Epidemic parotitis (pig) - causes, symptoms, diagnosis and treatment
Parotitis - This is an acute infection caused by the RNA-containing virus of the genus Paramyxovirus, mainly affecting salivary glands and nerve cells. The pathogen of epidemic vapotitis is transmitted by air-droplet, sometimes contacting through objects infected with saliva patient. The pork clinic begins with fever and intoxication symptoms, on this background, swelling and soreness in the near-wing area increases. A fairly typical clinic allows you to diagnose epidemic vapotitis without additional examination. Treatment is mainly symptomatic.
Epidemic vapotitis (pig) is an acute infectious disease that flows with the lesion of the near-dry salivary glands and the nervous tissue. The natural susceptibility of people to infection is quite high, post-infectious immunity resistant, long. Early children suffer rarely, in view of the low probability of contact with patients and the presence of maternal antibodies. Currently, the predominant incidence is marked in the age group from 5 to 15 years, most often male face. The incidence of the ubiquitous and all-season, with a minor increase in the number of cases of infection in the autumn-winter period.
The virus causing an epidemic vapotitis - RNA-containing paramixirus - is usually affecting people, but there were cases of infection of dogs from their owners. In the external environment, it is not racks, easily dies when drying, increasing the temperature, under the action of ultraviolet irradiation. Upon reduced ambient temperatures, it can save its viability up to a year. The reservoir and the source of the pathogen of the epidemic vapotitis is a sick person. The virus is highlighted with saliva and urine, found in the blood and liquor, breast milk.
The selection of the virus begins 1-2 days before the first clinical manifestations and continues about a week. 25-50% of cases of disease occur in an erased or asymptomatic form, but the patients actively distinguish the virus. The pathogen of the pig is transmitted by the aerosol mechanism with air-droplet. In rare cases (due to the disruption of the virus), transmission is possible through the objects of life of personal use, contaminated saliva patient. There are cases of the vertical path of transmitting the virus from the mother to the child in the prenatal period, childbirth, during lactation.
Symptoms of epidemic parotitis
The incubation period of epidemic vapotitis ranges from several days to a month, on average it is 18-20 days. In children, in rare cases, the overall signs may be celebrated: headache, light chills, Malgia and arthralgia, discomfort in the field of near-dry glands, dry mouth. Most often, the disease begins acutely with rapidly developing fever, chills. Fever usually persists until the week. There is a symptom of intoxication: headache, general weakness, insomnia.
Specific symptom of the pig is the inflammation of the parole salivary glands, and submandibular and sublinging glands are often captured. The inflammation of the salivary glands is manifested by swelling in the zone of their projection, on the touch of glands are tough, painful (mainly in the central part). The pronounced edema of the gland can significantly deform the oval of the face, giving him a pear-shaped shape and lifting the ear of the ear. The skin above the inflamed gland remains normal, stretched, with difficulty forms folds, glorify. As a rule, the disease is striking both paroles with an interval of 1-2 days, in some cases the inflammation remains one-sided.
In the near-wing domain, the feeling of cutting, pain (especially at night), may be noise and pain in the ears (as a result of the religion of Eustachius pipe), hearing can decline. The positive symptom of Filatov (severe pain when pressed behind the ear of the ear), which is specific in the diagnosis of vapotitis. Sometimes severe soreness of the glands interferes with chewing, in severe cases, the triumism of chewing muscles may develop. There is a reduced salivation. The pain in the area of the glands is preserved up to 3-4 days, sometimes irradiages in the ear or in the neck, later it gradually passes, swelling regresses. An increase in lymph nodes for epidemic vapotitis is not characteristic.
Adults transfer the pig it is more hard, they often show long-term signs, above intoxication, catarrhal phenomena may occur. The process is noticeably more often affecting the submandibular and sub-speaking salivary glands, sometimes localized only in them. The submandibular iron, sweeping, acquires the appearance stretched along the lower jaw swelling, drawn to the touch and painful. Sometimes the swelling applies to the neck. The inflammation of the inflammation of the gland is characterized by the occurrence of swelling under the chin, pain and hyperemia of the mucous membrane in the mouth under the tongue, pain in its progress. The swelling of the salivary glands is preserved in adults often for 2 weeks or more.
Usually the acute period of epidemic vapotitis proceeds easily, but later complications may be discovered as serous meningitis (sometimes - meningoencephalitis), orchitis, epididimitis, ooforitis and acute pancreatitis. It is believed that these diseases are a sign of a more severe course of epidemic vapotitis, since the virus has a tendency to affect the nerve and glandular tissues.
The diagnosis of epidemic vapotitis (pig) is made on the basis of a sufficiently specific clinical picture, laboratory tests practically do not give diagnostically significant information. In dubious clinical cases, serological analyzes can be applied: IFA, RSK, RTGA.
In the first days of the disease, the method of separate definition of antibodies to V and S-antigens of the virus can be applied. An additional diagnostic criterion is the degree of amylase enzyme activity and blood diastases and urine.
Treatment of epidemic vapotitis (pig)
Uncomplicated epidemic vapotitis is treated at home, hospitalization is shown only in cases of severe complications, or for quarantine purposes. With the development of complications of the epidemic vapotitis, the consultation of the andrologist, the gynecologist, the otolaryngologist and the Surdian is shown. During the fever, the bed regime is recommended, regardless of well-being, it is desirable for the first days to eat liquid and semi-liquid foods, more often drink water or tea. It is necessary to carefully monitor the hygiene of the mouth, rinse with boiled water or a weak solution of soda, thoroughly brushing the teeth. Dry warming compresses are imposed on the region of the inflamed glands, physiotherapy techniques (UHF, UFO, diathermy) can be used.
Disinfecting therapy is carried out according to the testimony, with severe intoxication, it is possible to prescribe small doses of glucocorticoids (steroid therapy is prescribed only with inpatient treatment). In the early terms of the disease, the healing effect can be administered to the interferon of a person or its synthetic analogues. If the epidemic vapotitis is complicated by orchitis, the therapy includes the use of suspensions, the first 3-4 days on the testicles are placed cold, in the subsequent - warming. The early purpose of glucocorticosteroids is shown.
Prediction and prevention
Forecast with an uncomplicated epidemic parotitis favorable, recovery occurs in time from one to two weeks (sometimes a few longer). When developing bilateral orchitis, there is a probability of a fertile function. After transferring complications associated with the damage to the nervous system, paresis and paralysis of muscle groups may remain, reduced hearing up to deafness.
Specific prophylaxis is carried out by the vaccination of the Live Vaccine of the LCD at the age of 1, further revaccination is carried out in 6 years. For specific prophylaxis, a live vaccine (LCD) is used. Preventive vaccinations are carried out in planned manner for children at the age of 12 months, not painted with vapotitis, followed by revaccination in 6 years trivaccin (measles, rubella, epidemic vapotitis). Vaccination contributes to a significant reduction in the incidence of epidemic vapor and reducing the risk of developing complications. Epidemiological indications produce vaccination of older people.
General prophylaxis is to insulate patients to complete clinical recovery (but at least 9 days), the focus is disinfected. Quarantine measures to dismiss children's teams in the event of the detection of epidemic vapotitis are appointed for 21 days, previously unvised children who have contact with patients are subject to vaccination.
Parotitis in children
Before one year old, children are not susceptible children. At the age of 1 to 2 years, the disease is rare. The most sensitive age in children to the causative agent of parotitis is 3-5 years. The peak of morbidity is marked in winter and spring.
Epidemic parotitis periods in children
During the epidemic vapotitis, children allocate the following periods: incubation (hidden), period of clinical symptoms and recovery period.
The incubation period of the disease lasts from 11 to 21 days. Usually it lasts about 18 days. This is a hidden period of the disease. Parotitis symptoms during clinical manifestations (the detailed stage of the disease) depend on the form of the disease. The recovery period in the patient may vary depending on the form of the disease.
Parotitis symptoms in children
A child with a disease "parotitis" symptoms begin after 11-21 days after infection. The first sign of the disease is often fever. Sometimes there are other manifestations of intoxication in the form of headaches, weakness, poor appetite.
The defeat of ferrous organs with steaming in children
The most common pairotitis symptoms are signs of inflammation of the near-dry salivary glands. This is expressed by pools in the ear and ear. Pains are intensified during chewing. Worried a feeling of dryness in the oral cavity. The child is difficult when opening the mouth. Since the parole surrounding iron increases, swelling is determined in front of the ear shell. It applies to the neck, cheeks and up to a depositous process of temporal bone.
There is a change in the skin over the inflamed gland. It becomes a glorifying, tense, but ordinary color. After one or two days in the pathological process, salivary iron is involved on the opposite side. Due to the two-way process, the lower part of the face becomes wider than the top. The patient's face becomes like a pig's head, which was the cause of such a name of the disease - "Pig."
In case of inspection of the o'clock, the doctor draws attention to the outlet duct of the varnish salivary gland. It is located opposite the sixth tooth on the upper jaw. The mucous cheek in this place when steaming becomes bright red and edema. The involvement of lymph nodes into the inflammatory process with vapotitis is not characteristic.
On the 3-5 day of the disease, the greatest increase in glands producing saliva is noted. Other symptoms are joined: the feeling of noise in the ears, a decrease in hearing. It is worth noting that the feeling of salivary gland is not accompanied by painful sensations in the patient. To the touch of iron test consistency, the pits during pressing remains. Gradually swelling gland passes, it is noted in the period from 6 to 9 day of the disease.
Parotitis in children can be accompanied by an increase in not only the near-dry glands producing saliva. Other glands that are located under the upper jaw and under the tongue can be involved in the pathological process. Inflammation of the submaxillic glands is called submaxillitis. And the inflammatory process of sub-speaking salivary gland is sublingvit.
At submaxill, edema develops, which is localized in the near-wing-chewing area. This edema can spread to the chest and the neck area. Submaxillitis in children is less common than adults. With the inflammatory process of the sub-banding gland, swelling and soreness appear in the chin area and under the tongue.
Other glazed organs that often suffer from steaming in children and adolescents are teenagers. This inflammatory process is called "Orchit". As a rule, inflammation affects only one egg, but sometimes the process is also bilateral. The development of the orchitis begins after the lesion of the salivary glands. This is happening at the end of the first week from the beginning of the development of the disease.
Orchitis is characterized by the development of the following signs: headaches, a feeling of chills, a new wave of fever, intense pain in the scrotum area, which irradiate in the groin and become stronger when moving.
When examining the scrotum, an increase in the sizes of the egg is 2-3 times. The scrotum becomes stretched, edema, blushing. When feeling the egg, its strong pain, density is determined. Especially painful egg in the field of seed rope. By the end of the second week, the disease is usually the opposite development of the pathological process.
The damage to the pancreas is another symptom of epidemic vapotitis. It does not always occur, but rather often. It may develop to the defeat of the salivary glands or after it. For inflammation of the pancreas characteristic of pain. Pains usually wear a look. In addition to pain in the stomach bothers vomiting and nausea, usually repeated. There may be a violation of the chair, both constipation and diarrhea. Patients complain about the decline in appetite and bloating. Often the temperature rises, and with it a headache.
To confirm pancreatitis, the sick child is examined by the blood for the content of pancreatic enzymes, which are increasing with this disease. Fortunately, the child fully recovers after such pancreatitis, after 5-10 days all his symptoms pass.
The defeat of the nervous system when steaming in children
In children with a disease, steaming, the symptoms of the damage to the nervous system can be both independent and combined with signs of inflammation of ferrous organs. When combined with inflammation of the salivary glands, these symptoms start at 3-6 sickness day. The disease is manifested in the form of serous meningitis.
For this disease, a sharp start is characterized, they are worried about fever, headache, repeated vomiting. Patients become sleepy, sluggish, sedentary. Sometimes there is a violation of consciousness, convulsions, hallucinations. The doctor or Feldscher in the examination of the diseased child marks the emergence of positive meningeal symptoms.
For the diagnosis of serous meningitis, a cereal puncture is carried out to take the liquor to the study. Likvor flows transparent, but under high pressure. It marks an increase in the number of cells (lymphocytic cytosis), the protein content remains normal or moderately rises.
Meningitis continues clinically about a week (5-8 days).
