated with cough, and dyspnea – respiratory system. In children, diarrhea may be present.

Acute encephalopathy is associated with influenza A infection.

The incubation period of influenza is on average 2 days but can vary from 1 to 4 days. Due to the aerosol transmission and possible (but less likely) transmission via asymptomatic individuals and contaminated surfaces, the patient may be unaware of disease exposure.

H1N1 flu pandemic

For the H1N1 flu pandemic, the initial symptoms were high fever, myalgia, rhinorrhea, and sore throat. Nausea, diarrhea, and vomiting were also reported.

In the medical history, avian influenza should be suspected in all patients exposed to sick, dead, or dying birds (such as poultry) or people with avian influenza. Many cases involve close contact, such as plucking or cleaning dead poultry or eating incompletely cooked poultry meat. Some patients have no history of exposure to diseased birds, suggesting that spread from asymptomatic birds is possible or that the virus may spread through the environment.

The average time from exposure to the disease’s onset is 2-4 days but can last up to 8 days. About 94-100% of cases begin with typical influenza syndrome, including high fever (over 38 degrees Celsius) and lower respiratory tract infection (cough and pleurisy). Headaches, myalgia, and fatigue are also common.

Dyspnoea has been reported in 76-100% of cases. Lower respiratory tract involvement appears to occur earlier with bird flu than with seasonal flu. Dyspnoea, hoarseness, and sputum can be the main complaints. Sputum is sometimes bloody.

Upper respiratory tract disorders such as sore throat or rhinorrhea occur in only about half of confirmed cases.

Gastrointestinal symptoms

Gastrointestinal symptoms such as diarrhea, nausea, and abdominal pain are common early complaints in 10-50% of patients. Bloody, watery diarrhea seems to be more common with bird flu than with human seasonal flu.

Encephalitis may occur. Only two people have presented encephalitis so far.

The incidence of asymptomatic or mild cases has not been established.

Physical examination

The general appearance varies among patients with influenza. Some appear acutely ill, with weakness and respiratory findings, while others appear only mildly ill. On examination, patients may have some of the following findings:

  • Fever of 37.5-40 degrees Celsius; fever is generally lower in older patients than in young adults,
  • tachycardia, which is probably the result of hypoxia, fever, or both,
  • pharyngitis – even in patients who report severe sore throat, the findings vary from minimal infection to more severe inflammation,
  • eyes may be red and watery,
  • the skin may be warm to hot, reflecting temperature status. Patients who have been febrile with low fluid intake may show signs of dehydration with dry skin,
  • pulmonary findings during the physical examination may include dry cough with clear lungs,
  • nasal discharge is absent in most patients.

High fever (over 38 degrees Celsius), tachypnea, and hypoxia can be reported with bird flu. Crepitations can sometimes be heard early and occasionally whistling. Patients typically have a productive cough, occasionally permeated with blood. Diarrhea is relatively common. Abdominal pain and vomiting are relatively rare. Signs of upper respiratory tract infection, including cholera (rhinitis), conjunctivitis, and pharyngitis, may not be noted, but these findings are not necessarily present.

Complications

Primary influenza pneumonia is characterized by progressive cough, dyspnea, and cyanosis after initial presentation. Thoracic X-ray shows a bilateral diffuse infiltrative pattern without consolidation, which may progress to a presentation similar to acute respiratory distress syndrome (ARDS).

Risks for viral pneumonia include several complex host immune system responses and viral virulence. Women in the third trimester of pregnancy have a higher risk. Other complications of influenza A and B. Older individuals, especially patients in nursing homes and those with cardiovascular disease, usually represent the most at-risk groups; however, certain influenza strains may target younger individuals. For example, in the 1918-1919 pandemic. Many young adults died of pneumonia, which some experts believe was caused directly by the virus.

