ARVI, ARI, ORZ. What is it, how is it different and what is important to know?

Shekinah

Natalya Nikolaevna

16 years of experience

General practitioner

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ARI is an acute respiratory disease. This is not a separate disease, but a collective term that unites a group of all pathologies of the respiratory system, regardless of genesis. Provocateurs can be viruses, bacteria and intracellular parasites. The prevalence is enormous; in the autumn-spring period, outbreaks occur that take on the character of an epidemic. Infections affect all groups of the population. They are especially dangerous for children under one year of age and people with reduced immunity.

Definition of acute respiratory viral infections and acute respiratory infections and their differences

ARI is an acute respiratory disease, which, like ARVI, can occur with damage to the upper and lower respiratory tract, but can be caused not only by viruses, but also by any other pathogens. These can be bacteria, fungi, protozoa, etc.

Also, this condition can develop during hypothermia, excessive stress, heavy physical exertion, various chronic diseases - in other words, under any conditions when our immune system’s protective function decreases. With reduced immunity, pathogenic bacteria and viruses are activated.

ARVI and acute respiratory infections are united by an inflammatory process that develops in the upper respiratory tract ( tonsillitis , pharyngitis , rhinitis, sinusitis, laryngitis ) and can spread to the lower respiratory tract (tracheitis, bronchitis, pneumonia).

ARVI and acute respiratory infections affect both adults and children , regardless of social and living conditions.

Treatment of acute respiratory infections in children, effective relief of symptoms

Recommendations on how to treat acute respiratory infections in children are aimed at relieving clinical manifestations associated with the inflammatory reaction.

Recommendations on how to treat acute respiratory infections in children are aimed at relieving clinical manifestations associated with the inflammatory reaction.

• a diet rich in vitamins;
• drinking plenty of water;
• antipyretic drugs.

Locally, symptoms are relieved by the following means:

• for nasal congestion - with vasoconstrictor drops;
• if the throat is affected - with sprays, local antiseptics, gargles;
• to relieve a wet cough - with expectorants;
• for dry cough - antitussives. Source: T.A. Samsygina Modern treatment of acute respiratory diseases in children // Pediatrics, 2013, No. 3, pp. 38-42

Inhalations and physiotherapy may also be prescribed.

Antibiotic treatment for acute respiratory disease is prescribed to children when the causative agent is a bacterial infection; only a doctor should give clinical recommendations, select the drug and dosage. If a child is prescribed an antibiotic for the flu, it is necessary to relieve complications that arise from bacterial damage (for example, pneumonia). In general, antibacterial drugs are powerless against viruses.

Doctors recommend avoiding antibiotics for uncomplicated respiratory viral infections. Their use is not justified even with mucopurulent runny nose lasting less than 2 weeks. Source: Seto WH, Conly JM, Pessoa-Silva CL et al Infection prevention and control measures for acute respiratory infections in healthcare settings: an update // East Mediterr Health J., 2013, i9 (Suppl. i), p. 39-47

Signs of a bacterial infection for which antibiotics are indicated:

• anaerobic sore throat;
• purulent processes;
• acute tonsillitis when group A streptococcus is detected;
• sinusitis, if clinical changes persist in the sinuses after 2 weeks from the onset of the disease;
• acute otitis media;
• pneumonia;
• chlamydia and mycoplasmosis (respiratory form);
• bronchitis caused by mycoplasma (mycoplasma bronchitis).

The child is required to have bed rest

until body temperature normalizes,
eat a balanced diet, take multivitamins
. You can gargle with decoctions of medicinal herbs, infusions, and antiseptic solutions. If the body temperature is normal, then the following will be useful: dry heat on the lower back and feet, hot foot baths.

How often do we get ARVI?

Acute respiratory viral infections (ARVI) are the most common form of acute diseases. Approximately 80-90% of residents of the Russian Federation fall ill with ARVI every year. And during epidemics, almost every person gets sick once or more1. And all over the world, according to the World Health Organization (WHO), every adult on average gets sick 2 to 4 times a year2.

This is due to the high contagiousness of viruses and their wide variety. Moreover, different viruses can change due to mutations and become more infectious.

What is the incubation period of ARVI?