The normalization of indicators of the spinal fluid does not occur immediately, and after 3-4 weeks from the beginning of the disease. Children after serous meningitis with a vapor infection are recovered, but residual phenomena of transferred infection can be disturbed from another 2 to 5 months. These include lethargy, mood swings, reduced ability to concentrate attention.
Temperature when steaming in children
Parotitis temperature is the first symptom of the disease in most children. Typically, the temperature with steaming rises to 38-39 degrees.
Sometimes the disease proceeds for a long time, since some glands are involved in the pathological process, then others are involved. Moreover, each involvement of the new gland in the inflammatory process is characterized by a new wave of fever. Thus, the temperature at vapotite can stay long, but waveforming.
Farm diagnostics in children
The diagnosis of epidemic vapotitis in children is usually not difficult. Therefore, the diagnosis is made on the basis of the poll data, complaints and inspection of the patient.
However, the laboratory diagnostics of the vaporist exists, although it is used very rarely.
- With the help of a virological method of diagnosis, a virus from blood, saliva, liquor can be distinguished.
- There are still serological diagnostic methods when blood is examined on antibodies to paramixes. But this study will need to re-evade the dynamics of the titer of antibodies.
- An immununimenal analysis is also used, which allows you to determine the blood-specific immunoglobulins of class M. This study is applicable only in the acute period of the disease.
- Recently, the PCR method has been developed for the diagnosis of epidemic vapotitis (polymerase chain reaction).
Parotitis treatment in children
Parotitis treatment in children includes symptomatic and pathogenetic therapy. That is, aims to eliminate the symptoms of the disease. Specific antiviral treatment with vapotitis is not carried out.
In the treatment of steaming in children, it is important to observe the bed mode until the body temperature becomes normal. Usually this period is from week to 10 days. The better the child will observe the regime, the greater the likelihood that the disease will go smoothly.
It is important to observe the oral hygiene in a child. For this, the oral mucosa is irrigated with a solution of furaticillin in dilution 1: 5000 or a solution of food soda 2%.
Dry warmth is shown to the field of swelling salivary glands. To do this, you can use blue light, cotton-gauze bandage, warm scarf or wool handkerchief. The compresses can not be done. Sometimes physiotherapeutic treatment is prescribed.
Diet with steam in children
Parotitis treatment in children necessarily includes compliance with a certain diet. It is necessary to eat fractionally, small portions, so as not to overload the digestive tract and its glands. It is advisable to use dairy-plant food. The dishes are better to do in the form of a puree or semi-liquid.
It is worth refrain from sweets, jam, citrus in the first days of the disease. These products have a saliva effect, so at the beginning of the disease they do not need to give them. But in the period of the disease, when the swelling glands will decrease, saliva products, on the contrary, can be given. This will contribute to the improvement of the outflow of the ferrous secret.
In the event that the patient has signs of pancreatitis, the diet is more strict. So, in the first two days of the disease, the patient is starving to unload the digestive tract. Then the food is gradually introduced, but fats and carbohydrates are limited. After 10-12 days, such a strict diet sicks are translated by 5 table (diet for patients suffering from diseases of the liver and biliary tract).
Drug therapy with steaming in children
There are no specific treatment for parotitis drugs. However, with severe diseases of the disease, interferon inductors (Viferon, Genferon, etc.) are prescribed patients.
Medicines for vapotitis are assigned to reduce the manifestations of some symptoms.
To reduce the high temperature when steaming, the children are prescribed antipyretic drugs containing ibuprofen or paracetamol.
In the case when the child is concerned with severe abdominal pain, it is possible to alleviate its condition using spasmolitics such as but-shpa and papaverine. In severe cases, it is sometimes necessary to prescribe drugs that depress the activity of digestive enzymes and fibrinolysis. These drugs include Corrórn, Galds.
In the period of recovery in Pancreatitis, it is necessary to prescribe drugs that improve the processes of digestion. These include enzymes such as pancreatin, Panzinorm-Forte, Festal.
Hospitalization when steaming in children
In which cases, the treatment of steams in children should be held in the hospital?
The child is assigned to bed mode. The scrotum area is superimposed by a special supporting bandage - suspensions. This is necessary in the acute period of the disease, until the signs of egg inflammation disappear. Consultation of the surgeon is assigned. Sometimes hormonal drugs are prescribed (corticosteroids).
Within two weeks, the child is on strict bed mode, which gradually expands. Digests are prescribed (diakarb, lazic) until meningeal symptoms disappear. The dynamics of these symptoms is watching the doctor.
They are also indications of hospitalization, during which the child is prescribed corticosteroid hormonal medicines, antihistamines and vitaminotherapy.
Parotitis complications in children
Like many other infectious diseases, the vapotitis gives complications. Farotitis complications arise not all children. As a rule, weakened children suffer from chronic infections, patients receiving drugs that oppress the immune system.
Most of the complications of the disease are due to the layering of a secondary bacterial infection, which can manifest itself in the form of inflammation of the lungs, otitis, angina, inflammation of lymph nodes.
The disease "vapotitis" can also give long-term consequences on human health. The most frequent and serious complications of the vapor are atrophy eggs and hypogonadism. They can cause impotence and infertility. Pancreatitis with epidemic parotitis in some cases does not pass without a trace. It can go into chronic pancreatitis or become a starting mechanism for the development of diabetes.
Predict in advance how the disease will leak, it is impossible. Therefore, the prevention of vapotitis is very important. Among the prevention measures of the disease "Parotit" vaccination is the most effective way. Parotitis vaccine is introduced to all children, starting with one year old, in the absence of contraindications and in the presence of parental consent.
The text is presented solely for informational purposes. We urge not to engage in self-medication. When the first symptoms appear - contact your doctor. Recommended reading: "Why not do self-medication?
Parotitis, epidemic vapotitis, or pig is a viral disease of a systemic character with specific external manifestations. The main sign of the formation of the disease is an increase in the salivary glands, accompanied by painful sensations caused by inflammation.
For the first time, such pathology is mentioned in the 5th century to our era. Epidemic parotitis is among the "children's" infections, since the causative agent of a disease with a sufficiently high contagiosity index is capable of rapid distribution mainly among the children's contingent. A vapor infection relates to "manageable" infections, the incidence of which depends on vaccination. To date, only 58% of the countries of the world, vaccination against epidemic parotitis is included in national vaccination calendars, so measures to reduce the incidence of this infection and its prevention remain very important.
The viral nature of the disease was determined by specialists in the field of microbiology only in the 20th century. Up to 18th century it was believed that the disease is local and affects only salivary glands. Only at the end of the 18th century were allocated the main forms of vapor, affecting ferrous and nervous tissues, including part of patients with parotitis diagnosed meningitis - viral lesion of cerebral shells, orchitis or ooforite - defeat reproductive organs, as well as pancreatitis.
The etiology of the disease is determined only in the 30s of the 20th century, after in 1934, Johnson and Gudpascher researchers first allocated the pathogen of the pigtail from the patient's biological material. In 1947, scientists McDougal and Henley virus was isolated from the patient's spinal fluid.
Morphology and pathogenesis of the disease. With the development of epidemic vapotitis, salivary glands are eateled with spot hemorrhages. The study of glasses under the microscope shows lymphoid mononuclear infiltrates in the area of ducts and glandular cells. At the same time, ironic epithelium is subjected to dystrophic changes, in the lumens of the ducts, a thickened secret containing leukocytes is visualized.
Risk factors. The only source of infection with epidemic vapotitis is the pathogen in the body in which it causes the pathological state due to the inflammatory process. At the same time, some risk factors can contribute to increased morbidity and lesion development.
The risk factor affecting the incidence is first of all is seasonality. In the northern hemispheres, the seasonality of the most extensive spread of the disease covers the period from March to May, in the southern - the disease is more often affecting the population from October to December.
The rejection of vaccination is a determining factor that increases the risk of morbidity. Recently, the rejection of vaccinations is a problem that provokes outbreaks of diseases by polio, measles, steaming, that is, typically childish diseases that can be avoided, by conducting timely vaccination at the child, and repeating it in an adult. People without the enhancing immunity are sick after the initial contact with the causative agent in 95-97% of cases.
Related to other risk factors:
- overall decrease in immunity and weakening the body;
- non-compliance with the rules of hygiene, sanitary regime;
- High population density.
Epidemiology of the disease. Who applies to risk groups? The main group is the children of school age. With age, the probability of getting sick is reduced by increasing immunity. It should be noted that adults with a weakened immune system are in the risk group, however, newborn children, people over the age of 40, including the elderly, extremely rarely suffer from parotitis. Boys and men are sick more often than female half of humanity.
Forms of the course of the disease and types of parotitis
Infectious vapotitis on the ICD 10 (International Classification of Diseases 2010) is classified by code in 26. Depending on the severity of the disease, the following forms of fears are distinguished:
With a light form, a subfebrile temperature is observed, as well as weakly pronounced manifestations of intoxication of the body. The disease, as a rule, proceeds without complications. The average, or the medium-haul form is accompanied by a temperature of up to 38-39 degrees, as well as a long-term frantic fever with symptoms of intoxication. It is possible to develop bilateral vapor with complications. The heavy form is characterized by a high body temperature (above 40 degrees), over the course of the week and more accompanied by sharply expressed symptoms of intoxication (asthenization, sharp weakness, tachycardia, decrease in blood pressure, sleep disorder, anorexia). Parotitis in severe form, as a rule, bilateral, and complications multiple.
There is also an asymptomatic (inapparantant) clinical type of vapor, when the presence in the body of the virus does not manifest itself.
Depending on the presence or absence of complications of the disease distinguish such types of steam:
Depending on the etiology of the vapor, the following varieties are determined:
- noncommunicable, or non-epidemic vapotitis: it can be formed against the background of injury, certain diseases or long-term supercooling, followed by inflammation of salivary glasses, and also after a specific operational intervention (postoperative vapotitis);
- Infectious (epidemic): formed after the penetration of the causative agent into the body;
- Allergic vapotitis: develops due to the body's reaction to allergens.
Depending on the clinical picture of the flow of pathology distinguish:
- Specific steam: epidemic, tuberculosis, actinomicotic;
- Non-specific: non-epidemic and purulent parotitis.
All known vapor types may acquire:
- Chronic shape (they include interstitial vapotitis).
A chronic form can be recurring, that is, periodically to give themselves to know the appearance of insignificant inflammation and pain. This type of disease is not infectious.
Causes of the development of the disease: epidemic parotitis virus and other factors
The pathogen, causing the development of epidemic vapotitis, is a RNA-containing virus from the Paramyxoviridae family, the genus Paramyxovirus is characterized by neuraminidase, hemolytic and hemagglutinating activity. Viruses are very polymorphic, mainly they have a rounded shape, and in diameter reach 120-300 nm.
The virus belongs to unstable microorganisms, it is destroyed when heated, under the influence of ultraviolet rays, as well as a solution of formalin, ethanol, lizol, and other disinfectants.
In the human body, the causative agent is allocated with urine and saliva, while the virus is found in the blood, breast milk, liquor.
In addition to viral etiology, the following factors can provoke the disease:
- injury salivary glasses;
- blockage of gravel of the gland in the thorny body;
- infection of the gland by bacteria that fell from the mucous membrane of the oral cavity;
- salivamental disease;
- allergic reaction.
The blockage of the duct of the salivary gland, as well as the salivamental disease - diseases associated with the functional impairment of the normal outflow of saliva, which is why there is a violation of the secretion of saliva and an increase in the gland due to the formative inflammation. Most often the big glands suffer, less often - the paroles and submandibular.
The process of formation of stones in the ducts occurs against the background of decreased saliva production or its thickens, as well as due to infallible nutrition, dehydration, redundant receipt to the body of minerals, against the background of long-term intake of antihistamine and psychotropic drugs, as well as funds for normalizing blood pressure.
Allergic vapotitis is formed as a result of sensitizing the body to medicinal, bacterial, food allergens. This type of disease does not apply to the otolaryngological group.
How is the infection of viral vapotitis
The source of the disease is a sick person who distinguishes the virus into the external environment in the last 1-2 days of the incubation period and within 9 days from the beginning of the disease. Especially infected with the patient in the first 3-5 days of the disease. After the symptoms disappear, the patient is no longer contagious. The source of the disease may also be patients with an erased and asymptomatic form. The transmission of the virus is activated by air-droplet, but in some cases it is possible to infected through household items, such as dishes or toys.