Secondary bacterial pneumonia

Secondary bacterial pneumonia can occur due to several pathogens (e.g., Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenza). Staphylococcal pneumonia, which develops 2-3 days after the initial presentation of viral pneumonia, should be feared the most. Patients appear severely ill, with hypoxia, elevated white blood cell count, productive bloody cough, and chest X-ray showing multiple cavitary infiltrates.

Methicillin susceptible S.aureus

Methicillin-susceptible S.aureus (MSSA) and methicillin-resistant S.aureus (MRSA) as causes of pneumonia after influenza pneumonia have also been reported. MRSA pneumonia can be severe and difficult to treat, and deaths occurred within 24 hours of presenting pneumonia symptoms.

S.pneumoniae or H.influenzae pneumonia

S.pneumoniae or H.influenzae pneumonia, if it occurs as a complication, usually develops 2-3 weeks after the onset of the initial symptoms of influenza and can be treated as community-acquired pneumonia (see guidelines).

Myositis

Myositis is a rare complication. This group of patients may develop true rhabdomyolysis, with elevated creatine kinase levels and myoglobinuria. Myocarditis and pericarditis have been associated with influenza infection.

A meta-analysis of bird flu cases in four countries found that the clinical course of progression in ARDS and respiratory failure in 70-100% of cases. The median time for ARDS development was 6 days. Lymphopenia at presentation is a significant predictive factor in ARDS progression and death.

Severe cases of bird flu can progress to multiorgan failure. A study of 12 hospitalized patients with confirmed H5N1 influenza, 75% had respiratory failure, 42% heart failure, and 33% renal failure.

Diagnosing the flu

The standard for diagnosing influenza A and B is viral culture nasopharyngeal specimens and pharyngeal specimens. Rapid diagnostic tests are also available, but most physicians diagnose influenza only based on clinical criteria because of their cost, availability, and susceptibility issues.

Complete blood counts and electrolyte levels are nonspecific but aid in diagnosis. Leukopenia and relative lymphopenia are typical influenza findings. Thrombocytopenia may be present.

Influenza prognosis

In patients without the comorbid disease, who acquire seasonal flu, the prognosis is excellent. However, some patients have an extended recovery time and remain weak and tired for weeks.

The prognosis in patients with avian influenza is related to hypoxia’s degree and duration. To date, cases have shown a mortality rate of 60%. The risk of mortality depends on the degree of respiratory disease more than bacterial complications (pneumonia). Little evidence is available regarding the long-term effects of the disease on survivors. The mortality rate for those cared for in most developed countries is significantly lower.

The U.S. CDC estimates that seasonal flu is responsible for an average of more than 20,000 deaths a year. Mortality rates are highest in newborns and the elderly.

Pneumonia infection

Pneumonia is an infection of the pulmonary alveoli or walls of the alveolar sacs. The diagnosis of pneumonia is quite obvious; however, as many organisms can cause pneumonia, determining the cause in a particular case can be very difficult.

Numerous microorganisms can cause pneumonia, but they most commonly cause its bacteria. Common causes depend on the patient’s immune status, the location where the patient developed pneumonia, the patient’s age, and the type of pneumonia the patient exhibits (e.g., typical of interstitial pneumonia). Clinical and epidemiological factors are used to determine the most likely cause of each particular pneumonia case.

pneumonia pneumonia table 1
pneumonia 2

Manifestations of pneumonia

Many patients diagnosed with pneumonia mention that they have previously had similar symptoms, flu, or upper respiratory tract infection. A patient with pneumonia will often continue to have an upper respiratory tract infection and develop respiratory symptoms that indicate a lower respiratory tract infection – cough, dyspnea, sputum production, and tachycardia. A pneumonia diagnosis is more likely if the patient also has a fever (except neonatal diagnosed with afebrile Chlamydia trachomatis pneumonia) and auscultatory findings that include abnormal breathing sounds, abnormal percussion findings, and crepitations.

