Toxic flu: symptoms and treatment. Laryngitis, pharyngitis, runny nose, sinusitis

Influenza is a severe acute infectious disease, which is characterized by severe toxicosis, catarrhal symptoms and damage to the bronchi. Influenza, the symptoms of which affect people regardless of their age and gender, manifests itself annually as an epidemic, more often in the cold season, affecting approximately 15% of the world's population.

History of influenza

Flu has been known to mankind for a long time. Its first epidemic was in 1580. In those days, people knew nothing about the nature of this disease. Pandemic of respiratory disease in 1918-1920. received the name “Spanish flu”, but it was just an epidemic severe flu. At the same time, an incredible mortality rate was noted - pneumonia and pulmonary edema occurred at lightning speed even in young people.

The viral nature of influenza was established only in 1933 in England by Andrews, Smith and Laidlaw, who isolated a specific virus that affected the respiratory tract of hamsters, which were infected with swabs from the nasopharynx of patients with influenza. The causative agent was named influenza A virus. Then, in 1940, Magill and Francis isolated the type B virus, and in 1947, Taylor discovered another variant, the influenza virus type C.

The influenza virus is one of the RNA-containing orthomyxoviruses; its particle sizes are 80-120 nm. It is poorly resistant to chemicals and physical factors, is destroyed in a few hours at room temperature, and at low temperatures (from -25°C to -70°C) it can be preserved for several years. It is killed by drying, heating, exposure to small amounts of ultraviolet radiation, chlorine, and ozone.

How does infection occur?

Source influenza infection- an exceptionally sick person with erased or obvious forms of the disease. The route of transmission is airborne. The patient is most contagious in the first days of the disease, when the virus begins to be released in droplets of mucus during sneezing and coughing. external environment. In an uncomplicated course of the disease, the release of the virus stops approximately 5-6 days from its onset. In the case of pneumonia, which can complicate the course of influenza, the virus can be detected in the body within two to three weeks from the onset of the disease.

The incidence of illness increases and outbreaks of influenza occur during the cold season. Every 2-3 years, an epidemic is possible, which is caused by the influenza virus type A; it has an explosive nature (20-50% of the population can get sick in 1-1.5 months). The type B influenza epidemic is characterized by a slower spread, lasting approximately 2-3 months and affecting up to 25% of the population.

There are such forms of the disease:

• Lightweight - body temperature rises by no more than 38°C, symptoms of intoxication are mild or absent.
• Moderate - body temperature is within 38.5-39.5°C, classic symptoms of the disease are noted: intoxication ( headache, photophobia, muscle and joint pain, profuse sweating), typical changes in the posterior wall of the pharynx, redness of the conjunctiva, nasal congestion, damage to the trachea and larynx (dry cough, chest pain, hoarse voice).
• Severe form - severe intoxication, body temperature 39-40°C, nosebleeds, signs of encephalopathy (hallucinations, convulsions), vomiting.
• Hypertoxic - body temperature is above 40°C, symptoms of intoxication are most pronounced, resulting in toxicosis nervous system, cerebral edema and infectious-toxic shock varying degrees expressiveness. Respiratory failure may develop.
• Lightning form influenza is dangerous due to the possibility of death, especially for weakened patients, as well as patients with existing associated pathologies. With this form, swelling of the brain and lungs, bleeding and other serious complications develop.

Flu symptoms

The duration of incubation is approximately 1-2 days (possibly from several hours to 5 days). This is followed by a period of acute clinical manifestations diseases. The severity of an uncomplicated disease is determined by the duration and severity of intoxication.

Intoxication syndrome with influenza is the leading one; it is expressed already from the first hours after the onset of the disease. In all cases, the flu has an acute onset. Its first sign is an increase in body temperature - from slight or subfebrile to reaching maximum levels. Within a few hours the temperature becomes very high, accompanied by chills.

