Bird flu symptoms, timely rescue

Avian influenza is a disease that makes people shudder, especially as spring approaches, when the peak season for bird flu has arrived. This year's H7N9 outbreak is caused by poultry - chickens that carry the virus, and there have been confirmed cases. So how do you determine if you have avian influenza and save lives in time? Here are some bases for this.

According to the investigation results of existing human infection cases of H7N9 and H5N1 avian influenza, the incubation period is generally within 7 days.

In the early stages of the disease, patients experience flu-like symptoms, including fever and cough, which may be accompanied by headache, muscle aches, and general discomfort. They may also experience runny nose, nasal congestion, sore throat, etc. Some patients experience symptoms such as chest tightness and difficulty breathing when their lung lesions are severe or their condition progresses rapidly. Respiratory symptoms appear early, usually within one week after onset, and last for a long time. Some patients still have severe cough and sputum one month after treatment. In the early stages of the disease, there are chest tightness, shortness of breath and difficulty breathing, which often indicates that the lung lesions are progressing rapidly and will quickly develop into severe hypoxia and respiratory failure. The condition of critically ill patients progresses rapidly, and severe pneumonia usually occurs within 5 to 7 days. The body temperature mostly remains above 39°C, and breathing is difficult, which may be accompanied by hemoptysis. It can quickly progress to acute respiratory distress syndrome, sepsis, and septic shock. Some patients may develop mediastinal emphysema, pleural effusion, etc. A considerable proportion of critically ill patients also have damage or failure of multiple other systems or organs, such as myocardial damage leading to heart failure. Some patients also show digestive system symptoms such as gastrointestinal bleeding and emergency ulcers. Some critically ill patients also develop coma and impaired consciousness.

The white blood cell levels of most patients infected with avian influenza are lower than normal, among which the lymphocyte levels are not high or even decreased. If the platelet level is low, it is necessary to consider whether disseminated intravascular coagulation is caused by severe infection, and a comprehensive identification should be made based on the results of coagulation analysis, fibrinogen level, etc. Blood biochemical examination often shows elevated creatine kinase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, elevated C-reactive protein, and myoglobin.

Imaging examinations revealed flake-like shadows in the lungs of patients with pneumonia. The lesions in critically ill patients progress rapidly, showing multiple ground-glass shadows and pulmonary consolidation images in both lungs, which may be accompanied by a small amount of pleural effusion. When ARDS occurs, the lesions are widespread.

The most reliable method is still pathogen detection. Before antiviral treatment, medical institutions with the necessary conditions should collect respiratory specimens (such as nasopharyngeal secretions, oral rinses, tracheal aspirates, or respiratory epithelial cells) for viral nucleic acid testing (real-time fluorescence PCR testing) and virus isolation.

In addition to avian influenza virus infection, human patients infected with avian influenza often have concurrent or secondary bacterial infections in the early stages. After using antibiotics for a long time or in large doses and inappropriate use of glucocorticoids, they may also have concurrent fungal infections. Therefore, sputum culture and respiratory aspirate culture should be performed multiple times clinically to check the type of bacteria and/or fungi, and their sensitivity or resistance type, so as to rationally select antibiotics and guide clinical treatment.