Chest X-ray of a patient with Q fever. The arrow indicates the consolidation of the lower right part of the lung and the thickened pericardium.

Pneumonia can be classified depending on the rate of pneumonia development. Pneumonia with an acute onset develops within 24-48 hands is common in typical pneumonia patients. The patient’s only complaint may be an infection of the upper respiratory tract. Still, the manifestations of typical pneumonia develop rapidly – high fever, shivering, dyspnea, tachycardia, productive cough with purulent sputum, and lung consolidation as seen on X-ray.

Interstitial pneumonia (atypical pneumonia) has a subacute onset; it may take several days to a week before the patient develops signs and symptoms of pneumonia – lower-grade fever, shivering, paroxysmal cough with or without mucoid sputum production, and pulmonary infiltrates seen on chest X-ray.

Chronic pneumonia takes weeks to months to develop full symptoms. Patients usually present a history of night sweats, low-grade fever, significant weight loss, productive cough with purulent sputum, dyspnea;  Ghon hotspots can be seen on an X-ray of the lungs.

The symptoms of aspiration pneumonia are similar to other acute-onset pneumonia, except that patients experience recurrent rigor rather than cold-induced rigor. The consolidation of lung segments is seen on X-ray. About half of patients with aspiration pneumonia will have unpleasant-smelling sputum.

Some causes of pneumonia that give unique signs and symptoms:

  • Legionnaires’ disease caused by Legionella sp . may result in pneumonia with relative bradycardia, abdominal pain, vomiting, diarrhea, hematuria, mental confusion, abnormal liver, kidney test results, and increased serum creatinine phosphokinase levels.
  • Psittacosis cause by Chlamydophilae psittaci  (formerly known as Chlamydia psittaci ) may result in pneumonia with relative bradycardia, epistaxis,  Horder points, splenomegaly, or normal or low white blood cell counts. The disease is associated with people who care for parrots.
  • Q fever caused by Coxiellae burnetti can cause pneumonia with relative bradycardia, hepatomegaly, endocarditis, and abnormal liver function tests. Q fever is associated with farmers who have recently given birth to animals.
  • Erythema nodosum and hilar adenopathy can be seen in patients with pneumonia due to fungi like  Histoplasma capsulatum and  Coccidioides immitis.
  • Fungal pneumonia most commonly causes Blastomyces dermatitidis. It can also produce rough verrucous skin lesions.

Epidemiology of pneumonia

  • In the United States alone, two to three million pneumonia cases are reported annually.
  • In the U.S. alone, pneumonia patients are responsible for over 10 million doctor visits, half a million hospitalizations, and 45,000 deaths a year. Expensive influenza and pneumonia are the seventh leading cause of death in the United States.
  • A patient with pneumonia usually had a previous viral infection of the upper respiratory tract.
  • Inhalation and aspiration are the two most common ways of acquiring infectious pneumonia.
  • Pneumonia is more common in the winter months and in people over 65.
  • Elderly patients are more likely to be hospitalized and have a higher mortality rate after the onset of pneumonia.
  • Aspiration pneumonia is an endogenous infection.
  • The following conditions predispose a person to aspiration pneumonia: altered level of consciousness, alcoholism, seizures, anesthesia, central nervous system disorders, trauma, dysphagia, esophageal disorders, and nasogastric probes.

Pathogenesis of pneumonia

Bacteria are not present in the lower respiratory tract of patients with pneumonia. Organisms that enter the alveoli are eliminated through alveolar macrophages, which are considered to be the most important pathway for the elimination of organisms that manage to escape the defense mechanisms in the upper respiratory system.

