Influenza

Influenza is a kind of acute respiratory viral infections, which is usually separated from the rest of diseases of this group. Influenza is different from other infections, with the distinctive especially severe clinical course and the presence of certain complications. Moreover, it can be fatal. Influenza is dangerous with its possible complications. That is why, the very young, the elderly, and patients with chronic severe heart or lung diseases are at the greatest risk for this disease. Another cause for concern is the state of pregnancy. Influenza can seriously harm a fetus, especially in the early stages of pregnancy. The disease spreads particularly quickly in big cities. People from a group of risk should primarily use the means of prevention and, in case of infection, should be immediately observed by doctors. The aim of the current paper is to study the causes, symptoms, complications, and treatment of influenza.

Influenza is an acute respiratory anthroponotic infection that is mainly caused by viruses of types A, B, and C. The disease flows with the development of intoxication and affection of the mucosal epithelium of the upper airway, more frequently the trachea. The disease is disposed to the rapid and global spread. In the book Influenza, it is stated that “Like all highly transmissible infectious diseases, influenza does not respect borders and nationalities” (Dehner, 2012, p. 11). Influenza epidemics usually occur on a yearly basis during the cold season and affect up to 15% of the population (Compans & Oldstone, 2014). During epidemics, the hospitalization rate increases by 2-5 times (Compans & Oldstone, 2014). Particularly high levels of hospitalization are among young children and the elderly. Mortality rates from influenza constitute 0.01-0.2% in the world and the average annual losses reach tens of thousands of people across the different countries (Compans & Oldstone, 2014).

The influenza virus belongs to the family orthomyxoviridae. It has a spherical structure and size of 80-120 nanometers (Wang & Tao, 2010). The core of the virus comprises a negative single-stranded RNA chain that consists of eight fragments that encode 10 viral proteins (Wang & Tao, 2010). RNA fragments have a common protein shell, which combines them, forming a nucleoprotein. The virus is covered by lipid envelope outside. Lipids are responsible for the severe toxicity, which affects a person during the illness. There are projections on the surface of the virus – hemagglutinin, named by their ability to agglutinate erythrocytes and neuraminidase – enzyme. Hemagglutinin allows the virus to join the cell. Neuraminidase is responsible for the ability of the viral particle to penetrate into a host cell. Moreover, it is responsible for the ability of virus particles to leave the cell after reproduction. Nucleoprotein is constant in its structure and determines the type of virus. In contrast, surface antigens are variable and determined by different strains of the virus. They play an important role in the immune response of the body during influenza and allow dividing influenza virus of type A into subtypes H1N1, H3N2, and others (Wang & Tao, 2010). The virus type A has the most pronounced virulence properties and is disposed to epidemic spread (Wang & Tao, 2010). Therefore, there are many subtypes of type A virus, which are classified by surface antigens – hemagglutinin and neuraminidase. At the moment, there are 16 hemagglutinin types and 9 neuraminidase types (Wang & Tao, 2010). Type A virus affects both humans and some animals, such as horses, pigs, and birds. Type B virus, as well as A, can change the antigenic structure (Wang & Tao, 2010). However, these processes are less pronounced than in influenza type A.

The reservoir and the source of infection is an individual with obvious and erased forms of the disease. The prolonged viral shedding is observed in patients with the severe or complicated course of the disease. Viral replication occurs with extremely high speed. The highest rate of influenza virus replication explains the short incubation period, which lasts 1-2 days (Compans & Oldstone, 2014). Subsequently, the virus enters the bloodstream and spreads throughout the body. Activation of the proteolysis system and damage of capillary endothelial cells leads to increased permeability of blood vessels, bleeding, and further tissue damage. The virus, getting into the blood, causes inhibition of hematopoiesis and the immune system. Leukopenia and other complications can develop as well. In the course of its life activity, influenza virus infects ciliated epithelium of the respiratory tract. The physiological function of the ciliated epithelium is the purification of respiratory tract from dust and bacteria. If ciliated epithelium is affected, it cannot fully conduct its functions and bacteria can penetrate into the lungs. Thus, there is a risk of bacterial superinfection, such as pneumonia, and bronchitis.

The severity of the disease depends on many factors, including a person’s overall health status, age, and others. Depending on this fact, the patient may develop one of the 4 forms of influenza – mild, moderate, severe, and hypertoxic. Symptoms and their strengths depend on the severity of the disease. The most common symptoms are hyperemia of the soft palate and posterior pharyngeal wall, intoxication, profuse sweating, weakness, photophobia, joint and muscle pain, and headache. Respiratory symptoms include affection of the larynx and trachea, cough, and rhinitis. In the book Pandemic Influenza, it is stated that “People with, fever, respiratory, and other early influenza symptoms require immediate evaluation by a trained health care provider” (Ryan, 2008, p. 168). The most common complication of influenza is pneumonia. As a rule, it is a secondary bacterial infection. Other secondary bacterial infections that tend to occur after influenza are rhinitis, sinusitis, bronchitis, and otitis media. Influenza can also lead to complications associated with the cardiovascular system, meningitis, and encephalitis. Treatment is mostly conducted at home. Only patients with a severe form of influenza should be hospitalized. Patients are assigned a permanent regime and vitaminized digestible food with plenty of fluids. Influenza does not require special treatment, as there is still no medication, giving 100% of the positive effect (Compans & Oldstone, 2014). Influenza is caused by a virus and, thus, consuming antibiotics is meaningless. They react only on bacteria.

The epidemiologic triangle includes three corners – an agent, a host, and the environment. As it was already mentioned, the agent of influenza is influenza virus. Hosts are people and animals. The environment includes factors that impact the further exposure and transmission of influenza.

Social determinants of health are the conditions, under which people are born, grow, work, and live, including the health system (Compans & Oldstone, 2014). These factors play a significant role in every disease, including influenza. Food security, income, social support, and housing are the main determinants that can make the course of disease better or worse. For instance, a patient needs only digestible food during influenza. However, the level of health determinants cannot allow consuming this kind of food. In this case, nurses play an extremely important role. They should understand the influence of determinants of health on the patient. Nurses should also ask questions regarding social determinants and consider them in treatment. They should carefully collect the information about causes of influenza and make sure that the patient closely follows the doctor’s prescriptions.

There are many agencies that deal with issues related to influenza. One of them is the National Center for Immunization and Respiratory Diseases (Compans & Oldstone, 2014). This center has the Influenza Division. It ameliorates prevention and global control of influenza. The division also improves pandemic response and preparedness for influenza.

Among all the existing infectious diseases, influenza is probably the most common. It is a severe viral infectious disease that affects people of all ages and nationalities. Among young children and the elderly, influenza disease is accompanied by a high mortality rate. Besides, some types of influenza can also affect animals. The disease can have many different symptoms and frequently leads to numerous complications. Despite this fact, there are still no certain drugs that can guarantee complete treatment of the disease.

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