The virus has high contagiousness in the air.
Approximately 25% of all cases of the disease proceed asymptomaticly, but the patient allocates the virus to the environment.
In addition to the air-drip and domestic path of infection, there is also a vertical way when the virus is transmitted from the mother to the child during pregnancy or during lactation.
Normal body resistance to the virus is usually high, and after a disease, a long and persistent immunity is produced.
The gate of infection is the mucous membrane of the upper respiratory tract. Penetration into salivary glands occurs through blood.
Finding into the bloodstream system, the causative agent is distributed throughout the body, finding favorable conditions for further growth and reproduction in glands and nervous system. The favorite place of the virus is salivary glands, where its accumulation and reproduction occurs. The virus is re-released from the salivary glands and the virus is supported for 5 days. During this time, the virus has time to involve other organs and systems in the process.
The defeat of the nervous system can occur in parallel with inflammation of salivary glands, before or after it. It should be noted that the causative agent is isolated from the blood, the parenchymathous tissue of the pancreas, breast milk.
In the body of a patient with parotitis, specific antibodies are produced, which perform neutralizing, binding and other functions aimed at eliminating the pathogen from the body. These antibodies can be found in the blood for several years after the suffered disease, and even throughout life.
The damage to the CNS, the pancreas and the peripheral nervous system occurs when the immune mechanisms are involved, namely, with a decrease in the number of T cells, the weakening of the primary immune response, the presence of a low immunoglobulin m, reducing the level of production of immunoglobulins of class A and G.
Neutralization of the viral causative agent occurs due to the production of specific antibodies, which suppress the activity of the virus, and its ability to intracellular distribution.
Clinical Picture: Diseases
Basic manifestations of parotitis
The incubation period lasts from 11 to 21 days, that is, from the moment the virus gets into the human body before the first clinical symptoms of the disease.
The initial period of the development of the disease is characterized by obvious feverish manifestations: increasing body temperature, decreased appetite, chills. Headache, myalgia, dry mouth, insomnia and general weakness may be present. Specific manifestation of vapotitis - inflammation of the parole salivary glands. In addition, subgroups can be captured with submandibular glands. The patient feels pain, the glands are significantly increased in the amount due to inflammatory infiltration. This can be seen not only when palpation, but also visually. Plastic structure purchased on the touch of glands. Facials may be deformed, up to a pronounced pear-shaped form, which can be observed visually. The ear of the ear over the inflamed gland is raised, and the cheek on one side (or both cheeks) increases in size. The skin over the glands does not change the colors, but becomes stretched and slow. Most often, the disease affects both eye-wing glands with an interval of 1-2 days, that is, it is a bilateral, but the vapotitis can be one-sided localization.
Basically, at night, the patient feels painting pain in inflamed tissues. In some cases, the disease affects Eustachiyev pipe, since the inflamed tissues are squeezed out, which is accompanied by noise and pain in the ears, hearing acuity may decrease.
Another specific feature that allows you to diagnose vapotitis - the symptom of Filatov, which is expressed in soreness during pressing behind the ear of the Ear. Because of the pain and inflammation, the patient is difficult to chew food, in their background, the trisms of chewing muscles can develop. The normal processes of salivation are broken, the patient decreases saliva production.
The flow and stage of the disease in adults and children
In children, long-term phenomena are extremely rare and appear in a period of 1-2 days before the appearance of typical clinical symptoms - it is accompanied by chill, headache and pain in muscle tissue, joints, dry mouth and unpleasant sensations in glares.
The long period in adults is marked more often, and accompanied by the presence of more vivid manifestations. In addition to the above-limited synovic syndromes, dyspeptic and catarrhal phenomena can be formed in the patient.
After the incubation stage is completed, the acute period of the disease is developing - its name fully reflects the clinical state. In most cases, the patient feels a sharp deterioration in well-being. In adults, more often than in children, there is an inflammation of the sub-surround and submandibular salivary glands, which are painful and plastic during palpation, take out an elongated shape along the length of the lower jaw. The subcutaneous fiber is infected around the affected fabric, the swelling can spread to the neck area. Inflammation of the sublicty glands can be determined by swelling in the chin area, pains under the tongue, swelling and redness of the mucous membrane. In adults, such symptoms are preserved over 2 weeks.
For the beginning of the acute period, the appearance of chills and an increase in body temperature is also characterized, while the temperature may be subfebrile or stable high. However, cases of the development of the disease without increasing the temperature are sufficiently common. Fevering condition is accompanied by a common weakness and ailment, headache, insomnia. It was during this period of the disease that the pain and an increase in the salivary glands began to bother, change the face form, noise and pain in the ears, redness and inflammation of the mucous membrane of the oral cavity, dryness in the mouth, reduction of salivation.
In general, adults suffer steam harder than children: they are more often formed by prolromal and catarrhal signs, intoxication is stronger. In children, the maximum body temperature (about 40 degrees) is usually observed on the second day of the symptoms of the disease. Over the next week, it gradually decreases. By the middle of the second week, the soreness of glands gradually disappears, they decrease in size. If the disease proceeds without the development of complications, by the end of the second week the child feels better, and the manifestations of the disease pass almost completely. Adult patients lose ability to work for 2-3 weeks. Women and girls are easier for women, they are less likely to have complications.
In other cases, we can talk about the formation of a particularly dangerous stage of the disease - complicated vapor, which in children is accompanied by loss of appetite, dehydration and exhaustion, expressed weakness, lowering blood pressure. For the fifth day, the baby may develop serous meningitis and acute pancreatitis, the symptoms of the lesions of the genitals appear for 6-8 days.
Serous meningitis is the most common complication in a pediatric group of patients. In addition to high temperatures, headaches, nausea and vomiting, parents should alert the increased tone of the occipital muscles, when the child cannot touch the chin to the chest, that is, can not tilt his head forward. Meningoencephalitis is a disease in which the process affects brain tissue and brain shell at the same time. The young male patients often, in the form of a complication of vapotitis, there is a lesion of the genital glands. Inflammation of the testicles and their appendages can begin by 6-8 days from the moment of the first symptoms of the disease. In the area of the scrotum appear pain, inguinal lymph nodes increase, the skin of the testicles becomes red. Ouoforit - a complication threatening girls and women. The inflammation of the ovaries flows with them easier and faster than the boys orchites may be one or bilateral. Pancreatitis appears as a result of the penetration of the virus in the pancreas, and develops in acute form, especially if the patient does not adhere to dietary constraints. There are sharp pain in the stomach, nausea, vomiting, loss of appetite, constipation, which alternates with the relaxation of the chair.
During the incubation period, detect the disease is almost impossible. In general blood and urine tests during this period, changes are made characteristic of the inflammatory process.
As for the acute and complicated period, at first glance, the diagnosis does not represent problems, as the vapotite is most often accompanied by characteristic inflammation of salivary glands, which can be seen and forgive during the primary inspection. However, there are several nuances: first, an increase in salivary glasses can be provoked by some other diseases, secondly, with a latent, hidden course, external manifestations of pathology are completely absent. During the inspection of the patient, information about the disease and epidemic history - information about all patient contacts in the last days. During when the incubation period passes into the acute stage of the disease, the causative agent can be revealed in saliva, urine, spinal fluid. Serodiagnosis implies the determination of the number of antibodies of different classes, their increase confirms the diagnosis. Laboratory immunofluorescent analysis (determination of specific antigens in the blood) is considered the most informative for diagnosing the disease.
One of the tasks of the doctor during differential diagnostics is to distinguish the classic vapotitis (epidemic or non-epidemic) from the false parmotitis of Gezenberg, which is formed as serous lymphadenitis in acute form. Most often, the process is one-sided, characterized by the accumulation of dense infiltration in the near-wing region, with the flow of the deep group, located inside the parole, while the gloomy ducts are not affected. Inflammation is formed against the background of the development of infectious damage at the root of the language, in the nasopharynx and almonds, with difficulty teething of wisdom.
Parotitis treatment in children and adults
The general direction of treatment is characterized by the appointment of symptomatic treatment, since the therapy sent directly to the elimination of the pathogen is absent.
First of all, the patient needs to be isolated from others, as well as provide him with bed regime to prevent additional infection and development of complications. Usually children and adults are treated at home, hospitalization is required only if the disease occurs in a severe complicated form.
Light forms in adults and children are treated with the appointment of non-steroidal anti-inflammatory drugs, if necessary, steroid therapy is carried out.
To reduce pain symptoms and signs of fever, the patient gives painkillers and antipyretic agents.
It is very important to comply with the diet for the period of treatment, so as not to create additional loads for internal organs of difficult-to-referred food. For patients with an attack of acute pancreatitis, it is important to comply with the "cold, hunger and peace" rule until the attack is bought.
Antibiotics for the treatment of viral vapotitis are ineffective.
In severe cases of the course of the disease, the attending physician in the hospital determines the treatment regimen, and can prescribe hormonal, anti-inflammatory and antipyretic agents in the form of droppers and injections.
If the patient strictly complies with all the rules of treatment and the requirements of the doctor, the chances of successful and rapid cure without complications are almost 100%.
Water procedures during the vapor, as under other acute infectious diseases are not recommended, until sharp symptoms go, and better - until the attending physician is allowed. Conventional bathing procedures, bathing in open water bodies and, pools do not exclude the likelihood of the abolition of the body, which for the patient may cause exacerbation of the state and forming complications.
Parotitis Prevention: How to Protect Disease
Anti-epidemic measures to prevent ferry infection are necessarily applied in relation to the disease - for this, it is placed in quarantine for 9-10 days, fully limiting contacts with others. Children can not attend kindergarten or school, adults - work. If children in the history of vaccination against the virus have been contacted with patients, they must be placed in quarantine for a period of 11 to 21 days.
An important active measure of the prevention of vaporotitis is planned and emergency vaccination. The patient is subcutaneously, 0.5 ml of a lively weakened vaccine is introduced into the shoulder area or under the blade. The first vaccination is recommended for children at 12 months. Re-vaccination is carried out at the age of 6. It uses a monovaccination (only from the vapor), or a combined vaccine against vapotitis, measles and rubella (the so-called PDA). Monovaccision revaccination is carried out in 4 years.
Non-specific measures during elevated epidemiological hazards for the population and for persons in contact with patients include:
- airing the premises where the patient is located;
- Disinfection of objects in the focus of the epidemic, including those with which contacts the patient (dishes, linen, toys, clothing);
- wearing gauze bandages;
An increase in non-specific immunity includes a refusal of smoking and alcohol receiving, constant hiking and sufficient stay in the fresh air, proper balanced nutrition. As prophylaxis for children in parotitis foci, pediatrics allows for the appointment of interferon immunomodulators.
Prevention of postoperative vapotitis development includes thorough oral hygiene (permanent rinsing, teeth cleaning and mixing massage), dehydration prevention. The patient is also recommended to periodically dissolve the lemon slicare to stimulate the salivation - the reception used to prevent stagnation of saliva.
In the foci of the epidemic, anti-epidemic activities are to carry out an emergency vaccination of all non-vaccinated adults. Wearing masks and gauze bandages, as well as constant disinfection of items that people contact are important measures to prevent the spread of the virus. Also, quarantine in children's institutions can be announced as a prevention of a pig, usually for up to 21 days.
Complications and consequences of parotitis
Parotitis in infectious form is a rather dangerous disease. It should not be thought that his light flow will surely pass without a trace, even if not to be treated fully and neglect the recommendations of the doctor.
One of the possible complications of viral damage for male is orchitis - inflammation of the testicles. It should be noted that children and adolescents have such a complication occurs less frequently than in adults not vaccinated men. Orchitis usually develops by 5-8 days after the lesion of the salivary glands. The state lasts 7-9 days, after which the symptoms gradually fade.