  • When a microorganism enters the alveoli, IgG can be opsonized in the fluid lining the alveoli and then digested. Macrophage via the Fc receptor.
  • If no specific antibody to the organism is present, the macrophage can still phagocytose the microorganism using C-reactive protein or complement receptors or via receptors for pathogen-associated molecular patterns (PAMPs). Mannan, lipopolysaccharides, lipoteichoic acid, N-formylated methionine-containing peptides, muramyl peptides, and peptidoglycans are examples PAMPs that alveolar macrophages can use to phagocytose bacteria.
  • When a microorganism phagocytoses, macrophages destroy the microorganism, if possible, and present microbial antigens on the surface for B and T lymphocytes.
  • When activated, B and T lymphocytes can produce more antibodies and activate macrophages. Macrophages simultaneously release factors that help carry polymorphonuclear leukocytes out of the bloodstream and initiate an inflammatory response. Polymorphonuclear cells, antibodies, and complement components are useful in destroying microorganisms.

Bacterial survival in areoles

Many bacteria that cause pneumonia can initially survive in the alveoli due to the following self-defense mechanisms:

  • Capsules (e.g., Streptococcus pneumoniae, Haemophilus influenzae ) prevents phagocytosis by alveolar macrophages.
  • Viruses and  Chlamydia invade the host cell before alveolar macrophages can phagocytose them.
  • Mycobacterium tuberculosis can survive in alveolar macrophages even after macrophages phagocytose them.

If organisms survive in the alveoli, microbial growth can cause tissue injury, stimulating the host to amplify the inflammatory response. Tissue injury can also occur due to exotoxins produced by bacteria, cell lysis caused by viruses, or the death of alveolar macrophages and the release of their lysosomal contents into the alveoli due to the growth of microorganisms in phagocytes.

Vascular permeability increases and polymorphonuclear cells arrive in the area with many serum components, trying to retain and eliminate microorganisms. While microorganisms damage the alveoli, other alveolar macrophages are recruited into the area of inflammation. Lung-associated lymphoid tissue (mediastinal lymph nodes) becomes enlarged after B and T lymphocytes’ activation. Chest X-ray may show enlargement of mediastinal lymph nodes in patients with pneumonia.

Typical or lobar pneumonia

Accumulation of microorganisms, immune system cells, and serum components can cause alveolar filling. This inflammatory response is called opacity or consolidation on chest X-ray and is commonly seen in patients with pneumonia caused by S.pneumoniae. This type of pneumonia is called typical or lobar pneumonia. The inflammatory response to infection produces factors that allow microorganisms to leave the lungs and cause systemic effects such as fever. Examples of microbial factors that may have systemic effects include gram-negative bacterial endotoxin that causes fever and septic shock and gram-positive bacterial cell wall components that can lead to fever and septic shock.

Organisms like Mycoplasma pneumoniae and influenza virus do not initially cause the accumulation of large amounts of fluid in the alveoli. However, after infection with these organisms, inflammation in the interstitial spaces (alveolar walls) occurs, resulting in interstitial or atypical pneumonia. Thoracic X-ray in patients with this type of pneumonia shows fine granular diffuse infiltrates.

Other organisms like Staphylococcus aureus, gram-negative rod-shaped bacteria, and anaerobic bacteria from abscesses or microabscesses. In these infections, the immune system can isolate itself from organisms and create localized abscesses or microabscesses that usually show a well-localized circular lesion with necrotic translucent centers on chest X-ray.

Diagnosing pneumonia

Patients with pneumonia may present with chest discomfort, cough (productive or unproductive paroxysmal cough), rigore (patients with typical pneumonia), or feeling cold (patients with interstitial pneumonia), dyspnea, and fever. Physical examination may reveal increased respiratory rate and mucus on percussion over the affected regions of the lungs.

rtg snimak dijagnozaChest X-rays show new consolidations or infiltrations and help diagnose pneumonia. When the alveolar sacs are filled with inflammatory cells and fluid, chest X-rays show consolidated well-defined density areas – unilateral (inhalation or aspiration pneumonia), bilateral (hematogenous spread to the lungs), localized, or uniform. When a chest X-ray shows inflammation and thickening of the alveolar septa surrounding the alveoli, rather than filling the alveolar sacs with inflammatory material, a diagnosis of interstitial pneumonia is more likely.