At mild form disease, the temperature in most cases is subfebrile. For the flu temperature reaction characterized by relative short duration and severity. The duration of the febrile period is approximately 2-6 days, sometimes longer, and then the temperature begins to decrease rapidly. Subject to availability elevated temperature Over a long period of time, complications can be expected to develop.

The leading sign of intoxication and one of the first symptoms of influenza is headache. Its localization is the frontal region, especially in the supraorbital region, around brow ridges, sometimes for eye orbits, it can intensify with movement eyeballs. Headache in older people is more common. The severity of headaches varies greatly. At severe course Influenza headache can be combined with repeated vomiting, sleep disturbances, hallucinations, and symptoms of damage to the nervous system. Children may experience seizures.

Most frequent symptoms flu are weakness, feeling of malaise, general weakness, increased sweating. Increased sensitivity to sharp sounds, bright light, and cold. The patient is most often conscious, but may become delirious.

A common symptom of the disease is joint and muscle pain, as well as aches throughout the body. Characteristic appearance patient: puffy, reddened face. It often occurs, accompanied by lacrimation and photophobia. As a result of hypoxia and disruption capillary circulation The patient's face may take on a bluish tint.

Catarrhal syndrome during influenza infection is most often weakly expressed or absent altogether. Its duration is 7-10 days. The cough can persist for the longest time.

Already at the beginning of the disease, you can see changes in the oropharynx: significant redness soft palate. After 3-4 days from the onset of the disease, a vascular infection develops at the site of redness. In severe cases of influenza, formations form on the soft palate. minor hemorrhages In addition, you can detect its swelling and cyanosis. Rear wall pharynx reddened, shiny, often grainy. Patients are concerned about dryness and sore throat. 7-8 days after the onset of the disease, the mucous membrane of the soft palate takes on its normal appearance.

Changes in the nasopharynx are manifested by swelling, redness and dryness of the mucous membrane. Breathing through the nose is difficult due to swelling of the nasal turbinates. After 2-3 days, the above symptoms are replaced by nasal congestion, less often by nasal discharge, which occurs in approximately 80% of patients. As a result toxic damage vascular walls, as well as intense sneezing, nosebleeds are often possible with this disease.

In the lungs with influenza most often hard breathing, short-term dry wheezing is possible. Tracheobronchitis is typical for influenza. It manifests itself as pain or rawness behind the sternum, and a dry, painful cough. (hoarseness, sore throat) can be combined with.

In children with influenza laryngotracheitis, croup is possible - a condition in which a viral disease is accompanied by the development of swelling of the larynx and trachea, which is complemented by difficulty breathing, rapid breathing (i.e. shortness of breath), and a “barking” cough. Cough occurs in approximately 90% of patients and with uncomplicated influenza it lasts about 5-6 days. Breathing may become faster, but its character does not change.

Cardiovascular changes in influenza occur as a result of toxic damage to the heart muscle. When auscultating the heart, you can hear muffled tones, sometimes a rhythm disturbance or a systolic murmur at the apex of the heart. At the onset of the disease, the pulse is frequent (as a result of increased body temperature), while skin pale. After 2-3 days from the onset of the disease, along with weakness in the body and lethargy, the pulse becomes rare, and the patient’s skin turns red.

Changes from digestive organs not significantly expressed. Appetite may decrease and worsen intestinal peristalsis, constipation occurs. On the tongue - thick white coating. The stomach is not painful.

Due to damage renal tissue viruses cause changes in the organs of the urinary system. Protein and red blood cells may appear in a urine test, but this only happens with complicated flu.

Toxic reactions from the nervous system most often manifest themselves in the form of a sharp headache, which intensifies under the influence of various external irritating factors. Drowsiness or, conversely, excessive agitation is possible. Delusional states, loss of consciousness, convulsions, and vomiting are often observed. Meningeal symptoms can be detected in 3% of patients.

IN peripheral blood the quantity also increases.

