Chapter II Bird’s flu.

MEDICINE AND PERSON

When an accident happens the people present are much more likely to be people of general public and not members of the medical profession.

First aid is terribly important and you can save lives if the right action is taken. Ninety per cent of first aid is common sense, and only ten per cent is specialist knowledge.

It’s worth while for the general public to learn basic first aid and to find out how they can help. Modern world is full of dangerous diseases that became nearly epidemic and require people to be literate and know prevention of all diseases. Diseases are AIDs, bird’s flu and others. Among such here are the different medical organization in our country and abroad which take part in healthy programs and make people in the country feel safe and healthy. In my report I want to describe the symptoms, prevention and treatment of the above mentioned diseases and give full information of activities such medical world organizations like National Health Care System in Great Britain and Health Care in USA.

Chapter I AIDS.

Acquired Immune Deficiency Syndrome (AIDS English AIDS.) - condition that develops in patients with HIV infection and is characterized by the fall of the number of CD4 + lymphocytes, multiple opportunistic infections, non-infectious and neoplastic diseases . AIDS is the final stage of HIV infection.

AIDS is the end stage of HIV infection, the period of infection with the human immunodeficiency virus to the development of AIDS takes an average of 9 - 11 years. Most symptoms are caused by opportunistic infections - bacterial, viral, fungal or parasitic infections, which do not develop in individuals with a full immune system and affect almost all organ systems.

HIV infection have increased levels of cancer, e.g., Kaposi's sarcoma, cervical raka and lymphomas. In addition, HIV-positive people often have systemic symptoms of infection, such as fever, sweating at night, swollen lymph nodes, chills, weakness and weight loss.Other opportunistic infections develop in HIV-infected patients, depending on the geographical position of the patient.

Symptoms:

• First, there are no symptoms.

• Swelling of the lymph nodes.

• Constant fatigue and general malaise.

• Repeated and prolonged fever, chills and night sweats.

• Susceptibility to fungal infections (candidiasis), the frequent appearance of herpes, fungal infections of the mouth (thrush), and others.

• Loss of appetite and unintentional weight loss.

• Coughing and breathing problems.

• A change in bowel habits, such as frequent diarrhea or constipation.

• The appearance of a skin rash or disorder of the skin color, especially the appearance of reddish spots (angiomatosis sarcoma).

• Memory impairment, confusion, changes in the nature.

Causes

• AIDS is caused by the human immunodeficiency virus (HIV), which is contained in all body fluids (blood, semen, secretions of the female genital organs, saliva and breast milk) of an infected person. The virus gradually destroys the human immune system, and it becomes vulnerable to many potentially deadly diseases or cancer.

• HIV is transmitted through exchange of fluids between organisms through sexual contact with an infected partner or by ingestion of contaminated blood. This is observed among drug addicts using intravenous drugs and share needles, or among hemophiliacs, who many times are subject to a blood transfusion (recent improvements in blood test reduced the risk of HIV infection through blood transfusions). The infected woman can pass the virus to her baby before birth or during breast-feeding. HIV virus is very unstable and can not survive for long outside the body. It is impossible to catch them after brief contact, such as hugging, a light kiss and drink from the cup of an infected person.

Diagnostics.

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• Medical history and physical examination.

• Blood tests. The presence of HIV antibodies usually confirm the diagnosis. Measuring the number of CD4 cells shows the degree of damage to the immune system. The measurement of virus in the blood indicates a risk of developing the disease.

• A diagnosis of AIDS is made when a person infected with HIV, there is one or more opportunistic diseases or cancers, or when the number of CD4 cells drops below 200 per microliter.

To diagnose as early as possible, it is necessary first of all to collect information on possible contamination: whether sexual intercourse with an unknown person, is not whether the person is a drug addict, if he did not receive a blood transfusion, if not subjected to surgery, and so on..

Ways of HIV transmission

The source of HIV infection may be asymptomatic virus carrier or AIDS. The main mechanism of transmission is krovokontaktny.

Ways of infection:

1. Sexual - for any form of sex, regardless of the orientation of the person. The greatest risk occurs during vaginal and anal sex, but oral and possible infection.

2. transfusion - after blood transfusion, plasma, platelet, erythrocyte, leukocyte mass or other components of the blood of an AIDS patient healthy person.

3. Tool or injection, typical for addicts share needles. However, this method of infection happens in hospitals, where the medical staff did not comply with the rules and regulations of using the syringes, needles and other medical instruments. This transmission path has led to the spread of disposable syringes, which is the prevention of AIDS.