Some organisms form abscesses in the lungs (e.g., S.aureus, Enterobacteriaceae, Pseudomonas aeruginosa, and anaerobic organisms); in such cases, a chest X-ray is useful for detecting abscesses. If present, certain radiological samples may have diagnostic value, e.g.:

A sign of a convex fissure as seen in Klebsiella pneumoniae infection (but also in other infections such as S. pneumoniae, P.aeruginosa, S.aureus, Legionella, and sometimes bronchoalveolar carcinoma.

  • Infection Klebsiella pneumoniae causes consolidation of the upper lobes, resulting in a “bulging fissure sign,” i.e., by dilating the affected part of the lung.
  • S.aureus  lung infections can cause multiple bilateral nodular infiltrates with central cavitation. In children, chest X-rays may show thin cavities (pneumatocele), bronchopleural fistulas, and empyema.
  • P.aeruginosa  infections can result in microabscesses that can merge into large abscesses.
  • Infections with gram-negative rods (e.g., Klebsiella, Proteus, E.coli ) often cause lung necrosis.
  • Consolidation of individual lung segments may indicate aspiration pneumonia.

Pathogen identification

To identify the specific pathogen that causes pneumonia, clinical and epidemiological data must be considered to limit the number of possible causes of pneumonia.

Gram staining of sputum in a patient with pneumonia due to Streptococcus pneumoniae. Gram-positive diplococci are seen in the sputum, and many polymorphonuclear leukocytes are present.

Gram staining of sputum of a patient with suspected pneumonia can help identify the cause of pneumonia. Some pathogens are poorly Gram-stained or not stained at all; other colors can be ordered: Dieterle silver color ( Legionella sp .), acid-fast Mycobacteria ), Gomori methenamine silver staining (fungi and Pneumocystis ).

Laboratory tests at diagnosis

Additional laboratory tests that can help establish a definitive diagnosis:

  • Sputum culture,
  • culture of blood samples for bacteria, fungi, or viruses,
  • serology for the detection of antibodies against pathogens (e.g., cold agglutination for M.pneumoniae; detection of antibodies to the capsule S.pneumoniae ),
  • antigenic tests to detect certain antigens produced by pathogens (e.g., polysaccharides for S.pneumoniae  and H.influenzae ),
  • skin tests to detect delayed hypersensitivity to certain pathogens (e.g., Mantoux test for M.tuberculosis, B.dermatitis, H.capsulatum, C.immitis).
  • PCR (polymerase chain reaction) for sputum samples and rapid determination of pathogens,
  • Urinalysis for  Legionella  antigens.

Treatment and prevention of pneumonia

Since bacteria cause most pneumonia cases, treatment usually involves antibiotic therapy. The tables list empirical treatments for patients with pneumonia. In about half of the patients, the etiological agent can be determined, and if it is known, more precise therapy can be started.

Two vaccines can be given to adults to help prevent pneumonia. The S.pneumoniae vaccine contains 23 types of capsular antigens and is used in people over 65 years of age. The influenza vaccine can be given annually to all people over the age of 50 to help prevent viral pneumonia or secondary bacterial pneumonia that can occur after an influenza virus infection. Chemoprophylaxis to prevent influenza infections is useful in preventing secondary bacterial pneumonia.

Conjugated heptavalent S.pneumoniae  The vaccine is important in preventing these infections in younger children. The conjugated H.influenzae type b (Hib) vaccine prevents H.influenzae infections in childhood. Premature neutropenic infants can prevent respiratory syncytial virus infections or infants with different predispositions to infection by periodic injections of immune globulin for respiratory syncytial virus or humanized murine monoclonal antibody (palivizumab). Annual immunization of children with influenza vaccine prevents infections in vaccinated children and appears to prevent the virus’s spread by close contact.