If the flu has an uncomplicated course, the fever can last 2-4 days, and the disease ends in 5-10 days. After the illness for 2-3 weeks it is possible post-infectious asthenia, which manifests itself general weakness, sleep disturbance, increased fatigue, irritability, headache and other symptoms.

Flu treatment

IN acute period The disease requires bed rest. Mild to moderate flu can be treated at home, if severe forms ah patients need hospitalization. Recommended drinking plenty of fluids(compotes, fruit drinks, juices, weak tea).

An important part of the treatment of influenza is the use antiviral agents- arbidol, anaferon, rimantadine, groprinosine, viferon and others. They can be purchased at a pharmacy without a doctor's prescription.

Comprehensive products help eliminate unpleasant symptoms ARVI, maintain performance, but often contain phenylephrine, a substance that increases blood pressure, which gives a feeling of cheerfulness, but can cause side effects from the outside cardiovascular system. Therefore, in some cases, it is better to choose a drug without components of this kind, for example, AntiGrippin from NaturProduct, which helps relieve the unpleasant symptoms of ARVI without causing an increase in blood pressure. There are contraindications. It is necessary to consult a specialist

To combat fever, antipyretic drugs are indicated, of which there are a lot today, but it is preferable to take paracetamol or ibuprofen, as well as any medicines, which are made on their basis. Antipyretic drugs are indicated if body temperature exceeds 38° C.

Used to combat runny nose various drops- vasoconstrictors (nazol, farmazolin, rhinazolin, vibrocil, etc.) or saline (no-sol, quix, salin).

Remember that flu symptoms are not as harmless as they seem at first glance. Therefore, with this disease, it is important not to self-medicate, but to consult a doctor and follow all his instructions. Then with high probability the disease will pass without complications.

If symptoms indicating influenza appear, you should contact your pediatrician (general practitioner).

The flu clinic is similar to the clinic of a number of diseases. Only a thorough analysis of all objective manifestations of the disease and taking into account the epidemiological situation make it possible to determine correct diagnosis. Toxic influenza, which occurs with meningeal and encephalitic manifestations, must first of all be differentiated from meningoencephalitis of other etiologies.

Influenza is distinguished from serous meningitis of enteroviral etiology and poliomyelitis by the absence or weak severity of catarrhal phenomena in the nasopharynx, less distinct disorders of the autonomic nervous system, the presence hemorrhagic syndrome. Cerebrospinal fluid has the flu normal composition, at serous meningitis of viral etiology, cytosis is usually increased. With serous meningitis, repeated vomiting, nausea and severe headache are observed. Meningeal phenomena are more pronounced.

The difference between influenza and the aparalytic form of polio is expressed in the absence the following symptoms: hyperesthesia, hypotension, decreased reflexes or anisoreflexia. Entero viral diseases Unlike the flu, they do not occur in the autumn-winter period, but more often in the spring-summer period.

With influenza, neurovegetative disorders are more pronounced - sweating, impaired intestinal motility, hemodynamic disorders: pulse lability, decreased blood pressure, pulmonary circulatory disorders detected by X-ray examination in the form of increased vascular pattern and sometimes segmental edema. A combination of abdominal and encephalitic syndromes, not accompanied by changes in the cerebrospinal fluid, is very typical for influenza.

For enteroviral diseases hemorrhagic phenomena are not typical. Influenza differs from parainfluenza catarrhs ​​of the respiratory tract by a more violent onset, more pronounced manifestations damage to the nervous system, vascular disorders, in children younger age- early onset of pneumonia. Influenza is more different from adenoviral diseases late appearance catarrhal changes, their lesser severity.

Catarrh of adenoviral etiology occurs with pronounced exudative manifestations and lasts for a longer time. A significant difference between them and influenza is the frequency and severity of conjunctivitis, which is often membranous in nature. With adenoviral diseases, the symptoms of intoxication of the nervous system are less pronounced. Feverish state lasts longer, sometimes 8-10 days.

