OverviewThe term "atypical pneumonia" has appeared before the development of the last pandemic and has been used to describe lung disease caused by pathogens are not ordinary pneumonia (Streptococcus and Haemophilus influenzae /S.pneumoniae, H.influenzae/), and atypical pathogens such as Legionella, Mycoplasma, Chlamydia, viruses. All of these microorganisms are intracellular agents, they are not detected when looking at the smear and standard bacteriological sputum or blood. For the diagnosis requires a more sophisticated and expensive methods. The pandemic of atypical pneumonia, frightened by the whole world in 2002-2003, was caused by a viral agent. More accurately reflect the peculiarity of the disease throughout the world adopted the designation "severe acute respiratory syndrome" (SARS) and its English synonym for "Severe Acute Respiratory Syndrome" (SARS). The disease was first noted in November 2002 in Guangdong Province of China (PRC), followed by registration of the disease in Vietnam, Hong Kong, Canada, the United States and 30 other countries around the world. Measures to prevent spread of the epidemic were not immediately accepted, as the PRC government initially concealed the emergence of this disease in the country.
Diagnosis of SARS based on the application of new molecular (PCR) and serological (ELISA, immunofluorescence) methods. The severity of symptoms, high mortality, the possibility of infection of hospital staff caused a very strong concern of the international community, and March 12, 2003, WHO issued a global alert about the need to stop the spread of the disease. It was recommended not to travel to southern China.
During an epidemic in 30 countries officially reported 8422 cases and more than 900 deaths from SARS. Complexity of the search treatment of SARS lies in the fact that, like any virus, the causative agent of SARS has the ability to mutate. Treatment of SARS is carried out in specialized intensive care units, use of antiviral agents, antibiotics, recent generations, glucocorticosteroid preparations. Often require transfer of the patient on mechanical ventilation.
Through the use of restrictive measures and the creation of protective regime of the international community have achieved the first victory over epidemiey TORS (SARS). Nevertheless, it remains unclear number of questions concerning the epidemiology and pathogenesis of SARS. The main condition of victory over SARS epidemic - is the creation of an effective vaccine, the development of highly specific and sensitive diagnostic tests and interrupt the chain of transmission.
The reasonsCausative agent of SARS is a mutant from the second group of coronaviruses. The virus is found in many organs and secretions of people who died from SARS, lung, kidney, bronchoalveolar lavage, sputum, swabs from the upper respiratory tract infections. ARI due to other coronavirus, usually manifested as acute rhinitis, sore throat and diarrhea. Most often there is an outbreak in September, November.
Source of agent - SARS patient. The existence of the animal as a source of infection for humans is not proven, but this theory is the main origin of the epidemic. It is still not clarified the issue of possible carriers of the people who have recovered from the disease. The mechanism of transfer - aerosol (airborne dust and air).
SymptomsFeature of atypical pneumonia is the predominant symptoms of intoxication, which sidelined pulmonary manifestations, lack of infiltrative changes on chest radiography in the early days of the disease (interstitial type). The course of pneumonia is unpredictable: they may occur as malosimptomno and hard, with the development of life-threatening complications. The difficulties of diagnosis and cause a variety of clinics are often ill-timed admission to a hospital patient, a late diagnosis and difficulties in the selection of therapy.
ComplicationsSARS is characterized by high fever, upper respiratory tract lesions, the development of bilateral pneumonia, severe respiratory failure and relatively high mortality. The new coronavirus infection in the human body leads to a marked immunosuppressive effect has the effect of the frequent addition of fungal and bacterial flora.
What can your doctor?Normally used to treat pneumonia antibiotics are inactive against "atypical" pathogens. Drugs of choice for the treatment of atypical pneumonia are macrolides, which are most active against legionella, mycoplasma, chlamydia, are also used by some of the quinolones, tetracyclines. Against most pathogens of pneumonia virus to date there are no drugs. Use a combination of corticosteroids and antiviral drugs such as ribavirin.
ProphylaxisWHO has developed the basic principles of infection prevention:
- Prohibition to visit the region, unfavorable in relation to this infection;
- Strict control of anti-people returning from regions unfavorable for the infection (detection of persons with fever, symptoms of respiratory tract infections and gastrointestinal tract, the processing of vehicles by means of disinfection);
- The use of individual single-use masks in case of need contact with people, suspicious for infection.