The development of the orchita is accompanied by a new wave of fever symptoms. In the blood circulates a large amount of toxic substances, which is due to the thermoregulation failure. In the first few days, the temperature rises to 39-40 degrees, after which it gradually subsides. Due to inflammation, swelling and egg develops in size in size and a half or twice. The tide of blood to the inflamed tissue of the scrotum causes it to redness. Orchitis is also accompanied by a violation of the function of urination, pain in groin, long-term erection with painful sensations. Orchitis is a complication that must be treated in a hospital. The outcome of the orchita may be the atrophy of eggs, infertility, chronic orchitis, impotence.
In 20-30% of cases for 4-6 days, acute pancreatitis can develop in an infected. Such a complication requires treatment under a hospital, as it can cause irreversible changes in the tissues of the pancreas. The patient appears pain in the stomach of a concerned nature that gave in the back with a concomitant nausea and vomiting, fever, diarrhea, an increased tone of the abdominal muscles. The absorption of food is disturbed due to the functional changes in the pancreas.
Patients may also have other complications of vapotitis. The ooforite is the inflammation of the ovarian in women, which is characterized by the appearance of pain at the bottom of the abdomen, disorders of the menstrual cycle, bleeding, not related to menstrual discharge, pain with sexual interchange. Usually, a subfebrile temperature is observed. Such a complication is extremely rare, and, unlike orchita, does not lead to infertility.
The inflammation of the thyroid gland is called thyroiditis. It is accompanied by pain in the throat area, swelling in this zone, an increase in cervical lymph nodes, as well as feverish manifestations (chills, increasing temperature, loss of appetite, headache, sweating). Functional cells are destroyed, hormones fall into the blood and cause an abnormal immunity reaction. Such a complication is extremely rare.
Meningitis and meningoencephalitis - inflammatory brain process (isolated or with a lesion of brain shells). It is characterized by sharp start with a sharp leap temperature, strong headaches, vomiting without nausea. Muscle's rigidity The backbone does not give the patient freely to tilt his head so as to touch the chin of the chest. The condition is accompanied by lethargy, drowsiness, confusion of consciousness. Pathology can develop for 4-7 days after lesion salivary glasses. The treatment is carried out only with the condition of hospitalization. Men can develop prostatitis - inflammation of the prostate gland. Its characteristic symptoms are chills, fever, pain in urination, headache, a sense of breakdown and fatigue. The health of the patient sharply deteriorates, adequate treatment in a hospital after 1-2 weeks already gives a positive result for the patient. The labyrinthitis is the inflammation of the interfachable formations and the nerve structures of the inner ear, which is accompanied by a hearing impairment, ears noise, with concomitant nausea, vomiting, coordination disorder. This rare complication of vapotitis occurs as a result of a constant increase in pressure in the region of the ear shell caused by an elevatedness of an inflammatory nature. Be sure to require consultation at the otolaryngologist.
Arthritis is accompanied by the integrity of joints, stiffness and soreness when moving. It usually begins 1-2 weeks after the occurrence of the disease. The parallel defeat of several large joints, for example, elbow, shoulder, knee, is extremely rarely observed.
In mastitis in women, the mammary glands are inflated, the temperature rises, feverish state appears. In rare cases, mastitis develops in men. Summing up - not the only danger of a vapor. It refers to the category of hazardous diseases is still due to the fact that after the suffered infection, a person may have a number of hazardous consequences and residual phenomena, which entail irreversible consequences, and sometimes they become the cause of disabled.
Due to the untimely or improper treatment of orchitis, men can develop infertility. First of all, the missed unqualified adult men may suffer. The irreversible lesion of the genual gland virus has a direct impact on the reproductive function and becomes the cause of male infertility.
Deafness is formed due to the launched damage of the inner ear or auditory nerve as a result of the transferred labyrinthitis. In advanced cases, hearing loss is irreversible.
Sugar diabetes is a dangerous disease caused by the inflammatory process in the pancreas tissues. If damage captures the islands of Langerhans, which are responsible for the production of insulin and decrease the level of glucose in the blood, a violation of glucose tolerance can be formed in the patient. The motion of cells producing hormone insulin leads to a decrease in its blood level, which is characteristic of diabetes of the first type.
The residual phenomenon in the form of diabetes mellitus appears in patients extremely rare, but the probability of its development can not be underestimated, since the missed time in diagnosing or error in treatment may cause the formation of a dangerous pathology with which the patient will have to live a lifetime.
The dry eye syndrome is the consequence of the transferred inflammation of tears glasses. Due to the violation of the gland, the secretion of the secret and the level of normal power supply is reduced. The mucous membrane dries too quickly, in the eyes begins and discomfort appears. Disorders can be maintained for 3-6 weeks after the disease. For treatment should contact an ophthalmologist.
After cured meningitis or meningoencephalitis, the patient may have disturbances of skin sensitivity, muscles, limbs. Sensitivity is restored by years after the disease. Such a consequence is the result of the wrong or late treatment of inflammation of the brain, and it rarely appears, but it can have a significant impact on the quality of life.
Is it possible to re-get a vapotite? Usually people who were sick in childhood do not get ill thanks to a sustainable immune response. However, the probability of re-infection exists, and is about 2%. After the suffering disease in the body, specific antibodies are produced against a specific type of pathogen. Specific immunity appears as a result of the contact of the virus with macrophages in the human body. Macrophages absorb viral particles, neutralize them, and form an immune response, namely antibodies in the blood. These antibodies are produced by a few weeks or months after the initial infection.
Antibodies to the epidemic vapotitis are preserved in human blood throughout life. It is due to this that the re-development of viral destruction is extremely unlikely.
As for non-epidemic vapotitis, one of the complications in its improper treatment, or in the absence of therapeutic therapy, the recurrence of the disease is, as a result of which the patient may develop a chronic form of vapotitis.
Vaccinated people can get viral vapotitis in cases where a poor-quality vaccine was used for vaccination, or if the vaccination was made with the presence of contraindications.
Diet as a component of a parapetitis treatment
The main task of the appointed diet with a swine is the unloading of the pancreas in order to avoid the attack of acute pancreatitis. For this, the patient is prescribed a standard diet number 5.
The diet of the patient per day should not exceed calorie content in 2600 kcal. We need to eat fractionally, 4-5 times a day, minor portions. In addition, on a day you need to drink about 1.5-2 liters of liquid - fasten black tea, a nonxid compote or simple water.
The menu may contain low-fat varieties of meat, birds, fish, almost all fresh vegetables and fruits (except cabbage, radish, sorrel, onion, garlic), low-fat soups, some sweets (marshmallow, honey, flip), pasta and cereal, and also Low-fat dairy products in small quantities.
Cheeses, eggs, boiled sausages, butter, tomatoes and tomato paste - in the reception of this food the patient should be limited.
It is strictly forbidden to use foods provoking appetite and reinforced digestion - it is fatty meat, oily fish, smoked, alcohol, chocolate, coffee, sturdy tea, fresh bread, legumes, pickled snacks, fried, sharp, salty dishes. Pancreatic glands, like the digestive tract as a whole, it is hard to digest milk, so it should be completely refused to completely recover.
The main principle of the diet - the easier and faster food is absorbed, the less enzymes for digestion it is necessary to produce iron, it means that the risk of its lesion will be reduced.
In the case of acute pancreatitis, even starvation is allowed in the first one or two days of the attack, at which only drinking water is allowed. Such a measure is appointed only by the attending physician.
It is allowed to prepare dishes for a couple, as well as cooking, quenching and baking without forming a crust (especially relevant for vegetables, meat, fish).
Epidemic viral vapotitis is considered typical childhood disease, but recently it has been somewhat "matured." This is happening due to the fact that the immunity of an adult is not always able to cope with the causative agent entered into the body, for example, if the body is weakened by an incorrect lifestyle, or if a person in childhood was not vaccinated against the vapor.
The disease most often has a positive forecast for the diseased, if it is revealed in time if the correct treatment is assigned and all the recommendations of the doctor are fulfilled in full. This is especially important in order to prevent the development of complications and hazardous consequences in patient.
Medvedev Larisa Anatolyevna
Specialty: Therapist, nephrologist .
Common experience: 18 years .
Place of work: Novorossiysk, Nephro Medical Center .
Education: 1994-2000 Stavropol State Medical Academy .
Mother Valentina Yakovlevna
We will be grateful if you use the buttons:Parotitis ( piggy )
- This is a respiratory viralinfection
which represents a serious epidemiological danger due to high contagiousness. The disease is most often found in children (more often aged 5 - 8 years
). In children under 3 years old, the infection is extremely rare. Increased danger of infection remains up to 15 - 16 years. Adults are less susceptible to epidemic vapotitis, however, the possibility of infection remains.
The pig does not represent a serious danger to the patient's life, but the treatment of the disease is paying much attention due to the high risk of complications. In recent decades, the difficult course of the disease is rare. Also, due to mass vaccination in most countries, the incidence of fear in general fell.Interesting Facts
- Epidemic vapotitis is often called a pig or cauldron due to the characteristic swelling of the top of the cheeks in front of the ears.
- The first description of the classic patient with epidemic vapotitis was made by another hypocratic 2400 years ago.
- Big progress in the diagnosis and treatment of the pig made military doctors in the XVII - XIX centuries. During this period, the parotitis was often observed in a soldier environment due to the large crowd of people in barracks and trenches and low hygiene. In some sources of that time, it is even referred to as "Equal" or "Soldier" disease.
- The viral nature of the vapor was proven by infection of monkeys of salic patients.
- In natural conditions, the pig is a strictly anthroponous disease, that is, only people suffer. Only in the laboratory conditions are possible to transfer the virus by some types of monkeys and dogs, however, such animals are hurt themselves, no longer represent the danger of infection.
- The first pig vaccine was obtained only in 1945.
- Epidemic vapotitis represents a greater epidemic hazard, so currently more than 80 countries around the world conducts planned vaccination of children from this disease.
Parotitis causative agent
Puncher Pig - VirusPneumophila parotiditis
From the familyParamyxoviridae.
. It is a RNA chain (Genetic material
), covered with a dense protein shell. If in the cell, the virus begins to multiply, producing duplication of genetic material. The cell of the macroorganism is used to produce proteins necessary for the formation of the capsule.
When studying under a microscope, the virus is polymorphic (of different shapes
) Particles with dimensions from 100 to 600 nm. They are unstable in the external environment and quickly destroyed under the influence of various chemical and physical factors.The following measures can be used to inactivate the pairotite pathogen:
- The effect of high temperature;
- ultraviolet radiation ( including the impact of direct sunlight );
- Changing the pH of the environment ( His or alkaline );
- The impact of ethyl alcohol ( 50% or more );
- Impact of formalin solution ( 0.1% or more );
- Other disinfectants.
Under the optimal conditions, at a temperature of less -10 degrees and the preservation of high humidity, the virus can be maintained up to 3 weeks, but its pathogenic (pathogenic
) The potential is greatly reduced. Thus, the virus can be considered unstable in the external environment.
In the human body to the vapotitis virus are sensitive, first of all, glandular cells of some parenchymal organs. Usually there is a lesion of salivary glands, several less frequently - pancreas and sex glands (More often male testicles than women's ovaries
). It is also possible to damage the tissues of the nervous system.
Infection of a pig is airborne droplet. During breathing (less
Or sneezing patient spreads viral particles with saliva droplets. If you get to the mucous membrane of the respiratory tract of another person, the virus affects ferrous cells in the epithelium. Also described cases of infection when a virus hit the mucous membrane of the eye (conjunctiva
). In the cells of the mucous membrane, its primary reproduction in the body occurs. After that, the virus enters the blood (stage of virusemia or viremia
) and spread over all organs and systems. However, a specific viral lesion is developing only in the cells of the above-listed organs, which show special sensitivity to this disease.The guinea virus has the following specific fabric damage mechanisms:
- Gemagglutinizing activity . Gemagglutinating activity is to effect on blood erythrocytes. Under the action of specific substances, erythrocyte gluing. This leads to the formation of microtrombov in capillaries and contributes to the development of edema.
- Hemolytic activity . Hemolytic activity is the destruction of blood cells ( First of all, red blood cells ) With the release of hemoglobin and a number of other toxic decay products.
- Neuraminidase activity . The specific enzyme neuraminidase facilitates the penetration of virus particles inside the cell, which contributes to the breeding of the virus.