"Emergency Pediatrics", K.P. Sarylova

Influenza is a serious infectious disease that can affect people of any age and gender. According to statistics, millions of people around the world die every year from influenza and its complications. Thus, influenza represents serious danger for life and health. Therefore, it is very important to know what the main flu symptoms look like.

Description of the disease

Influenza has been known for a very long time, since ancient times. However, it became a serious problem only in the twentieth century, as the most terrible bacterial infections - plague, cholera, typhoid - receded. The pandemic is well known" spanish flu", which took place at the beginning of the twentieth century and affected almost all countries and continents. Then two tens of millions of people died from the disease, many of them young and healthy. Often these days in individual regions There are outbreaks of new dangerous varieties of disease, such as swine or bird flu.

However, epidemics regular flu, sometimes called seasonal, can be dangerous. During seasonal flu, the disease affects many children, the elderly and people with chronic diseases and other health problems. The flu is also dangerous for pregnant women, as it can harm the health of the child.

It is also worth considering that the disease causes great damage to the economy of any country that is exposed to an epidemic, since a significant part of the working population is disabled for some period of time. In general, seasonal flu can affect up to 15% of the world's population during the year. And approximately 0.3% of diseases end fatal.

How does the flu occur?

The disease is caused by tiny biological particles - viruses. The influenza virus was isolated in the mid-20th century. It belongs to the group of RNA viruses, that is, viruses that store genetic information in an RNA molecule. There are three known genera of the virus - A, B and C, within which virologists distinguish individual strains and serotypes, depending on what proteins the influenza virus contains.

A characteristic feature of the influenza virus is its ability to constantly mutate. This means that every year new strains appear, and if a person has had the flu and acquired resistance to infection with one strain, this does not mean that he is next year will not be able to catch a disease caused by another strain of the virus.

The most severe influenza epidemics are caused by type A viruses. They can be transmitted both from person to person and from animals to humans. Viruses of the B genus are less likely to cause epidemics, although among the viruses of this group there are those that cause severe forms of the disease. Influenza virus type C never causes epidemics. This is a relatively safe type of virus for humans. It affects only the most weakened categories of people.

The influenza virus is usually quite resistant to adverse external influences. It can be stored frozen for up to several years. At room temperature, it can persist on various objects for several hours. Drying and heating to +70 ºС kills the virus within a few minutes, and boiling does it almost instantly. The virus is also sensitive to ultraviolet radiation, ozone and some chemicals.

In most cases, the virus is transmitted by airborne droplets, when sneezing or coughing, in some cases even during normal conversation. Infection can also occur through household objects, for example, when a person touches the surface of objects on which the virus is located, and then their face. When it enters the mucous membranes of the respiratory tract, the virus begins to multiply.

Incubation period flu is caused by various factors– number of viral particles entering the body, condition immune system person, type of virus, etc., and can vary from a few hours to 5 days.

A person infected with the virus can pose a danger to others because he spreads the pathogens around him. This danger remains even if the person is not yet sick or has already had the flu. However, a person is most dangerous with the flu in the first two days of the disease.

Forms of the disease

There are several main forms of the disease, depending on the intensity of the observed symptoms:

• light,
• average,
• heavy,
• toxic,
• lightning fast.

With mild and medium forms Influenza treatment can be carried out at home. In other cases, hospitalization is recommended. This is especially true for persons who have chronic diseases cardiovascular system and lungs.

Complications of influenza

Most deaths from influenza are not due to the disease itself, but to its complications. Complications of influenza primarily affect the cardiovascular and nervous systems, lungs, kidneys and liver. The most dangerous complications influenza are:

• viral pneumonia, difficult to treat even in a hospital setting;
• inflammation of the heart muscle - myocarditis and tissues surrounding the heart - pericarditis;
• inflammation meninges() and brain (encephalitis);
• severe renal and liver failure;
• early termination of pregnancy and fetal infections in pregnant women.

