Frequently ill child. How not to spend autumn on sick leave

Frequently ill child. How not to spend autumn on sick leave

13.09.2022 0 By admin

Returning from vacation is a joy of communication: old and new friends in kindergarten and school, favorite company on the playground. But where there are contacts, there are microbes. It is no coincidence that at the beginning of the school year there are outbreaks of SARS and influenza. Some children get sick with a break of two or three weeks, especially for children who are adapting to kindergarten or school. And this means that parents will have to stay up at night, take sick leave …

In children, the interferon system, which plays an important role in the formation of immunity, is not fully developed.
In children, the interferon system, which plays an important role in the formation of immunity, is not fully developed.

How to make the child’s adaptation to the new environment easier and protect him from seasonal infections? Our questions are answered by Olga Vasilievna Shamsheva , Director General of the Association of Pediatric Infectious Diseases of Russia, Doctor of Medical Sciences, Professor, Head of the Department of Infectious Diseases in Children of the Pediatric Faculty of the Russian National Research Medical University. N. I. Pirogov.

Olga Vasilievna, how do you feel about the fact that now many parents do not take ARVI seriously, they think that the body must cope with the infection without outside help, and do not go to the doctor if the child’s temperature drops on the second or third day?

– Indeed, for us SARS or, as the people say, “cold”, is a common thing, but in no case should they be taken lightly. Self-diagnosis and self-treatment, and even more so, a complete lack of treatment, can lead to complications: bronchitis, sinusitis, otitis, pneumonia. It is from this point of view that viral infections can be dangerous. The flu is especially dangerous, which a layman can confuse with a common cold. Parents should remember that children tolerate the disease much worse than adults, especially when they first encounter the virus, and they are more likely to experience complications.

Is it related to the characteristics of childhood?

– Yes, the fact is that in addition to anatomical features (narrow and short larynx, loose mucous membrane, etc.), the interferon system, which plays an important role in the formation of immunity, is not fully developed in children [1] . Interferons are proteins that the body produces in response to a virus, they block its reproduction and at the same time protect healthy cells from infection by the virus. Interferons help to quickly cope with the disease, to alleviate its course.

Scientists have been actively studying interferons and the features of their production by the human body for many years. In particular, it was found that in patients who often and for a long time suffer from respiratory infections, the production of their own interferons is impaired.

It should be noted that in young children, the production of “adult” interferon, which has antiviral properties, is reduced, so they are more vulnerable to SARS, in addition, the presence of chronic diseases, “wrong” lifestyle, which include lack of sleep, can also affect the level of interferon , unhealthy diet, passive smoking (when parents smoke in the presence of a child), as well as stress and unfavorable ecology. All this affects the immune system. Also, the risk group for severe ARVI and the development of complications includes pregnant women and the elderly.

Some children get sick two to three weeks apart
Some children get sick with a break of two to three weeks.

How to treat SARS effectively?

– Efficiency often depends on timely treatment. When the first symptoms of SARS appear (cough, runny nose, sore throat), it is better to leave the child at home. Because in the team it will infect other children. You need to immediately call a doctor at home, who will diagnose and prescribe treatment. As a rule, with ARVI, this is bed rest, drinking plenty of water, symptomatic remedies that alleviate the condition, and antiviral drugs that fight the virus.

Since there are a lot of respiratory viruses, drugs with a wide spectrum of antiviral action are especially relevant. These include preparations of recombinant interferon, they contain an antiviral protein, which I mentioned above. This interferon is identical to human, only obtained using modern biotechnology. Such drugs have long been used to treat influenza and SARS, including the coronavirus that causes COVID-19, and are included in the treatment protocols for these diseases [2] . Unlike other drugs that have age restrictions, interferon preparations can be used at any age, and even in pregnant and lactating women and the elderly. I mean interferons produced in the form of suppositories.

What kind of child can be called frequently ill and should we be afraid of this definition?

– FIC or frequently ill children are children, usually of preschool age, who get sick 8-10 times a year or even monthly. And it’s not just about colds. With ARVI, a herpes infection can also join, which manifests itself in the form of vesicles on the skin and mucous membranes.

In fact, the term “frequently ill child” is not a diagnosis [3] . The diagnosis in each case is one or another respiratory disease, for example, influenza or parainfluenza and others. We all, including adults, repeatedly get sick with ARVI throughout our lives. This is normal. It’s just that children get sick more often and sometimes more severely than adults, which is associated with the first encounter with viruses.

A frequently ill child can be referred for a consultation with an immunologist, who will prescribe drugs that strengthen the immune system. And, of course, such children require increased attention from their parents, they must have the right daily routine, a healthy diet enriched with vitamins, and they also need to carry out wellness procedures. Over time, a frequently ill child will get sick less and less and, eventually, will move into the category of “normal” children.