This is the period of time from the moment the virus is introduced until the first clinical manifestations (symptoms) appear.

The incubation period for most ARVIs ranges from 2 to 7 days. For some viruses, this period can last from several hours to 2 days.

When the virus enters a cell of the body, it begins to actively multiply (actively replicate), capturing more and more new cells. A patient with ARVI is a source of infection from the first day of symptoms. Maximum virus shedding occurs on day 3 after infection and is accompanied by the most severe symptoms. Typically, 5 days after the onset of the disease, symptoms subside, including a decrease in viral shedding.

Flu

Influenza is not a separate disease, but is part of the ARVI group.

Influenza is an acute infectious disease characterized by damage to the upper respiratory tract, as well as the lower respiratory tract, mainly the trachea. Manifested by high fever, severe catarrhal symptoms (cough, runny nose, sore throat, etc.).

Its special place among ARVI is due to the ability of the virus to undergo constant antigenic variability (mutation). The influenza virus is very active and is very easily and quickly transmitted from a sick person to a healthy person, especially in crowded places, including public transport, schools, boarding schools and kindergartens.

According to the WHO, every year between 3 and 5 million people worldwide fall ill with influenza. Unfortunately, in 250-500 thousand cases, influenza is fatal. During influenza epidemics, both adults and children become actively ill. People over 65 are especially vulnerable, with flu deaths being the highest among this population group. Epidemics can lead to a decrease in productivity in enterprises whose employees are absent from work due to illness, as well as a deterioration in the quality of education, as schoolchildren and students miss classes. During epidemics, the load on medical institutions increases, which affects the quality of medical services3.

Influenza can occur in mild to moderate forms, which end in complete recovery. But sometimes the development of various complications, the presence of severe chronic diseases of the heart, blood vessels, kidneys, and lungs can lead to the development of a severe form of the disease and, in some patients, to death4.

Patients with cancer, patients with severe immune disorders and pregnant women are most at risk of infection due to reduced immunity.

Influenza is transmitted by airborne droplets, when infection occurs when talking, coughing and sneezing, or by household contact, in which virus particles settle on common household items (toilet paper, door handles, dishes, children's toys).

The incubation period for influenza lasts about 2 days, but can vary from 1 to 4 days. Isolation of the virus from a sick person with an uncomplicated course of influenza lasts 5-7 days, with a complicated course - 10-14 days from the first day of the disease. A high temperature that persists for more than 5 days indicates the presence of bacterial complications.

Signs of depression and excitation of the central nervous system

Catarrhal manifestations of the upper respiratory tract (runny nose, difficulty nasal breathing, sneezing, cough) may be absent.

Symptoms of ARVI and influenza

The clinical picture of ARVI can vary greatly depending on the cause of the disease, the age of the patient, the state of the immune system and the presence of concomitant diseases.

Symptoms are divided into:

• Special symptoms of ARVI
• Specific Flu Symptoms
• Catarrhal phenomena

Special symptoms of ARVI:

• Gradual or acute onset of illness
• Moderate or mild intoxication
• Increased body temperature (up to 38.0 °C)
• Minor headache (not always)
• Aches in the muscles, sometimes in the joints, pain when moving the eyeballs or when pressing on them, lacrimation (as a rule, these symptoms are mild or may be absent)
• Runny nose, nasal congestion, sore throat, hoarseness
• Watery eyes, conjunctivitis
• With the development of an inflammatory process in the larynx, trachea or lungs, a dry and wet cough is possible5

Specific flu symptoms:

• Sudden onset of illness
• Severe intoxication
• High body temperature
• Strong headache
• Severe aches in muscles and joints
• Pain when moving the eyeballs
• Decreased appetite
• Dry cough due to the development of tracheitis at the beginning of the disease, but which after a few days becomes wet, with a large amount of mucous sputum
• Sore throat and sore throat, while runny nose is not very pronounced5

Catarrhal phenomena:

• runny nose (characterized by copious, watery, clear discharge)
• sneezing
• conjunctivitis (itching, watery eyes, red eyes)
• sore and burning sensation in the throat, pain and discomfort in the throat (these manifestations are characteristic of pharyngitis, tonsillitis, laryngitis)
• cough

It is important to know!