Under the action of the above pathological mechanisms, a pronounced inflammatory edema is developing. It is observed mainly in a sharp period of the disease. To the place of breeding the virus also migrateLeukocytes
, impregnating the surrounding fabrics. The result of the inflammatory process and damage to functional cells are serious violations in the work of the organ. Depending on the intensity of inflammation, structural changes can become irreversible. In this case, even after recovery, serious residual phenomena may be observed.
From an immunological point of view, the varotitis virus is presented by a number of antigens. These are unique substances characteristic only for this group of microorganisms. The antigens pig virus are represented by the capsule proteins. The human body perceives them as alien substances. When contacting with peripheral cells, the antigen structure is recognition. Encoded information about the structure of the alien substance is transmitted to the central organs of the immune system. The formation of an immune response is based on this information. It lies in the development of specific antibodies. These are in-lymphocytes equipped with a special receptor that recognizes the viral antigen. Antibodies are circulated in the blood, selectively attached to viral particles and leading to their destruction.
In people who have switched, antibodies in the blood continue to circulate throughout life. Therefore, when re-entering the virus on the mucous membrane, it will occur its fast neutralization of antibodies and the disease does not develop. On this mechanism, the action of the anti-optical vaccine is based. However, even such acquired specificimmunity
The pig is not absolute protection. It is believed that even after the suffering disease, a risk remains (About 0.5 - 1%
) Re-infection. In people who have suffered serious operations with massive blood transfusions, or after bone marrow transplantation, the risk of re-infection rises to 20-25%, since a significant part of the antibodies is derived from the body.
Causes of pigs
Epidemic vapotitis is an infectious disease, so the only root cause of its development, one way or another, is a virus that penetrated the body. In the body, it leads to the development of specific lesions of tissues at the above mechanism. However, a number of predisposing factors can also be attributed to the reasons for increased incidence of pork. Their presence increases the risk of infection.To the risk factors with epidemic vapotitis include:
- seasonality of the disease;
- rejection of vaccination;
- Weakening of general immunity;
- high population density;
- non-compliance with the sanitary regime.
Seasonality of the disease
Peak incidence of pork falls on the spring months (March - May
) in the northern hemisphere and on the autumn months (October December
) - in southern. This pattern is explained by weakened immunity. After a cold period, the body weakens and its protective resources are depleted. At this time of the year, the diet of children is usually the most poor vegetables and fruits, which leads to hypovitaminosis or avitaminosis (Forms of lack of vitamins
). In addition, the pork virus is well maintained in the environment at a temperature of about 0 degrees, which also increases the chances to get infected.
Refusal of vaccination
In recent years, many parents decide to abandon the vaccination of children due to the high risk of complications. Such a decision imposes great responsibility to parents before their children. In the future, the child will be susceptible to the vapotitis virus and will relate to the risk group. Unvaccified people without specific immunity are ill when they first contact with a pig causative agent at 95 - 97% of cases. Thus, the child will remain defenseless until the age of adulthood, when he can independently decide on vaccination. Additional problems are created for doctors and nurses in kindergartens and schools. Children without specific immunity constantly pose a danger to others. With a vapotitis, the patient may be contagious before the emergence of the first expressed symptoms. It makes doctors every time eachOrz
(acute respiratory disease
) and ORVI (acute respiratory viral infection
) suspect a pig and conduct additional diagnostic measures.
Weakening of general immunity
The state of general immunity plays a significant role in the protection of the human body from infection in principle. The immune system is able to deal with the overwhelming majority of viral and bacterial diseases, which reduces the likelihood of infection. As noted above, most people have a weakening of immunity at the end of winter and at the beginning of spring. However, the time of year in this case is not the only factor.The child's immunity can be weakened for the following reasons:
As you know, the pig is considered child infection. Most often the children of younger school age are sick. As a consequence, it is in this period of time that parents should be the most attentive. Children of senior school age (After 15 years
) And adults are sick on average 5 - 7 times less often.
High population density
As with any other infectious disease, the density of the population plays an important role. First of all, we are talking about the crowded children in kindergartens and schools. In such conditions, one child, a sick pig, can infect at once a large number of children. Thus, the threat of an outbreak of epidemic parotitis in the framework of educational institutions increases. To avoid this, it is necessary to conduct classes in large well ventilated classes.
Non-compliance with sanitary regime
High risk for others represent patients who have not been isolated. As mentioned above, the patient is a source of infection from the last days of the incubation period (5 - 6 days before the appearance of the first symptoms
) Until 7 - 9 days of the course of the disease. During this period, the patient should remain at home to avoid the spread of infection. Failure to comply with the sanitary regime increases the risk of infection of people who are in contact with the patient.
Types of epidemic parotitis
As noted above, the pig's causative agent has increased activity in respect of a number of ferrous organs. Depending on which of these organs will be affected, these or other symptoms will prevail during the disease. In many ways, the clinical form of vapotitis also predetermines the danger of certain complications and treatment tactics.The main clinical forms of the flow of the pig are:
- defeat salivary glands;
- The defeat of the testicles;
- damage to the pancreas;
- The defeat of other organs and systems.
Defeat of salivary glasses
Actually the name of the disease - parotitis - implies inflammation of the near-dry salivary glands. They are located ahead and a book about the ear shell. As a rule, the process affects both parole glands, but one-sided options are found. Symptoms can also develop first on the one hand, and only a few days later, the disease will reinstate the steam gland.
Several less frequently near-dry pigs affects other salivary glands (submandibular and sublabit
). This variant of the flow of the disease, when the inflammatory process develops only within the salivary glands (one or several
), considered uncomplicated. It is characterized by a number of typical symptoms.
Symptoms of the lesions of the salivary glands with an epidemic parotitis
|Symptom||Mechanism of appearance||Features with vapotitis|
|Pain when moving jaws||Pains appear mainly due to the pronounced edema of gland tissues and stretching its capsules. The formation of pus in the gland is extremely rarely observed, then pain becomes acute and caused by the destruction of gland tissues and irritation of nervous endings.||Pain and discomfort appear as edema develops or precede it. Usually pains are stupid character and are intense. They persist within 7 - 10 days until swelling.|
|Swelling in the field of salivary glands||Plowness is explained by the intensive development of the virus in the cells of the salivary gland. This leads to the establishment of inflammatory edema.||The swelling of the parotid glands the face characteristic of the epidemic parotitis shape, hopping the sides of the ears on the parties. This symptom is considered specific precisely for the pig and with other diseases appears extremely rarely.|
|Increase body temperature||An increase in body temperature is explained by the reproduction of the virus and the products of its livelihoods in the blood. The chain of biochemical reactions leads to the release of pyrogen - specific substances affecting the center of thermoregulation in the brain. Its irritation leads to an increase in body temperature.||The temperature increases in the extended period of the disease, or at the stage of specific appearances of the disease. Often it begins to rise in 24 - 48 hours before the lesions of the salivary glands. The temperature rise is usually sharp, accompanied by chills. Starting from 4 to 5 days of the disease in the absence of complications, the temperature begins to subscribe. In the first days, it can reach 39 - 40 degrees.|
|Dry mouth||The dryness in the mouth appears due to the violation of the function of the salivary glands. Often she is accompanied by redness of the mucous membrane of the mouth and pharynx.||The symptom is usually not very pronounced and quickly passes. Some discomfort due to dry patients experience only during the first days of the disease.|
|Noise in ears||The noise in the ears can be caused by pressure on the outer hearing pass. With the defeat of the auditory nerve, the symptoms are significantly more pronounced. This form refers to a specific complication - maze.||The noise in the ears is rare, appears episodically in the first days of the disease. In the absence of hearing nerve damage, patients often do not even mention this symptom at a doctor's reception.|
|Characteristic landing of the head||Significant swelling of the salivary glands provokes pain when moving head, so patients are trying not to move.||The symptom is especially noticeable in the first days of the disease, when the edema is growing. The head is usually tilted in the affected side ( With one-sided lesion ), or a little drawn in the shoulders when bilateral.|
Defeat the testicles
The defeat of the testicles is one of the serious complications of the epidemic parotitis. It is found mainly in men of adults who were not in childhood grafted from a pig. In children and adolescents, this form of vapotitis is less common. Typically, the spread of the virus on the tissue of the egg occurs after the healing glands (for 5 - 7 day
). This is accompanied by the emergence of new symptoms and a noticeable deterioration in the overall condition of the patient. In rare casesOrchit
(Egg inflammation or appendage of eggs, respectively
) It is the first specific manifestation of the disease. In other words, he does not precede the defeat of the salivary glands. In such cases, diagnosis often causes difficulties, since doctors are looking for other reasons for the inflammatory process. Orchitis is most often unilateral (Only one egg is affected
), however, bilateral processes are found. The disease lasts 7 - 9 days, after which it goes into the phase of the extinction and the symptoms begin to subscribe.
Typical symptoms in the development of orchita in patients with pork
|Symptom||Mechanism of appearance||Features with vapotitis|
|New wave of fever||The new wave of fever is noted due to massive damage to the virus of a new piece of fabric ( Eggs and his appendat ). This is accompanied by circulation in the blood of toxic substances that annoying the thermoregulation center.||Usually there is a new increase in temperature to 39 - 40 degrees. In subsequent days, its gradual decrease occurs. Orchitis must be treated in a hospital, as there is a danger of irreversible infertility.|
|Equipment of eggs||Egg increases due to inflammatory edema. The virus penetrates the fabric of the gland, causing inflammation. As they migrate to the hearth leukocytes, there are a release of specific mediators. They increase the permeability of capillaries and contribute to the exit of the fluid from the vessels in the tissue.||The egg may increase in one and a half - twice. Its reduction occurs gradually, as other symptoms retreat.|
|Midge hyperemia||Hyperemia ( redness ) The scrotum is explained by tide of blood to the affected body and the establishment of inflammatory edema.||Hyperemia is observed quite rarely and can remain unnoticed with significant overeating in the groin area.|
|Pain in gagha||Pain pain appear due to the establishment of inflammatory edema. At the same time there is a mechanical compression of pain receptors.||Pakhu pain with vile stupid, non-intensive ( as the edema is growing gradually ). They can give to the area of the loin, in the foot or in the suprapo region. When driving or urination, pain is enhanced. As a result, the patient may wipe it.|
|Urination disorders||Urination disorders appear reflexively due to increased pain. Reducing the muscles empty the bladder slightly increases pressure and in the scrotum, squeezing and nervous receptors. The patient may experience fear of urination ( Especially children ), They go to the toilet often and gradually.||Urination disorders are a rare symptom and usually last no more than a few days in the most active phase of the disease.|
|Priapism (long-term painful erection)||Because of the enemy of the egg, the receptors are irritated responsible for filling the cavernous bodies of the genital blood. There is an erection that is not associated with external stimuli.||This symptom is extremely rare and lasts usually not more than 24 - 36 hours ( more often a few hours ).|
Damage to the pancreas
The damage to the pancreas in the swing is observed quite rarely (2 - 3% of cases
). Some researchers believe that a low percentage is due to insufficient diagnosis, andPancreatitis
With vapotitis are found much more often. Be that as it may, this complication requires special attention, as it can lead to serious structural changes in the structure of the gland and the disorders of its function. The first specific signs of pancreatitis are celebrated on 4 - 7 days of the disease and almost always follow the damage to the salivary glands. The isolated damage to the pancreas without affecting other organs and systems in patients with vapotitis is extremely rare. The patient's condition in the development of pancreatitis is noticeably deteriorating. Such patients are recommended to be hospitalized for more intensive treatment.