Ten natural remedies for colds and flu

I am currently writing this post while recovering from a cold. I usually have one severe cold every year. Over the years, I have developed a protocol to help my body overcome colds or flu faster. There are so many effective remedies that you can find in the home that I would rather reach for them than for conventional medications. My opinion is shared by big brands that are constantly looking for new natural remedies that help with colds and flu. I was a partner of CVS pharmacies that released a new series of Live Better products that help your body heal naturally. Live Better products do not contain artificial preservatives, colors, flavors, flavors, so you can be sure when using them.
 
I have my own protocol when I catch a cold or feel signs of a cold or flu. The protocol contains ten natural remedies that will help you recover and heal without official remedies. Use the recipe that suits you, but then be completely consistent in its application. Stress can also cause illness or aggravate the disease’s symptoms, so it is crucial to relax, sleep and let the body rest and strengthen.
 
Here are ten medicines against flu and cold that help your body in a natural way
 

Gargling with salt water

Do this as soon as you start to feel sick. Not only helps relieve sore throat, scratch in the throat, gargling salt water draws viral fluids from the throat area.1 / 4 to 1/2 tablespoon of salt dissolved in a glass of warm water rinse the throat once or twice times a day.

Honey

Honey helps soothe sore throats and acts as a cough suppressant. Honey can soothe irritated mucous membranes, which removes the irritation that stimulates the cough reflex. CVS cough syrup effectively uses a mixture of dark types of honey, vitamin C, and zinc. Vitamin C and zinc significantly help the immune system, so the syrup’s effect is enhanced. This product does not contain artificial preservatives, colors, and flavors, so it is completely safe to use. It is a great natural solution for solving colds and coughs.
 

Ginger

Ginger has anti-inflammatory and antibacterial effects. It is known to help with colds, nausea and fever. Eating ginger can also help or buy ready-made juice.

Blueberry

Blueberry is a fruit grown from an older tree with anti-inflammatory and antioxidant properties, which makes it powerful in fighting colds. Studies have shown that taking blueberry juice can shorten the common cold and alleviate sinusitis.

Propolis

Do you know that bees produce more than honey? Propolis is a substance that bees use in closing hives, so it is a super antibacterial and antiviral substance. It is great in the fight against sore throats and colds, and it is my favorite product that I use when I have a cold.

Essential oils

There are many powerful essential oils that you can use for colds and flu, but here are a few of the most available: eucalyptus oil has antiviral and antimicrobial properties that have been used extensively in the past for colds. Peppermint oil is used as a natural decongestant and to soothe fever. For topical use, be sure to use essential oils diluted with oil carriers.

Garlic

Garlic is a powerful antioxidant with antimicrobial, antiviral and antibiotic properties. Garlic is full of minerals, enzymes, vitamin C, sulfur and selenium that help against colds and flu.

Probiotics

When my intestines were sick, probiotics did me no good. On the contrary, they only made my condition worse. If you have a healthy gut, probiotics can help strengthen your immune system. Whether you use probiotics in capsules or ingest them in foods rich in them, such as yogurt, sauerkraut, or other fermented foods, you should know that it all starts in the intestines.

Bone soup

 Bone soup
Bone soup, or chicken soup made by grandmothers for centuries, effectively fights colds and fevers. The soup contains anti-inflammatory amino acids and is full of immune vitamins and minerals that are very easy for your body to digest. To take advantage of the soup in the right way, use only home-made ones.

Bath with bitter salt

Add they are bitter in a warm bath and some essential oils to relax and detoxify the body. Minerals in the bathtub through osmosis cause toxins to be released from your body in the bathtub, which relaxes you and detoxifies your body.

Sleep

To really heal, your body needs rest and enough sleep. If you have trouble sleeping, melatonin plus a mixture of vitamins and minerals is recommended. Melatonin will help you fall asleep easier and allow your body to rest and heal.