In winter and spring, the climate is cold and dry, and the temperature difference between indoor and outdoor is large, so the elderly are prone to acute respiratory infections, mainly upper respiratory tract infections, acute tracheobronchitis, pneumonia and so on. Common cold and influenza are often called upper respiratory tract infections, while acute tracheobronchitis and pneumonia are lower respiratory tract infections. Each of these diseases has its own characteristics and treatment methods are different.
I. Acute upper respiratory tract infections
Acute upper respiratory tract infections are caused by viruses in 70% to 80% of cases, and bacteria in a few cases. Generally, after cold, rain, excessive fatigue, due to the decline in resistance, the original virus or bacteria already present in the upper respiratory tract or infected from outside can rapidly multiply, causing the onset of disease, especially the elderly are more susceptible.
In fact, acute upper respiratory tract infection is a general term that includes acute infections of the nasal cavity, pharynx or larynx. The symptoms of acute upper respiratory tract infection vary from one individual to another, for example, some people only have nasal congestion and runny nose, while others only have cough. Therefore, according to the different clinical symptoms, acute upper respiratory tract infections are divided into: common cold, acute pharyngitis, acute tonsillitis, etc.
1, the common cold is commonly known as “cold”. Mainly caused by rhinovirus, coronavirus and parainfluenza virus.
The characteristics of the cold are: the nose and throat are dry, hot and itchy at the beginning, followed by nasal congestion, runny nose, sometimes itchy eyes and watery eyes. The cough is usually mild and sometimes there are systemic symptoms such as chills, backache, fatigue, headache and loss of appetite. The body temperature is usually not high and may be low. If secondary bacterial infection is combined, the body temperature may be higher. After 2-3 days of illness, the amount of nasal discharge gradually decreases and becomes thicker, and the cough is reduced and finally disappears.
2. Acute pharyngitis and acute laryngitis: like colds, they are also caused by rhinovirus, coronavirus and parainfluenza virus, etc. The clinical features are sore throat, hoarseness, cough, and often fever.
The symptoms of common cold and acute pharyngitis and acute laryngitis often occur simultaneously, so they are generally referred to as acute upper respiratory tract infections in general.
The main treatment for acute upper respiratory tract infection is symptomatic, such as: antipyretic, analgesic and cough relief. The main measures are as follows: patients should rest in bed, drink more water and eat a liquid or semi-liquid diet; taking steam baths or washing feet with hot water can promote early recovery from cold; nasal congestion and runny nose can be treated with drugs such as paracetamol or Contec; using cough mixture, compound licorice combination or other cough suppressants; various kinds of proprietary Chinese medicine containing tablets for sore throat, etc. Since acute upper respiratory tract infections are mainly caused by viruses, antimicrobial treatment is ineffective. For those who do not have secondary bacterial infection, antibacterial drugs are generally not used. If appropriate, Chinese herbal medicines such as antelope cold tablets, cold punch and silver fork antidote tablets can be used for treatment.
Influenza
Influenza is caused by influenza virus, which is highly contagious and prone to epidemic outbreaks, often affecting many people in a region at the same time. In most cases, the onset of influenza is very sudden, starting with symptoms such as chills and chills, followed by fever, body temperature rising above 39℃, headache, body aches, fatigue, sometimes nausea, diarrhea and other symptoms are obvious, but cough, cough, runny nose and other nasopharyngeal symptoms are relatively mild. Generally, high fever lasts for 3-5 days before the body temperature gradually returns to normal, and its symptoms are more severe than those of acute upper respiratory tract infection. Influenza is a respiratory infection that seriously endangers the health, especially for the elderly, and can easily cause complications in the heart, lungs and other vital organs.
For patients with influenza, they should rest in bed, give easily digestible and absorbable food, drink more water, and take oseltamivir (trade name: Tamiflu), which is a specific anti-influenza drug, within 3 days of the onset of influenza. You can also take compound aspirin (i.e., APPC), silver warp antidote tablets and other drugs. If there is high fever and dehydration, glucose saline infusion can be given; if there is pneumonia, heart failure or coma and convulsions, corresponding treatment should be given. Pay attention to prevent comorbidities in case of influenza.