Symptoms of pancreatic damage in patients with epidemic parotitis
|Symptom||Mechanism of appearance||Features with vapotitis|
|Pain||Pains appear due to tissue edema. Usually, in the case of pancreatitis, against the background of parmotitis, the edema is not so strong, but the organ itself is extremely sensitive.||Pains are localized in epigastry ( Top of belly ) And wear a look. They can be given to the back area or blades and to achieve significant intensity.|
|Fever||The mechanism of the new turn of the temperature in pancreatitis is similar to those with other virus localizations and is associated with the irritation of the thermoregulation center.||The temperature rises quickly, usually following the appearance of pain. Can reach 38 - 39 degrees. Keeps from 3 to 9 days ( depends on the intensity of treatment ).|
|Vomot||Pancreas takes an active part in the process of digestion. Her damage to the virus reduces the release of digestive enzymes and makes it difficult to absorb food. This may cause repetitive episodes of vomiting during the disease. In addition, at the beginning of the disease, one-time vomiting may be observed due to the reflex irritation of the nerves.||Vomiting is usually single in the early disease. Repeated episodes talk about massive tissue defeat and worsen the forecast. To prevent and reduce vomiting, the appropriate diet should be observed, which will be described below, and take the pancreatic enzymes to facilitate digestion of food during the disease.|
|Diarrhea||Diarrhea is also observed due to insufficient digestion in the small intestine. Because of this, many substances fall into the colon poorly digested, do not absorb and cause irritation of the mucous membrane. Reflexo it leads to the participation of the chair.||Diarrhea is rarely observed and lasts a few days. The symptom can be delayed only when the secondary bacterial infection is attached or the development of complications ( accumulation of pus or necrosis of the pancreas ).|
|Abdominal muscle tension||The stress of the abdominal muscles is reflexive because of the edema and irritation of the peritoneum.||With palpation, the belly is solid, pressure causes an amplification of pain. The patient cannot arbitrarily relax the muscles of the abdominal press.|
The main danger of pancreatitis in patients with pork lies in the possible irreversible defeat of the islets of Langerhans, producinginsulin
. In this case, after recovery, the patient will suffer from diabetes mellitus of the first type.
The defeat of other organs and systems
The defeat of other organs and systems in the epidemic vapotitis is rarely found. These are mainly not a serious threat to patient health. Nevertheless, some clinical forms of illness (Serous Meningitis
) Maybe without timely treatment, even to death. It is because of the threat of such complications, a massive vaccination of pigs from a pig is currently recommended.
The defeat of other organs and systems in the epidemic parotitis
|Complication||Typical symptoms||Features of the course of the disease|
|Ouoforit (ovarian inflammation in women)||Pains at the bottom of the abdomen, disorders of the menstrual cycle ( Amenorrhea or Dysmenorrhea ), intermented bleeding, pain during sexual intercourse. Temperature can remain subfebrile ( 37 - 38 degrees ), but more often increases somewhat.||The ooforite meets in children more often than adult women. In general, he belongs to rare parotit complications, and, unlike orchita, men almost never lead to infertility. To confirm the diagnosis, ultrasound is usually sufficient ( Ultrasound ).|
|Thyroiditis (thyroid inflammation)||Increasing the thyroid gland ( swelling in the throat area ), Pain in the area of the neck, in the head of the bottom and the upper jaw, an increase in the neck lymph nodes, an increase in body temperature, chills, headache, weakness, sweating, the increase in heart rate.||Thyroidite as a complication of the vapotitis is rare, but can lead to very serious consequences. In particular, there is the possibility of developing an autoimmune process. In such cases, the patient after recovery may suffer the insufficiency of thyroid hormones. Endocrinologist's doctor attracts for the treatment of thyroiditis.|
|Meningitis and meningoencephalitis (inflammation of brain shells and brain itself)||Acute start, increase body temperature up to 39 - 40 degrees, strong headache, vomiting of central genesis ( without preceding nausea ). Meningkeal syndrome: the rigidity of the occipital muscles, the symptom of Kerniga and the symptom of the Brudzinsky ( Upper and Nizhny ), symptom of woodland ( in children ). In addition, there are characteristic changes in the analysis of the spinal fluid: the liquid flows under pressure, the protein content is up to 2.5 g / l, cytosis up to 1000 cells in 1 μl, chlorides and glucose is normal. With the defeat of the brain fabric itself ( encephalitis ) There is lethargy, drowsiness, disturbances of consciousness, paralysis and paresa.||Serous meningitis develops for 4 - 7 days after the lesions of the salivary glands, less often - simultaneously with it. Despite the fact that the course of the disease in the development of meningitis deteriorates sharply, the forecast is usually favorable. Treatment is carried out only in stationary conditions and lasts at least 2 - 3 weeks. Meningkeal syndrome with proper treatment disappears on 10 - 12 day of the disease. The latter returns to the norm indicators of the spinal fluid ( 1.5 - 2 months ).|
|Prostatitis (inflammation of the prostate gland)||Fever, chills, rapid and painful urination, weakness, headaches, feeling fatigue.||With specific damage to the prostate gland, a sharp deterioration of the patient's condition with a new wave of fever and signs of intoxication occurs. Stationary treatment of patients with this complication is recommended. With adequate treatment of prostatitis, all symptoms retreat as recovery ( within 1 - 2 weeks ) Without any consequences.|
|Labyrinthitis (damage to the hearing body)||Headaches, nausea ( maybe without vomit ), dizziness, disruption of coordination of movements, noise and ringing in the ears. Reducing hearing or, on the contrary, the ringing in the ears may be one-sided.||The labyrinthitis is a rare complication of the pig. It can be caused by increased pressure in the region of the abnormal sink due to inflammatory edema, but the symptoms are more pronounced with a specific lesion of the auditory nerve and the vestibular apparatus. With the development of Maze, a consultation of the ENT doctor is required. Symptoms from the hearing body are usually observed no more than a few days and disappear as they recovery.|
|Arthritis (lesions of the joints)||The edema of the joints, soreness, stiffness of movements.||Speed arthritis is rarely developed, usually in 1 - 2 weeks after the start of the disease. In rare cases, the simultaneous lesion of large joints may be observed ( knee, ankle, elbow, shoulder, rascal ) and salivary glands. This complication is more common in men. Symptoms disappear as recovery, rarely leaving serious consequences. With moderate defeat of the joints without intensive edema, the treatment of this complication at home is allowed.|
|DacryoDenate (inflammation of the tear glands)||Powerness of the eyelid ( more often bilateral ), expressed edema, pain, eye redness, eye dryness.||This complication occurs quite rarely and requires urgent advice of an ophthalmologist. During the course of the disease, special drops are prescribed, moisturizing and feeding the mucous membrane. The forecast is usually favorable. Extremely rarely dacryo adenate can, in turn, complicate the gear abscess.|
|Mastitis (inflammation of the mammary glands)||The disease is characterized by fever, soreness and sealing of the mammary glands. Rarely observed a small amount of separated ( mucus or, less often, pussy ).||Mastitis develops mainly in girls and women, but men have the appearance of this complication, too, is also not excluded. The overall condition of the patient suffers a little. Symptoms are short and quickly retreat against the background of treatment.|
In what period of the patient is dangerous for others (infectious)?
The infinity of the patient with a pork is one of the most important criteria in the course of the disease. It is she who predetermines the period of time when the patient should be isolated in the hospital or at home. With epidemic parotitis contagious period (time when the patient is contagious
) May vary. For better time orientation, you need to know all periods of the course of this disease.During epidemic vapotitis, the following stages distinguish:
- incubation period;
- Promotional period;
- the period of the main manifestations of the disease;
- period of fading;
- Period of recovery.
The incubation period is a segment of time at which the virus has already fallen into the human body, but the disease is not yet coming. In other words, the patient does not bother anything and he does not suspect that he fell ill. In this period, the virus breeds in the mucous membrane of the respiratory tract and penetrates the bloodstream. In rare cases, at the end of the incubation period of the patient, implicit common symptoms are be bored, as weakness, increased fatigue, drowsiness.
Epidemic parotitis the incubation period lasts from 11 to 23 days (Maximum described duration - 30 - 35 days
). The danger is that in the last days of the incubation period, the patient may be a danger of infection for others. In some cases, the virus particles may be contained in saliva even before the first obvious symptoms of the disease appear.
Promotional period is a period of nonspecific symptoms. That is, a person understands that he fell ill, but it is still impossible to diagnose the symptoms. In patients with pork, the long period lasts not more than 24 - 36 hours, but it can often be absent at all. Characteristic symptoms are headache, muscle pain, articular pain, sleep disorders. If the long period is present, then the patient is infectious throughout the entire time.
The period of the main manifestations of the disease
This period is characterized by the appearance of symptoms characteristic of the pig. First of all, we are talking about redness of the mucous membrane of the mouth, throat and pharynx. Especially expressed red in the field of output ducts of salivary glands. The unpleasant sensations and swelling of the near-dry salivary glands appear somewhat later (area from the bottom and in front of the Ear
). The patient continues to actively allocate virus particles of another 5 - 9 days after the appearance of the first characteristic symptoms. It is unambiguous to determine this period is difficult, since an increase in the near-dry salivary glands is not always the first symptom. With an atypical course of the disease, the virus can hit the genital gland or pancreas at the beginning.
Period of Ugasania
Specific symptoms usually go to the decline in 7 - 9 days after their appearance. A longer current of the active phase is observed under the defeat of several glands or related complications. During the period of rational, some visible symptoms can still be maintained (The swelling of the salivary glands and the characteristic form of the face
), but their intensity falls. As a rule, by this time the temperature also returns to normal. The patient in this phase no longer represents the threat of infection for others and during normal well-being and the absence of complications can be returned to the educational or working team.
Period of recovery
In the period of recovery, all specific and nonspecific symptoms are gradually disappeared. Treatment is required only in cases where the complications of the pigs led to serious health consequences. No contagious about the child in this case can not be speech. Immunity by this time has already been formed and the patient finally ceased to allocate virus particles.
Thus, a period of danger to surrounding lasts on average 7 - 9 days. It is for such a period that it is recommended to isolate patients who are diagnosed with epidemic vapotitis.
In the period when the patient is inflated, it requires particularly thorough and attentive care. The most important task is to prevent the dissemination of infection. In addition to the beddown, it is necessary to observe all non-specific prevention measures, which will be described in detail below. In the event of an atypical course of the disease (If the diagnosis was raised late
), Care features should be discussed with the infectious disease physician.
Treatment of epidemic vapotitis in most cases is carried out at home. The patient shows the bed mode from the moment of diagnosis before the measurement period of the symptoms (1 - 2 weeks in the absence of complications
). The final decision on the treatment of patient and treatment conditions takes the attending physician infectious person after examining the patient. In the case of complicated vapotitis, hospitalization of the patient is recommended for more intensive treatment.To prevent residual phenomena after a pig, other specialists are often involved in addition to infectious examiners:
- Endocrinologist With damage to the genital glands, thyroid or pancreas;
- Neuropathologist with the development of serous meningitis or meningoencephalitis;
- otorhinolaryngologist ( Laura )with the development of labyrinthitis;
- rheumatologist With a concomitant pronounced lesion of the joints.
Currently, there is no effective treatment directed against the virus - pairotitis causative agent. In this regard, the emphasis is on symptomatic treatment to prevent the development of complications and reduce the suffering of the patient. With a favorable course and defeat only the salivary glands, treatment lasts about 2 weeks.In general, the treatment of vapors can be divided into several directions:
- compliance with the regime and care for the patient;
- compliance with diet;
- Medical treatment ( can vary greatly with the development of complications ).
Compliance and patient care
In the course of treatment, the bed regime is recommended even with uncomplicated forms of vapor. It must be observed about 10 days - from the moment of diagnosis before the disappearance of acute symptoms. If necessary, this period may be increased by the attending physician according to individual indications. The patient should avoid physical and emotional loads, as well as avoidPrecooling
. Statistically in people who do not comply with bed regime in the acute period of illness, various complications are observed several times more often (This is especially true of the orchita in men
Caring for the patient includes measures to prevent the dissemination of the disease. It is advisable to use masks or gauze bandages to prevent infection. To the patient during the contagious period, it is strictly forbidden to allow unvacked people.
Compliance with diet
The diet with a vapotitis is mainly observed in order to avoid the development of pancreatitis. To do this, it is necessary to observe a few simple principles in nutrition. They relate to the standard diet number 5 by Pevznera.Diet for the prevention of pancreatitis involves compliance with the following principles:
- Limited calorie diet ( no more than 2600 kcal );
- rapid power supply ( 4 - 5 times a day in small portions );
- Consumption 1.5 - 2 liters of fluid per day.
To fulfill these conditions, the emphasis is placed on easily digestible food. Thus, the body does not need a large number of pancreas enzymes, and the risk of its lesion is significantly reduced. The list of products that are allowed are limited or is prohibited by a diet number 5 is given in the table.