Expectorants and mucolytics should not be taken simultaneously with antitussives: this can cause an excess of phlegm in the bronchi. For a dry cough or cough with little sputum, sputum thinners are prescribed; for a wet cough, expectorants are prescribed. Antitussive drugs are prescribed in exceptional cases when a person has a persistent cough.

Treatment of acute respiratory infections in adults should be carried out under the supervision of a doctor, especially if there are the following symptoms:

• high temperature, which has no or almost no effect from paracetamol;
• high temperature persists on the fourth day of illness;
• severe pain in the chest or head;
• purulent discharge;
• return of temperature a day after it disappears or on the seventh day of illness;
• deterioration of the condition after a short period of improvement;
• pale skin, severe lethargy, shortness of breath;
• intense sore throat in the absence of a runny nose or cough;
• severe dry cough that cannot be softened, attacks when trying to take a deep breath;
• rash.

It is important to know!

Despite numerous advice and the strong belief that a glass of vodka at night is the best medicine, alcoholic drinks do not help treat acute respiratory infections and acute respiratory viral infections. Alcohol lowers an already weakened immune system, blocks the ability of the kidneys to remove toxins, constricts blood vessels, causing headaches - in a word, it prevents the body from fighting infection. And drinking alcohol at high temperatures increases dehydration and leads to an exacerbation of the disease.

Symptoms of ARVI and influenza

The world of viruses is very rich and diverse, and despite the common manifestations of symptoms, there are still some differences in clinical signs. It is these features that help the doctor more accurately determine the possible pathogen. Let's look at common viruses:

• Adenovirus infection
• Rhinoviruses
• Respiratory syncytial infection
• Enterovirus infection
• Coronavirus infection

Adenovirus infection

An acute infectious disease that affects the mucous membranes of the respiratory tract, organs of vision, intestines, and lymphoid tissue6.
Children and young people get sick more often. The incubation period lasts up to 14 days7. Main symptoms:

• rhinitis (runny nose) with copious mucous or watery discharge
• pharyngitis or tonsillitis
• conjunctivitis
• temperature increase 37-38°C and above

Possible manifestations of laryngitis, tracheitis, bronchitis, enlargement of several groups of lymph nodes, enlargement of the spleen and liver. Children may experience diarrhea and abdominal pain.

Rhinoviruses

An acute, highly contagious infectious disease.
The main and leading symptom is a runny nose (rhinitis) with very copious watery discharge. Main symptoms:

• severe rhinitis
• dry cough
• possible development of sinuses and otitis media
• sometimes the temperature rises to 37°C and slightly higher

In young children the disease is more severe than in adults. Complications are rare.

Respiratory syncytial infection

A disease characterized by fever and the development of bronchitis.
Children get sick more often, especially under 2 years of age. The incubation period lasts from 3-6 days. Main symptoms:

• constant paroxysmal dry cough, wet cough
• temperature rise to 37-38°C and above
• sneezing
• pharyngitis (rare)

Enterovirus infection

This is a group of acute infectious diseases caused by intestinal viruses and characterized by a variety of clinical courses8.
Most often children get sick. The incubation period lasts from 1 to 10 days. Main symptoms:

• sudden rise in temperature to 38-40°C
• headache, general malaise, dizziness, weakness
• nausea and vomiting
• phenomena of tonsillopharyngitis with the manifestation of a rash in the form of multiple red blisters on the arches and soft palate at the onset of the disease
• rhinitis
• dry or wet cough
• often combined with other syndromes - intestinal disorders, muscle pain

Coronavirus infection

This is a group of infectious diseases, in most cases it manifests itself as rhinitis with profuse watery discharge from the nose in the absence of symptoms of intoxication and fever, but with damage to the lower respiratory tract.
The incubation period is 1-14 days. Main symptoms:

• Mild course
• rhinitis
• temperature increase to 37-38°C
• headache, dizziness
• pain in muscles and joints
• pain in the eyeballs

Complicated course:

• temperature rise above 38°C
• dry cough
• dyspnea
• feeling of lack of air
• headache, dizziness
• pain in muscles and joints
• pain in the eyeballs

Intestinal manifestations in the form of abdominal pain, bloating, and diarrhea are possible.