4. Perinatal - from an infected mother to the fetus, including the passage of the baby through the birth canal.

5. Milk - through breast milk infected with HIV.

6. Transplant - a transplant of infected bone marrow, internal organs or artificial insemination of infected semen.

. Household and professional when infection occurs through broken skin and mucous membranes in contact with some of the secrets of AIDS patients.

Simultaneously with the HIV can not be transmitted through saliva, tears, food, water or air. Saliva is dangerous if the blood contains impurities.

Treatment of AIDS

In the fight against AIDS a significant role played by the timely diagnosis of the disease. If you start HIV therapy until the time when he will have time to destroy the human immune system, AIDS patients have the opportunity to permanently push the last stage of the disease and prolong their normal life. Scientists have developed a special treatment regimen by which manages to significantly slow the progression of the disease.

The most popular anti-retroviral and other drugs to fight AIDS:

-zidovudine;

- zalcitabine,

-stavudine and didanosine;

-trimethoprim,

-pentamidine,

-foscarnet,

- ganciclovir,

-fluconazole;

Preventing AIDS

HIV - this is the most effective means in the fight against AIDS.

- AIDS prevention includes the need to:

- have only one sexual partner;

- avoid sexual relations with strangers and suspicious persons, prostitutes, drug addicts;

- have the group of contacts; to use condoms;

- do not use other people's machines, razors, toothbrushes, use of medical devices;

- insist on disposable instruments in the dentist's office, gynecologist, cosmetologist and other professionals.

Treatment.

AIDS can be divided into antiretroviral therapy and symptomatic therapy for opportunistic infections. In the terminal stage of HIV - AIDS treatment plays a smaller role for opportunistic infections than HAART. One goal of antiretroviral therapy is to reduce the AIDS stage opportunistic infections by increasing the number of CD4-cells.

HIV-positive, having the number of CD4-cells above 500 per 1 mm3, are not at risk of occurrence of opportunistic infections. Individuals with a CD4 content of 500 to 200 cells per 1 mm3 of blood, often susceptible to candidiasis and Kaposi's sarcoma. In the fall of CD4-lymphocytes from 200 to 100 cells per 1 mm3, having Pneumocystis pneumonia, histoplasmosis, coccidioidomycosis and PML. By reducing the number of cells to 50 from 100 to 1 mm3 appear toxoplasmosis, cryptosporidiosis and cryptococcosis, cytomegalovirus infection [50]. From the above opportunistic infections, according to the French researchers, prevention of Pneumocystis carinii pneumonia, toxoplasmosis and mycobacterial infections is more effective ratio output / cost, while the prevention of fungal and CMV infection is less effective than the other therapy for HIV infection, including the , HAART, and should have a lower priority.

Chapter II Bird’s flu.

Avian influenza (Latin Grippus avium.), Classical swine birds - an acute infectious viral disease of birds, characterized by lesions of the digestive, respiratory, high mortality. Antigenic variation of influenza virus of birds and the presence of highly virulent strains make it possible to assign it to an especially dangerous disease that can cause great economic losses. Different strains of the avian influenza virus can cause 10 to 100% mortality among the cases and to strike at the same time of one to three species of birds. The natural reservoir of the virus are migratory birds, usually wild ducks. The wild bird populations, in contrast to the home, high resistance to influenza virus. For the first time avian influenza has been identified in Italy more than a hundred years ago.

Etiology

The causative agent of avian influenza - RNA virus Influenza virus A, belonging to the family Orthomyxoviridae, by complement-binding antigen (RNP) is related to the virus of influenza A man and animals. For virion characteristic polymorphism, dominant spherical shape, the size of 60-180 nm. The virion has a lipoprotein envelope with radial spines on it that contains Minimized ring HSD. Genome virion contains 6 or more types of RNA. The virus has a contagious, hemagglutinating and neuraminidase activity. Good multiplies in developing 10-11-day-old chick embryos. Virus-containing allantoic fluid is able to agglutinate red blood cells of many species.

By culturing virus in tissue culture, many strains have haemadsorbing cytopathic effects and properties. The strains of avian influenza virus isolated from different species of birds vary in virulence, pathogenicity, and the structure of the spectrum of surface antigens (hemagglutinin and neuraminidase). The virus is inactivated rapidly by 3% sodium hydroxide and phenol, 0.1% formaldehyde solution. Long stored at low temperatures and drying

We influenza type A virus known variants sixteen hemagglutinin structure (HA1-16) and nine neuraminidase (NA1-9). It is the combination of these two glycoproteins determine the subtype. Of theoretically possible 144 combinations, 86 of which actually found in nature. For most birds pathogenic variants of the H5 and H7.

Symptoms

The incubation period (time from getting the virus in the body before the onset of symptoms) is on average 2-3 days, rarely - 7-10 days.