Consumption of various products within the diet number 5 by Pevznera
|Permitted products||Products whose consumption should be limited||Prohibited products|
| || || |
The same diet principles are observed in the development of pancreatitis. A more detailed diet can be made individually with the attending physician.
As noted above, medication treatment with epidemic vapotitis is symptomatic and is aimed at eliminating the manifestations of the disease. Typically, the timely beginning of such treatment prevents the development of complications and residual phenomena after the disease. Heavy forms, giving complications, even against the background of treatment, can only be observed in people who were not grafted in childhood. In people with a specific immunity against the vapotitis, the forecast in the overwhelming majority of cases is favorable. Important condition is the rapid diagnosis and the beginning of medication treatment. Parotitis can not be treated independently due to the high risk of complications. It is also impossible to use warming compresses on the salted areas - salivary glands or testicles - during the increase in edema. This will strengthen swelling and aggravate the course of the disease. Groups of medicines used in the treatment of pigs are shown in the table.
Groups of preparations used to treat epidemic vapotitis
|Group of drugs||Representatives||Mechanism of action||Guidelines for use|
|Non-steroidal anti-inflammatory means||Ibufen, ibuprofen, diclofenac, aspirin, pyroxics, ketoprofen.||Preparations of this series effectively knock down a high temperature and weaken inflammation.||These drugs make up the basis of treatment in the case of uncomplicated vapor. The appointment is made by the attending physician on the basis of the age of the patient and the intensity of the inflammatory process.|
|Corticosteroid drugs||Dexamethasone, methylprednisolone, prednisone.||These drugs have a much stronger anti-inflammatory effect. A side effect is the oppression of the immune system.||Used with severe complications for rapid inflammation ( With orchitis ). Dosage and recreation mode of corticosteroids are necessarily coordinated with the attending physician.|
|Desensitizing drugs||Suprastin, Tavagil, Erius.||These drugs are also struggling with an intense inflammatory process and reduce the reactivity of the immune system.||Assigned in parallel with other drugs throughout the entire sharp period.|
|Analgesics ( Anesthetics )||Analgia, Baratgin, Pentalgin.||Preparations of this group are struggling with severe pain syndrome, if there is a patient.||These drugs are applied far from all cases. The removal of pain syndrome is usually required with pancreatitis, orchitis and meningitis.|
|Pancreatic enzyme preparations.||Festal, Pankreatin, Mezim.||Contribute to improving digestion and normal food absorption. Are the analogues of natural pancreatic enzymes.||Applied only with the development of pancreatitis with pronounced symptoms from the head of the gastrointestinal tract ( gastrointestinal tract ): Vomiting, diarrhea.|
Other groups of drugs are used less often. They are prescribed on the basis of which authority or system are affected. The choice of drugs and their dosages should only carry out the attending physician after a careful examination of the patient. Many drugs used in the treatment of vapors have side effects and can aggravate the course of the disease with incorrect reception.
In addition to drug therapy, the irradiation of the salivary glands can be shown, puncture of the spinal cord or cold on the belly in the pancreatic projection. These measures contribute to the speedy recovery and improve the overall condition of the patient.
Consequences of parotitis
Despite the fact that with the invention and the introduction of a vaccine from epidemic vapotitis, deaths are extremely rare, this infection is still related to the category of hazardous diseases. It is mainly due to a number of complications and residual phenomena that may be observed after transferred pigs. They are quite rare, but in some cases they can entail irreversible consequences and even cause disability.
Epidemic parotitis with timely detection and proper treatment in most cases has a light course and does not lead to complications. However, with a decrease in the protective forces of the body or in the presence of concomitant diseases of the organs and systems that are targets for the pathogen of epidemic vapotitis, the complications described above may be the appearance of the complications described above. After some of them, there may be serious residual phenomena that will be made about themselves throughout life.The residual phenomena after the transferred parotitis include:
- dry eye syndrome;
- Sensitivity disorders.
Infertility as a residual phenomenon after the pig is found primarily in men. First of all, this applies to those who have not been instilled in childhood and does not have specific immunity. For such people in adulthood, the risk of the development of orchitis or epididimitis with an irreversible lesion of the genital glands is high. In women, infertility due to the ooforite on the background of the pig is observed very rarely. Due to the threat of a given residual phenomenon of all patients with parotitis with signs of lesions of eggs and ovaries, it is necessary to treat in the hospital under the watchful supervision of specialists.
Deafness can develop due to the lesion of the auditory nerve or inner ear (The consequence of transferred labyrinthitis
). Hearing loss in running cases is irreversible. However, such complications are extremely rare, and the standard diagram of treatment of infection typically prevents deafness even with obvious signs of damage to the organ of hearing.
Due to the massive inflammatory process at the pancreas level, there may be damaged islands of Langerhans. These are sections of cells in gland fabrics that produce hormone insulin. It is necessary to reduce the level of glucose in the blood and its deposit in cells as a stock of energy. If the vapotitis became complicated by sharp pancreatitis, the risk of irreversible violations in the formation of insulin appears. Cells that produce this hormone die, leading to its shortage. Such a mechanism for increasing blood sugar is characteristic of the diabetes of the first type. Despite the rarity of this residual phenomenon, doctors relate to its timely diagnosis with great attention. The overlooking the time or error in treatment can lead to the fact that the patient will suffer from a lack of insulin. In the event of growth in blood glucose level in patients with parotitis, the consultation of the endocrinologist must be consulted.
Sukho eye syndrome
The dry eye syndrome can be observed for some time after transferred dacryojaenitis. The inflammation of the tear glands is accompanied by a decrease in the allocation of their secretion and disruption of the eye. This leads to a rapid drying of the mucous membrane, constant drains in the eyes and discomfort. To solve this problem, it is necessary to refer to the ophthalmologist. As a rule, these violations are reversible and persist for several weeks (rare - months
) After the suffered infection.
Sensitivity disorders are the result of transferred serous meningitis or meningoencephalitis. With these complications of pigs, shells and head fabric are affected (Rightly spinal
) Brain. Directly during the course of the disease, there may be sluggishly current paralysis and paresis. The sensitivity in severe forms is restored long, which explains the residual phenomena after, it would seem complete recovery. As a rule, sensitivity is still restored after some time (Months, years
). Lifetime preservation of these residual phenomena is observed extremely rare.
Parotitis prophylaxis includes specific and non-specific measures. Their ultimate goal is to reduce the incidence of pork in general, as well as the prevention of severe forms of the disease.Non-specific vapor prevention includes the following measures:
- Isolation of illness from illness. Isolation is produced mainly at home, where the patient gets the necessary treatment. Hospitalization is prevented not in order to insulate the patient, but for more intensive treatment in the case of complications. Considering that the pig is common mainly among children, this measure includes exemption from school sessions or from a kindergarten visiting for a while, while the child is dangerous to others. Insulation is carried out in a sharp period. The patient is considered unsuccessful, starting from 9 days of the acute phase. Not vaccinated children in contact with patients are tolerated for a period of 11 to 21 days ( At the discretion of the doctor of the epidemiologist or infectiousnessist, liquidating the focus of infection ).
- Carrying the premises in which he was sick. Considering that infection occurs with air droplets, ventilation helps reduce its likelihood. At home, it is enough several times a day to air the room in which the patient is constantly located.
- Disinfection of objects with which in contact with the patient. If we are talking about the case of a disease with a fear of kindergarten, then it is necessary to disinfect toys and other items in the game room. Sufficient is considered to be a single treatment with medical alcohol, or chlorine-containing disinfectants. In microscopic drops of saliva on items, the amount of viral particles may be preserved, sufficient to infect. Disinfection will exclude such infection. At home, it is necessary to regularly disinfect the dishes from which it eats the patient, and other items on which saliva drops can be preserved.
- Wearing protective masks. Reliable protection from infection is wearing a patient with a special protective mask or a marlevary bandage ( Marla is folded several times ). Drops of saliva with a virus are delayed on the fabric and do not fall on the mucous membrane. Theoretically, the possibility of infection through the eye conjunctival remains, but such cases are extremely rare.
- Strengthening nonspecific immunity. Strengthening nonspecific immunity involves limited alcohol consumption, smoking refusal and regular outdoor walks. It is also necessary to avoid hypothermia. An important component in strengthening immunity is proper nutrition. It should include both plant and animal food with a sufficient amount of vitamins. Balanced nutrition, which is necessary to strengthen immunity, should not be confused with a special diet for patients who are already sick.
Specific treasure prevention involves large-scale children's vaccination. At the moment, it is carried out in many countries of the world at mandatory to prevent epidemics. The appearance and widespread use of a pig vaccine made it possible to reduce the incidence of more than 50 times.
Types of parotitis vaccines
There are several types of vaccines from epidemic vapotitis. They differ in methods of obtaining, methods of use and efficiency of immune defense. Each of the vaccines has several advantages and disadvantages.There are the following types of pig vaccines:
- Inactivated vaccine . Inactivated vaccines that contain some killed virus particles. Inactivation is made by ultraviolet or influence of chemicals. In this case, the effects of chemical disinfectants should be moderate, and irradiation - dosed. The virus must completely lose pathogenicity ( Ability to cause a disease ), but maintain your structure. The immune system in response to the entry of structural proteins will produce the necessary set of antibodies, which will provide patient protection. Vaccination inactivated viral particles is safe from the point of view of complications or adverse reactions. The disadvantage of this type of vaccine is relatively low immunogenicity. In other words, the likelihood of the formation of reliable immunity against the disease is lower than when using live vaccines.
- Live attenuated ( weakened ) vaccine . Live vaccine is called those drugs that contain lively weakened viral particles. The ordinary strain of the pigs of the pig is excreted in laboratory conditions on nutritional environments. With repeated places of culture, the pathogenicity of microorganisms is reduced. In other words, the virus in the laboratory is not allowed to grow fully and multiply. As a result, they receive a strain, which, hitting the human body, will no longer cause a serious illness. The patient, in principle, will converge with epidemic parotitis in asymptomatic form without the danger of the development of any complications. Since the introduction of a living vaccine preserves the integrity of viral particles, immunity acquired by the body is very reliable. A minus of living weak vaccines is a higher risk of allergic reactions and other side effects after vaccination.
- Combined vaccine . Combined are vaccines containing antigens of two or more different microorganisms. In particular, parotitis vaccine is often produced in one bottle with measles and rubella vaccine. With the introduction of such drugs into a healthy children's body, the immune system produces antibodies against each of these infections. In view of a large number of diseases from whom children in our days, the combination of several vaccines within one drug greatly facilitates the vaccination process. Most countries in vaccination from epidemic parotitis prefer precisely combined drugs.
The mechanism of action of the vaccine
Regardless of which type of vaccine was applied, the child's body recognizes antigens and produces against them the corresponding antibodies. With vapotitis, in particular, these antibodies will continue to circulate in the blood throughout life. For the reliability of immunity formation in many countries, revaccination is provided. This is the secondary introduction of the vaccine a few years after the first. It is required, as a rule, precisely when using combined drugs.
Dates of vaccination
There is no single universal standard for the administration of an anti-optical vaccine. Many countries using a combination vaccine measles - volatitis - rubella, vaccinate children twice - at 12 months and 6 or 7 years. However, in the National Vaccination Calendar for each country, time can be varied somewhat. The drug is introduced into the blade area or in the region of the deltoid muscle (Middle or top one third of the shoulder
) subcutaneously in a volume of 0.5 ml.
If the child was not vaccinated in childhood (In case of feeding parents from vaccination
), vaccination can be carried out in adulthood. This is done at the request of the patient himself or by epidemiological indications (directly at the epidemic of the pig
). Emergency immunoprophylaxis is carried out according to individual testimony, if a person has in contact with a person, obviously sick pork, and has undergone a high danger of infection. In such cases, urgent vaccination is possible no later than 72 hours after the first contact (preferably in the first day
). Then the body will have time to develop antibodies, and the disease will pass in a light form without complications.
In addition, there are a number of situations where vaccination deadlines can be changed under medical testimony, even if parents have not refused the procedure.Vaccination can be postponed for the following reasons:
- acute infectious diseases in the last 1 - 2 months before vaccination;
- aggravation of chronic diseases;
- Malnutrice ( Insufficient or unbalanced nutrition that led to the depletion of the child );
- reception of corticosteroid drugs in the last 1 - 2 months before vaccination;
- diseases of the hematopoietic system;
- Other pathological conditions accompanied by weakening immunity.