Frequently sick children are children who get sick 8-10 times a year.
Frequently sick children are children who get sick 8-10 times a year.

Is there specific therapy for frequently ill children?

– As I said, in those children who often and for a long time get sick with ARVI, the interferon production system may be disrupted. And this means that the immunity of such children cannot cope with infections, and therefore they get sick more often than others. We have extensive experience in the treatment and prevention of SARS in these children. Studies conducted at various Russian universities, including our Russian National Research Medical University named after N. I. Pirogov, have proved the high clinical and immunological efficacy of interferon preparations in IBD, which was expressed in a decrease in the number of ARVI episodes. After treatment with interferon in suppositories (using the drug “Viferon”), the total number of episodes of acute infections per year and related complications decreased by two to three times, and the number of exacerbations of chronic diseases also decreased. Complications included exacerbations of chronic tonsillitis, otitis media, sinusitis, pneumonia, and others.

And how to reduce the frequency of respiratory infections if the child has just started attending kindergarten or school?

– First of all, we must remember about prevention. Over several years of the pandemic, we have learned to observe personal hygiene: wash our hands often, especially after returning from a walk, garden or school, avoid attending public events during the rise in the incidence of influenza and other acute respiratory viral infections, use antiviral agents, for example, a gel based on the same interferon , which is applied to the previously dried surface of the nasal mucosa. Nobody canceled these procedures even now.

Antiviral drugs “catch” viruses at the “entrance gate” of a respiratory infection, do not allow them to penetrate further into the body and multiply. Here, topically applied interferon preparations can also come to the rescue – they are applied to the nasal mucosa. Preparations on a gel or ointment basis have a long-term effect and do not dry the mucosa. The gel must be applied twice a day, for example, before leaving the house, visiting a kindergarten or school. This, it seems to me, is not at all difficult for mom and baby.

Are interferon preparations also suitable for the prevention of COVID-19?

– Undoubtedly. Interferon preparations are included in the recommendations of the Ministry of Health for the treatment and prevention of acute respiratory viral infections and a new coronavirus infection [2] . Many of my pediatric colleagues during the pandemic conducted research on such drugs in “combat conditions”, that is, in hospitals, and received inspiring results. For example, a team of doctors led by Asiya Ildusovna Safina, a professor at the Department of Pediatrics and Neonatology at the Kazan State Medical Academy, conducted a study in the summer of 2021 at a covid hospital in Kazan [4] . The children were divided into two groups: the first group received symptomatic therapy and the interferon drug “Viferon” in the form of suppositories and gel, and the second group received only symptomatic therapy. So, in the children in the first group, the symptoms disappeared faster, namely, the body temperature decreased twice as fast, the cough disappeared after 5-6 days, while in the second group, which did not use interferon, these symptoms disappeared only by 9-10 day. And most importantly, the first negative test for COVID-19 in the first group (with the use of interferon preparations) was obtained already 4 days after the appointment of therapy, and in the second group only after 10 days.

The main thing in the fight against SARS and influenza is immunity support and prevention.
The main thing in the fight against SARS and influenza is immunity support and prevention.

Olga Vasilievna, what would you advise our readers on the eve of the autumn rise in the incidence of influenza and SARS?

– The most important thing is to support the immune system and prevent these diseases. First of all, this applies to children and their parents, as well as the elderly. It is important to remember that it is not so much a viral infection that is dangerous as its complications. And if you still get sick, despite the preventive measures taken, it is necessary to start treatment with antiviral drugs as early as possible – on the first or second day of the disease.

It is important not to carry the disease on your feet and not to teach your children to do this, to minimize stressful situations, to observe the regime of work and rest (no matter how trite it sounds), not to neglect physical activity, walk more in the fresh air, eat well and get enough sleep. During the period of the rise in the incidence, it is necessary, if possible, to reduce visits to public places and the use of public transport, maintain social distance and use antiviral agents to prevent respiratory diseases.

Links:

  1. Nesterova I.V., Kharina D.V., Shuvalov A.N., Malinovskaya V.V. Local interferon therapy in the immunorehabilitation of young children with frequent and long-term respiratory infections. Questions of practical pediatrics. 2018; 13(3): 68–74.
  2. Temporary guidelines for the diagnosis, treatment and prevention of Covid-19: http://www.consultant.ru/document/cons_doc_LAW_347896/
  3. Samsygina G.A. “The problem of frequently ill children in pediatrics” Pediatrics. Journal them. G.N. Speransky, vol. 94, No. 1, 2015, pp. 167-169.
  4. Safina A.I., Sharipova O.V., Lutfullin I.Ya., Naumova O.S., Daminova M.A. Modern possibilities of interferons in the treatment of children with COVID-19. Medical advice. 2021;(1):59-65. https://doi.org/10.21518/2079-701X-2021-1-59-65

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