In the majority of patients (80-90%), the disease ends in recovery.

Treatment of upper respiratory tract infections

All methods of treating colds can be divided into non-drug and medicinal.

Non-drug methods

• Mode

In most cases, treatment of acute respiratory infections does not imply hospitalization, but compliance with the home regime is always mandatory. Moreover, it is better to spend the first days of the disease, while the fever persists, in bed. This is especially important for children, but adults should not ignore this rule either.

• Hygiene measures

It is necessary to maintain a room temperature of about 200 C and a humidity of about 50-70%, which is achieved through wet cleaning and frequent ventilation of the room2. Heat and dry air “dry” the airways, intensify coughing and promote bacterial infection. Cold and excessive humidity in the room lead to hypothermia and aggravate the course of acute respiratory infections.

To purify the air from viruses and bacteria, it is recommended to use ionizers, bactericidal and ultraviolet lamps2. They help reduce the risk of bacterial complications during treatment and also protect family members and guests from respiratory tract infections.

• Diet

The diet should be chemically and mechanically gentle, aimed at fully satisfying the body's needs for nutrients, vitamins and microelements. It is better to exclude spices, spices and smoked foods, limit salt and sugar intake, reduce the amount of sour and carbohydrate foods: sweets, flour products, potatoes, legumes and corn. You should not get carried away with raw vegetables and fruits; it is optimal to consume them boiled and baked. Meat – mostly minced and in small quantities. Fermented milk products, various fruit drinks, jelly, and puddings are useful.

• Drinking regime

Compliance with the drinking regime is a fundamental principle in the treatment of diseases of the upper respiratory tract4. Fever is accompanied by increased sweating. To prevent dehydration and maintain optimal moisture in the mucous membranes, you need to consume a sufficient amount of fluid (at least 30 ml per 1 kg of body weight per day)4. You can drink plain clean water, still mineral water, fruit drinks, compotes without sugar, cold green or herbal tea. It is advisable to avoid coffee, cocoa, and carbonated sweet drinks: they irritate the mucous membranes.

• Nasal rinsing and gargling

Liquid nasal mucus has a protective function. It prevents the penetration of microbes into the mucous membrane, moisturizes and cleanses it. Nasal rinsing is aimed at removing dried mucus and maintaining a liquid state of nasal secretions4. As rinsing solutions, you can use regular saline solution and special preparations based on sea water.

Gargling helps cleanse the mucous membrane of the oropharynx, eliminate soreness, burning and pain in the throat, and reduce cough4. For rinsing, decoctions and infusions of medicinal herbs that have an anti-inflammatory effect are suitable4.

Medication methods

Methods of drug therapy for ENT diseases, in particular respiratory tract infections, can be divided into general and local.

• General treatment

It includes etiotropic therapy: antiviral and antibacterial, implying the destruction of pathogens, as well as symptomatic therapy aimed at combating the manifestations of the disease.

• Antiviral and antibacterial therapy

Antiviral drugs for ARVI are less effective than for influenza1,5, so the advisability of their use is questionable.

Systemic antibiotics (taken orally, by injection and infusion) are indicated only in cases of proven bacterial infection, in particular with the development of bacterial complications such as acute tonsillitis, otitis media, sinusitis1,5.

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Diagnosis of ARVI and colds

When the first symptoms appear, you should first consult a doctor. Only a doctor can distinguish ARVI from the flu or a common cold. The doctor also knows the epidemiological situation in the region and knows which virus is currently circulating among the population. The doctor carefully collects all information, including the presence of chronic diseases, how long the disease has been, possible contacts with a sick person, and the severity of symptoms. The throat is examined and the lungs are auscultated.

Pathogens of acute respiratory infections

An acute respiratory infection can occur in a person due to the following reasons:

• A variety of special viruses that affect the human respiratory system (there are about 200 species of such microorganisms).
• Bacteria, for example, staphylococci. As a rule, they cause acute respiratory infections in only 5% of cases.

The treatment strategy for acute respiratory infections primarily depends on what pathogen caused the disease.

If it is not bacteria (this is true for the vast majority of cases), then antibiotics should not be taken. Therefore, self-medication is strictly prohibited. The doctor usually prescribes medications that are designed to combat the symptoms of acute respiratory infections.