The first symptom - high temperatures - up to 38-39 ° C, and sometimes up to 40 ° C.

Fever, pain in muscles and joints, headache. Fever lasts up to 2 weeks, and in severe cases - up to the patient's death.

In half the cases - conjunctivitis, pharyngitis, gum bleeding, abdominal pain, diarrhea, kidney failure.

At 2-3 days after the first symptoms added acute respiratory syndrome - cough, sputum, laryngitis, shortness of breath, runny nose, hoarse voice, viral pneumonia.

The symptoms are amplified for 10-15 days: arises pulmonary edema, acute respiratory failure, meningoencephalitis in children - such complications in many cases lead to the death of the patient.

Causes

Avian influenza virus belongs to the influenza A family Ortomyxoviridae. The virus envelope may contain different types of proteins, however there are several types of virus (strains). For someone particularly dangerous strains of H5N1 and H7N7, which lead to serious complications and in most cases are fatal.

The main pathways of human infection - airborne and fecal-oral. Therefore, in the area of ​​high-risk people who live in rural areas, poultry workers, veterinarians. But transmission of the virus from person is not registered to the person.

When to see a doctor later, the low concentration of leukocytes in the blood, as well as the presence of a number of co-morbidities for bird flu leads to serious complications and ends with death.

Complications

-Viral pneumonia, SARS.

-Renal failure, hepatic failure.

-Meningoencephalitis.

-In 70% of cases - death, the death of the patient from H5N1 avian influenza is most often occurs on the second week of illness.

Diagnostics

The first signs of avian influenza (fever, fever, runny nose), very similar to the common flu. Usually the main factor causing suspicion of dangerous H5N1 strain in humans, is information about cases of avian influenza of birds and animals in the region, or if a person visited the region in which the detected outbreak in birds or animals. be sure to consult a doctor and get tested in these cases.

If for 3-4 days after the initial symptoms of the temperature rose to 40 ° C, there was diarrhea, sputum, laryngitis, and breathing became difficult, it is necessary to sound the alarm: the complications will only increase, the patient should be kept under medical supervision.

Of course, the diagnosis of avian influenza into account not only the symptoms and patient experience. The final diagnosis is made after delivery of analyzes based on laboratory techniques: immunofluorescence assay (ELISA), PCR, virologic, serologic methods.

Keep in mind that timely diagnosis not only improves the patient's chances of getting the necessary medical care and survival in the fight against avian influenza, but also raises a concern throughout the region, which makes it possible to take measures to prevent the bird flu epidemic.

The differential diagnosis of avian influenza is carried out with an ordinary flu, parainfluenza, adenovirus, and rhinovirus infection.

Treatment

As practice shows, is that none of the developed drugs are not able to destroy the bird flu virus. Effective vaccines are also not yet available. The greatest effect is shown neuraminidase inhibitors: zanamivir (Relenza) and oseltamivir (Tamiflu). Other antiviral drugs are only used as a complementary therapy. For example, in the first day can be used Arbidol and rimantadine, which hamper the development of influenza viruses.

But bird flu treatment with aspirin or antibiotics useless and even dangerous. For example, aspirin reduces blood clotting, and antibiotics cause serious damage to internal organs, although they do not reach the influenza virus, which hides inside cells.

As already mentioned, the number of deaths in the disease of avian influenza in humans is 70%. People who were able to recover from the virus, the immune system is not developed, ie already at the next contact with an infected bird may re-infection. In the absence of a vaccine and effective treatment for avian flu, scientists predict large-scale epidemic that could spread across the planet, and carry out many millions of lives.

Prevention

Birds made vaccination against viruses and infections. Periodically monitored by the presence of avian influenza virus in migratory birds.

If confirmed case of bird flu all livestock birds on the farm must be destroyed. At the same time the people who carry out the destruction of birds must be in protective clothing, shoes and masks.

In all the surrounding farms quarantine: eggs, meat birds are not taken out, the premises disinfected farms.

People should avoid contact with wild birds and to limit contact with poultry. Do not allow children to play with sick birds. Do not use in cooking the meat of the dead birds. The dead birds do not touch the hands (use gloves and protective clothing), these birds need to dig in and report on the death of a local veterinarian.

Human vaccination against normal seasonal flu helps to slow down the development of complications and improves the chances of recovery.

Strengthen your immune system: fresh air, cleanliness in the house, taking vitamins and antiviral agents for prophylaxis increases the body's resistance to viruses.

If after contact with diseased or dead birds appeared the first symptoms of influenza, should immediately seek medical attention and tell about the possible danger.

It should be remembered that the earlier outbreak of bird flu was detected in the region, the easier it is to prevent the spread of the virus, which can save more than one human life.