In the above cases, it is observed in one degree or another weakening of immunity. As a result, the body will not be able to adequately respond to the introduction of viral antigens and will not produce a sufficient number of antibodies. The result may be unreliable and short-term protection against infection in the future. In addition, with concomitant diseases, the risk of developing complications and side effects from the introduction of the vaccine is greatly increasing.
Side Effects and Complications after Vaccine
As noted above, for vaccination against epidemic vapotitis, they are mainly used, a lively weakened virus culture. As a result, there is a risk of developing side effects and complications. The side effects include local nonspecific reactions of the body for the introduction of the vaccine. Complications also imply the appearance of symptoms characteristic of the disease from which the vaccine was injected.In the case of an anti-optical vaccine, the following side effects and complications may occur:
- Redness and pain in the injection site. Most often, they are due to the inadequate reaction of the body on the vaccine. If a sufficient amount of antibodies in the blood ( After the first vaccination or after the suffering disease ), then they will actively deal with the virus when re-local administration.
- Allergic reactions. It is rare enough and can be caused not only by the strain of the virus, but also by other components of the drug. Allergic phenomena ( Itching, urticaria ) True usually yourself for several days. Extremely rarely occurs a severe systemic allergic reaction - anaphylactic shock. It requires resuscitation activities due to a sharp drop in blood pressure, circulatory disorders and a possible respiratory stop.
- Subfebrile temperature. The temperature in the range of 37 - 38 degrees can be maintained within 5 - 7 days after vaccination. With a longer fever or higher temperature, it is desirable to undergo a survey from a physician to exclude other reasons.
- Edema and redness of the mucous membrane of the throat. Phenomena resembling catarrhal angina may occur due to the abundance of lymphatic tissue in almonds. This fabric reacts with inflammation of the introduction of the vaccine. Symptoms can be maintained for 5 - 12 days, but almost never pass into heavy high temperature angina and the formation of plaque on almonds.
- Increase the varnish salivary glands. This symptom can be attributed no longer to side effects, but to vaccination complications. The virus contained in the preparation is most sensitive to the tissues of the salivary glands. Therefore, their increase suggests that the body has not coped even with a weakened strain of the virus. On the other hand, this strain will not lead to a long-term increase in temperature or complications from other organs. In most cases, swelling will disappear independently in a few days. The main reason is considered to weaken immunity, which has not allowed to overcome the virus. This suggests that there were any contraindications before vaccination that did not take into account or did not notice the doctor. The introduction of the drug was preferably transferred. If, after the introduction of the vaccine, the swelling of the parole glands appears, it is desirable to see a physician.
- Serous meningitis. Serous meningitis after the introduction of the vaccine is extremely rare. He suggests that the patient had contraindications to vaccination and immunity at the time of the meeting with the virus was greatly weakened. In rare cases, there is a violation of the rules of vaccination with medical personnel. The risk of developing severe complications increases with the introduction of excessive vaccine ( more than 0.5 ml ). In addition, a number of drugs contain a larger amount of viral particles even in a standard dose. With the appearance of meningeal symptoms, it is necessary to urgently apply for qualified medical care.
Given the large number of possible side effects and complications, many parents in recent years refuse vaccination. However, it should be understood that in unvaccinated people the likelihood of developing severe parotitis complications in the event of infection is significantly higher. In addition, from an epidemiological point of view, such children represent some danger to others, as they can infected the light shape of the pig and to distribute infection for some time. As a result, WHO (World Health Organization
) It strongly recommends a large-scale vaccination of the population. It should be noted that with attentive relations and the corresponding care, none of the side effects will bring serious harm to the health of the child.
Answers to frequently asked questions
Is it possible to re-get a vapotite?
As a rule, people who have suffered with epidemic parotitis in childhood, do not get ill. This is explained by the mechanism of an immune response to infection. However, cases of re-infection were described in the literature. It is believed that the probability of re-illness is no more than 2% (By some authors less than 0.5%
). This found the system of vaccination of children from a pig. For a deeper understanding of the issue, it is necessary to deal with more detail in the mechanism for the formation of specific immunity.
Specific is called immunity produced by the body against a certain type of microbes. It appears when contacting microbial antigens (Proteins typical of this microbe
) with special cells in tissues - macrophages. Macrophages not only absorb the alien organism, trying to neutralize it, but also launch a complex chain of cell reactions aimed at forming an immune response. As a result of this, special substances appear in the patient's blood - antibodies aimed at destroying a specific type of microbes. Specific immunity is formed in a few weeks or months after the first episode of the disease. The duration of protection depends on how long the patient's blood circulate antibodies. For different infectious diseases, this period is different.
With an epidemic vapotitis of the antibody continue to circulate in the blood almost all life. Therefore, with the secondary getting of the virus on the mucous membrane, it will be quickly identified and destroyed, and the disease does not develop. Artificially provoke the formation of antibodies against a pig with a vaccine. A grafted person has almost the same immunity as a person who has suffered a vapor.
However, this mechanism does not allow one hundred percent protection. This applies to both people who have fallen by vapotitis and graft children. The re-development of infection is explained by the fact that in the blood cease to circulate antibodies against the causative agent of infection. It makes the body vulnerable.The reasons for re-infection, the pork can be:
- Long straight contact with patients. As a result, a large number of microbes on the mucous membrane of the respiratory tract occurs, and in the blood can simply do not have enough antibodies to instantly neutralize all the viral particles. Then a person suffers a weak form of the disease.
- Non-quality vaccine. A poor-quality vaccine or an expired vaccine can cause unreliable immunity. Then the specific defense will last only a few years. A person will think that he will be grable. This can lead to severe forms of the disease in adulthood.
- Massive blood transfusions or bone marrow transplant. The blood circulating antibodies can be removed from the body as a result of massive blood transfusion. The transplant of the same bone marrow affects the hematopoietic system as a whole. Similarly, a person may lose specific immunity in severe blood-forming diseases.
- Vaccination in the presence of contraindications. Vaccination is not recommended to be carried out in the presence of any infections in the acute phase in the body. For example, at elevated temperatures on the day of vaccination, the procedure can be postponed before recovery. The fact is that diseases in the acute phase affect the reactivity of the immune system. As a result of this influence, the immune response will be insufficient, and the defense in the future is unreliable.
Nevertheless, cases of re-infection, the lead is extremely rare. Typically, this disease belongs to the category of infections that are sick only once in life
What is the duration of the pairotitis, the time of recovery?
The total duration of the pairotite flow consists of several phases. They are typical practically for all infectious diseases, but in each case there are a certain duration. In addition, there are a number of factors that affect the rate of disease and the deadlines of the final recovery.During the guise, the following stages distinguish:
- Incubation period . This stage begins with the breakage of the virus on the mucous membranes of the respiratory tract. The virus gradually multiplies and propagates with blood flow through the body. The end of the incubation period is the appearance of first expressed symptoms. The duration of this stage is from 11 to 23 days ( more often about 2 weeks ). Often the incubation period patients are not included in the duration of the disease, because they themselves do not feel sick.
- Promotional period . Promotional period is a period of nonspecific symptoms. A person begins to feel sick, but rarely immediately appeals to the doctor. He is worried about head and muscle pain, general weakness, drowsiness, reduced performance. These symptoms are explained by the circulation in the blood of toxins. With a pig, the duration of the long period is small - from 24 to 36 hours. In children, he is often absent at all.
- Period of specific manifestations . At this stage, typical pairotite symptoms appear. It begins with a rapid temperature increase, with the classical course of the disease up to 39 - 40 degrees. Characteristic symptoms are redness of the mouth mucosa in the field of ducts of salivary glands, swelling of the self-salted glands. If the disease proceeds without complications, the duration of this stage is from 7 to 9 days in children and from 10 to 16 days in adults.
- Period of Ugasania . The period of fading is characterized by the gradual disappearance of symptoms and normal body temperature. Clinically it is difficult to distinguish it with a period of specific manifestations. In children, these stages of the disease are often united. In adults, the period of extinction is characteristic mainly for the complicated flow rate. Its duration depends on what complication was observed in a particular patient.
- Period of recovery. During the recovery period, the patient no longer suffers from the disease itself, but may experience some difficulties due to residual phenomena. The period of recovery by the normalization of all analyzes and life indicators ( Blood test, analysis of spinal fluid during serous meningitis ). Patients do not refer this period to the total duration of the disease, since there are no sharp symptoms.
Thus, the total duration of the course of an uncomplicated epidemic vapor can vary from 2 to 3 weeks from the patient's point of view. During this period, he was disturbed by sharp symptoms, and it will have to pass intensive treatment. From the point of view of the doctor during the disease, it is also necessary to include the incubation period and the period of recovery. Thus, the duration will be from 1 to 4 months.
Recovery can delay when there are no complications of the pig. Complications with this disease consider any manifestations of the disease in addition to the lesion of the salivary glands. Treatment of such forms usually takes more time and is carried out in stationary conditions.Possible complications for pork are:
- Orchit ( inflammation of the testicles in men );
- Ouoforit ( Inflammation of ovarian in women );
- Pancreatitis ( Inflammation of the pancreas );
- serous meningitis or meningoencephalitis ( Defeat of brain shells );
- DacryoDenit ( Inflammation of the tear glasses );
- thyroiditis ( Inflammation of the thyroid gland );
- Arthritis ( Inflammation of the joints );
- Labyrinthitis ( Inflammation of the inner ear );
- Mastitis ( inflammation of the breast, more often found in women, but perhaps in men );
- prostatitis inflammation of the prostate gland in men ).
These complications usually appear in the midst of the disease, at the stage of specific manifestations. Because of them, the temperature can again rise and begin a new round of the disease. This will extend the period of recovery on average for 1 to 2 weeks. In addition, after some complications, residual phenomena are possible, which will remain a lifetime. Such cases are extremely rare, mainly in non-adult adults in the absence of qualified treatment. Lifetime residual phenomena are infertility (more often in men after transferred orchita
), diabetes mellitus of the first type (After transferred pancreatitis
) and deafness (After transferred labyrinthitis
What do patients look like a vapor?
Pig or epidemic vapotitis have a number of distinctive symptoms that can be seen by ordinary people without visiting the doctor. Knowing these manifestations of the disease can help parents earlier to suspect steam and consult a doctor for a more detailed examination.
At the initial stages of the disease (in the long period
) Patients with epidemic vapotitis resemble ordinary people with colds. Gradually blushes the mucous membrane of the throat, there may be minor discharge from the nose. This marks general weakness, moderate headaches, nausea, sweating. In general, to suspect the disease and not enter close contact with such people possible. It is important that it is at this stage that patients already identify a significant amount of viral particles and pose a threat to infection.
The appearance of specific symptoms helps to suspect the epidemic parotitis directly. If parents notice in children such changes accompanied by an increase in temperature and other common symptoms, it is necessary to urgently access the doctor to form an accurate diagnosis. Up to this point, the child is preferably isolate at home.
Distinctive features of patient with epidemic parotitis
|Characteristic symptom||Danger of infection||View of the patient|
|Swelling in the field of salivary glands||Swipping in the field of the salivary glands appears in the first days of the acute flow of the disease. The patient in this period is particularly infectious and must be isolated. Contact with the patient is allowed only for 8 to 9 days after the appearance of this symptom.|
|Redness of the mouth mucosa||Redness of the mucous membrane of the mouth and throat is observed most often in a sharp period of the disease, so the patient with a high degree of probability is contagious and represents the danger to others. A distinctive feature from Angina is that the redness is applied to the mucous membrane of the oral cavity ( The inner surface of the cheek ). Especially pronounced red stains are formed at the place of exit to the oral cavity of the ducts of the salivary glands ( Symptom Mursu ).|
|Equipment of eggs||An increase in eggs or both eggs is usually found when orchitis. Elek can reach significant sizes, causing blunt pain and interfere with man moving ( When walking the pain intensify ). During this period, the patient, as a rule, no longer represents the danger of infection.|
With timely, the early treatment of epidemic vapotitis takes place quite quickly, without leaving serious consequences.