Which doctor should I see if I have a cold?

An initial consultation with a therapist is required. It may be necessary to examine other specialists, for example, an infectious disease specialist, an ENT specialist, an ophthalmologist. If this data is not enough, then laboratory tests can be performed.

Methods for clinical and laboratory diagnosis of respiratory infections include the following9:

• PCR diagnostics based on detection of RNA or DNA viruses
• immunofluorescence and enzyme immunoassay
• serological methods
• test for rapid diagnosis of influenza
• rapid diagnosis of beta-hemolytic streptococci
• microbiological cultures to determine the sensitivity of microflora to antimicrobial drugs.

The basic principle of diagnosing ARVI and influenza is to compare the general clinical picture of the disease (a set of complaints, symptoms) with the results of laboratory tests. The specialist should also take into account the epidemiological situation in the region, information about circulating strains of viruses, the emergence of new pathogens and mutations of viruses.

Treatment of ARVI and colds

It is worth starting with non-drug treatment methods.

Non-drug methods of treating acute respiratory viral infections and colds

The patient must be provided with:

• strict bed rest (in case of fever)
• plenty of warm drinks: this can be regular drinking water, warm tea with lemon, fruit drinks
• adequate intake of protein (meat, poultry), vegetables and fruits
• physical methods of reducing temperature10

It is especially recommended to ventilate the premises and change bed linen. You should avoid stuffy and dusty rooms. If possible, wet cleaning should be done.

Drug treatment of ARVI and colds

Drug treatment mainly consists of eliminating any severe symptoms: reducing fever, reducing headaches or sore throat, eliminating runny nose and nasal congestion, etc.
Antiviral therapy is prescribed when influenza is detected and should be started no later than 48 hours after the first symptoms appear. This is important to ensure the most effective therapeutic effect. The duration of use and dosage is adjusted by the doctor.

Antibacterial therapy is not used in the treatment of ARVI and influenza.

The antibiotic does not work against the virus. The use of antibiotics is only possible for the treatment of bacterial diseases or for the treatment of dissipating bacterial complications. Self-treatment with antibiotics for ARVI and influenza without a doctor's prescription is not recommended.

Local therapy

In the form of gargling with antiseptic solutions, drugs to reduce sore throat in the form of sprays and tablets are relevant for the development of an inflammatory process in the pharynx.

About the mode

Rest, bed rest and drinking plenty of fluids are recommended.

If the child is breastfed, then more frequent breastfeeding is advisable. You can offer water, as the need for liquid increases as the temperature rises.

If the baby is bottle-fed, then it is necessary to offer the baby regular drinks (water or baby teas) more often. Adding a fermented milk mixture to your diet, for example, Nutrilak Premium Fermented Milk, will facilitate the digestion process and maintain the balance of the microbiota, promoting a speedy recovery.

Children over 1.5-2 years old often experience a decrease in appetite, so children's drinks, for example, Nutrilak Premium 3 or 4, will be indispensable. They will support the baby's immune system and quickly restore his strength.

Prevention of respiratory diseases

A sick patient should reduce social contacts, especially with the elderly, pregnant women and people with chronic diseases. To reduce the risk of infection, you must follow a few simple rules:

• washing hands thoroughly with soap
• limiting contacts during epidemics: it is worth limiting close contact with a person who has catarrhal manifestations of ARVI (coughing, sneezing, runny nose)
• irrigating the nose with saline solutions after visiting public places (in the autumn-winter period, when the heating is on, dry air in the room negatively affects the nasal mucosa and it becomes more vulnerable to the penetration of various pathogens, and the use of saline solutions moisturizes the nasal mucosa)
• regular ventilation and wet cleaning of premises
• general strengthening methods, which include hardening, the use of vitamins and dietary supplements, the elimination of bad habits, and a healthy balanced diet help strengthen the immune system

Vaccination remains the most effective way to prevent influenza . The influenza vaccine protects the vaccinated person, even if the circulating viruses are not exactly the same as the vaccine viruses. Vaccination allows you to avoid a severe course of the disease and reduce the likelihood of complications and death. It is especially important to get vaccinated against influenza for people with chronic illnesses and people living with those at high risk11.