Influenza: sintomi, complicazioni e trattamento
Table of Contents
Definizione
L’influenza è una malattia virale, contagiosa ed epidemica, caratterizzata da febbre, infiammazioni delle vie respiratorie superiori e complicazioni broncopolmonari più o meno gravi secondo l’epidemia e i soggetti. L’influenza è la settima causa di morte negli Stati Uniti e la terza causa di morte per malattie infettive in Italia (dopo AIDS, tubercolosi).
Eziologia
I virus influenzali appartengono alla famiglia degliOrthomyxovirus. Il loro corredo genetico è costituito da RNA.
Si distinguono due tipi di virus influenzali:
- Il virus dell’influenza A: è responsabile di regolari epidemie e l’unico che ha causato pandemia. I virus dell’influenza infettano anche gli animali domestici (maiali, cavalli, polli, anatre) e alcuni animali selvatici.
- Virus dell’influenza B e C: diversamente da quanto si riteneva, possono infettare oltre all’uomo anche alcuni animali (maiali e foche).
I virus dell’influenza A e B sono più diffusi del tipo C che è causa di infezioni respiratorie solo nei bambini di età <6 anni, e sono responsabili di una malattia più severa.
Trasmissione del virus influenzale
La trasmissione interumana del virus dell’influenza si può verificare per via aerea attraverso legocce di saliva di chi tossisce o starnutisce, ma anche per via indiretta attraverso il contatto con le mani contaminate dalle secrezioni respiratorie. La contaminazione delle mani può venire anche per contatto con superfici contaminate. Per questo, una buona igiene delle mani e delle secrezioni respiratorie può giocare un ruolo nel limitare la diffusione dell’influenza.
E’ buona norma quindi:
- Lavaggio delle mani(almeno 30-40 secondi) conacqua e sapone,in assenza di acqua lavarsi le mani congel alcolici.
- Buona igiene respiratoria(coprire naso e bocca quando si starnutisce o tossisce e buttare subito il fazzoletto monouso, in mancanza di fazzoletto starnutire nella piega del gomito).
- Non toccare occhi, naso e bocca con le mani.
- Isolamento volontarioa casa di persone con malattie respiratorie , febbrili specie in fase iniziale.
- Uso di mascherine chirurgicheda parte delle persone con sintomatologia influenzale quando si trovano in ambienti sanitari o luoghi affollati.
Quadro clinico
Il periodo di incubazione è in genere di 2-3 giorni.
I sintomi classici dell’influenza sono:
- Febbre, di solito a insorgenza improvvisa
- Mialgie
- Mal di gola
- Tosse secca
Possono comparire anche:
- Rinorrea
- Cefalea
- Nausea
- Diarrea.
I sintomi regrediscono in genere dopo 2-3 giorni dall’esordio.
Anche se la malattia ha di solito un andamento clinico non grave e guarisce spontaneamente in pochi giorni, quadri clinici più severi si possono osservare in età pediatrica e senile, in presenza di morbilità e in soggetti immunocompressi. In alcuni casi si può presentare come unapolmonite comunitaria,con:
- Febbre
- Tosse secca
- Infiltrati polmonari bilaterali
- Ipossiemia
- Leucopenia.
La polmonite virale è spesso difficile da distinguere dalle polmoniti batteriche, che possono anche essere concomitanti: non esistono criteri clinici che consentano una diagnosi differenziale certa.
Complicanze dell’influenza
La complicanza più frequente è la polmonite batterica secondaria. I germi più spesso responsabili sono:Staphylococcus aureus,Streptococcus pneumoniae, Haemophilus influenzaee, altri batteri Gram-. Frequenti riacutizzazioni di malattie croniche polmonari.
Altre complicanze rare ma descritte sono:
- Miocardite virale
- Encefalite
- Sindrome di Reye
E’ descritta nei bambini trattati con aspirina e in occasioni di malattia influenzale, si manifesta con vomito e confusione mentale e di stato di coma. E’ stato descritto qualche raro caso anche nell’adulto per cui l’aspirina non deve essere mai usata in caso di sindrome influenzale. raramente l’influenza è causa diretta di morte. Più importanti, come causa di morte, sono le complicanze batteriche polmonari; (polmonite, riacutizzazione di bronchite cronica ostruttiva) e, malattia ischemica cardiaca.
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