Whether it is a cold or flu, the most important thing is prevention. The most important thing is to prevent cold and warmth, strengthen physical exercise, enhance body resistance, not to go to densely populated public places during the winter and spring epidemic seasons, and to receive influenza vaccination in advance if possible.
3. Acute tracheobronchitis and bronchitis
Acute tracheobronchitis is an acute inflammation of the tracheobronchial mucosa caused by a variety of factors, such as chemical and physical irritation. In fact, we usually most often see acute tracheobronchitis due to the downward spread of viral acute upper respiratory infection, and here we also focus on this group of patients. Acute tracheobronchitis in this group of patients can be solely viral, or in some cases, it can be secondary to bacterial infection due to reduced immunity of the tracheal and bronchial mucosa caused by viral infection, or in some cases, mycoplasma or chlamydia, and in some cases, 2 or more pathogenic microbial infections at the same time.
Patients often have symptoms of acute upper respiratory tract infection first, and may have fever, around 38°C, which mostly decreases to normal in 3-5 days. However, the cough and sputum still do not disappear. The cough may be dry or with a small amount of mucus sputum, and then may turn mucopurulent or purulent, with increased sputum volume and increased cough, occasionally with blood in the sputum, and the cough may last for 2 to 3 weeks before disappearing. Shortness of breath with varying degrees of chest tightness may occur.
Acute tracheobronchitis should be treated with antibiotics, usually azithromycin, levofloxacin, moxifloxacin, etc. Oral treatment should be preferred for milder symptoms, and intravenous administration is available for severe symptoms. A course of antibiotics for about a week is sufficient, usually not more than two weeks. When the body temperature is normal and the sputum turns from purulent to white or disappears, it means that the bacteria have been cleared, that is, the antibiotics should be stopped. In some patients, even if there is still a dry cough or only a small amount of white sputum, antibiotics should not be continued, but symptomatic treatment with cough suppressants should be used.
Other symptomatic treatments are similar to those for acute upper respiratory tract infections.
Fourth, the elderly should pay attention to acute upper respiratory tract infection and acute tracheobronchitis
Acute upper respiratory tract infection is a common disease, multi-morbidity, common cold symptoms and light, so it is easy to be ignored. When upper respiratory tract infection occurs in the elderly, it is easy to develop complications such as bronchitis, pneumonia, acute nephritis, myocarditis or rheumatic fever. For those who have chronic bronchitis, emphysema, coronary heart disease, diabetes and other underlying diseases, it is more important to seek medical advice early, take reasonable medication, pay attention to rest and prevent complications.
Patients with chronic bronchitis and emphysema, especially those with poor lung function, should apply antibiotics as soon as purulent sputum appears, and should not delay treatment, because one or two days of delayed treatment may lose the best opportunity for treatment, leading to rapid progress of the disease, a large increase in treatment costs or a threat to life. Patients with original asthma should seek timely medical attention to reasonably increase asthma treatment medication under the guidance of a physician if wheezing is aggravated by an acute upper respiratory tract infection.
V. Prevention of acute upper respiratory tract infection and acute tracheobronchitis in the elderly
The occurrence of acute respiratory tract infection depends not only on the pathogenic power of virus or bacteria, but also closely related to the immune defense ability of individuals. Physical exercise, nutritional status, hygiene habits and attitude to life have an impact on the body’s ability to prevent and fight diseases. In summary, the following points should be noted.
1, the elderly winter to pay attention to keep warm, usually keep the indoor air circulation, more outdoor air in a fresh place to carry out suitable exercise to enhance physical fitness.
2, to avoid excessive fatigue, pay attention to rest, to maintain sufficient sleep.
3, pay attention to nutrition, protein, calories to be adequate, fruits and vegetables to be very important, the seasonal climate is dry, the air dust content is high, the human nasal mucosa is easily damaged, pay attention to drink more water.
4, the elderly and frail people or people with chronic respiratory diseases try not to go to public places where there are many people and noisy air circulation.
5, for people over 65 years old, with chronic diseases and recurrent respiratory infections, an annual vaccination against influenza can effectively prevent and reduce the occurrence of influenza.
6, Finally, for those elderly who smoke, the most important thing is: quit smoking. Smoking can seriously damage the immune defense function of the respiratory tract, destroy lung function, and cause coronary heart disease, cerebral atherosclerosis, thrombosis and many other diseases.