Symptoms

Flu symptoms are extremely varied. The main symptoms include:

• high temperature,
• cough,
• headaches,
• pain in the body and muscles,
• sore throat,
• pain in the eyes,
• runny nose (rhinitis),
• weakness and weakness,
• disorders gastrointestinal tract,

All these symptoms, with the exception of high temperature, may not always appear and not in all patients.

High temperature

This symptom is characterized by high values. The typical temperature at the onset of the disease is usually above +39 ºС, and can often exceed +40 ºС. Only with mild forms of influenza can the temperature fluctuate around +38 ºС. Such a strong increase in temperature is a consequence of intoxication of the body, as well as the reaction of the immune system to it.

Another feature of the temperature increase is that it usually occurs very sharply, literally within a few hours. The duration of the period during which the patient's temperature is elevated depends on the severity of the disease and whether the patient is taking antipyretic drugs. It usually lasts 2-4 days. Then the temperature drops to low-grade levels. In case of severe forms of influenza high temperature does not respond well to antipyretics. Or it gets lost for a very short period of time.

Cough

Influenza viruses mainly infect the bronchial mucosa. Therefore, with the flu, cough is also typical symptom, appearing in 9 out of 10 patients. However, cough does not always appear in the first hours of the disease. In addition, the cough may often be relatively mild compared to the cough seen with other respiratory diseases. The cough is usually continuous and can plague a person and prevent him from falling asleep.

At the onset of the disease, the cough is usually dry and unproductive. As the mucus clears, the cough changes to a wet one.

Pain in the head and body

Headaches, chest pain, and vague pain in other parts of the body, especially in the leg muscles, are a consequence of intoxication of the body. Often these are the first symptoms of the flu, appearing even before the temperature rises. Painful sensations There may be aches and pains in the muscles. The headache is usually concentrated in the frontal area, although it can spread throughout the head. Sometimes pain in the eyes and photophobia may occur. These are all fairly common flu symptoms.

Laryngitis, pharyngitis, runny nose, sinusitis

Symptoms of inflammation of the mucous membranes of the upper respiratory tract - runny nose, sore throat, sneezing - may often not be observed at all. However, such symptoms also occur (in about half of the cases). Often they are explained not by the influence of the influenza viruses themselves, but by secondary bacterial infection. Most often from similar phenomena children suffer.

Other symptoms

Sometimes there are disturbances in the functioning of the gastrointestinal tract - nausea, dyspepsia, loss of appetite. Vomiting and diarrhea are sometimes possible. Although in general for the flu similar symptoms uncharacteristic.

Also, against the background of a high temperature, the patient may experience increased sweating, redness and hyperemia of the skin, rapid heartbeat, low blood pressure, disorders heart rate. When listening to the heart, muffled tones and systolic murmur are noticeable.

Duration of the disease

Active phase flu with clearly defined symptoms usually lasts no more than 3-5 days. More long course disease increases the risk of various complications– inflammation of the lungs and pleura, otitis, myocarditis, endocarditis, encephalitis, liver and kidney damage.

What are the different types of influenza?

With a mild form of influenza, the patient experiences relatively low temperature– around +38 ºС, and sometimes low-grade fever, cough is mild or may be absent. General health satisfactory. The active phase of the disease lasts 2-4 days, and full recovery comes after a week.

With a moderate disease, the temperature is about +39 ºС. The cough is moderate. The patient's health is satisfactory, despite severe weakness. Headaches may be present. In severe cases of influenza, the temperature rises to +40 ºС. Severe headaches and aches throughout the body. Severe cough, nosebleeds are possible. When the temperature rises above +40 ºС, convulsions, delirium, hallucinations, and loss of consciousness are possible.

The fulminant form is a rare form of influenza, but no less dangerous. Characterized by very rapid development symptoms, an increase in temperature to +40 ºС for several hours, and the presence of signs of general intoxication of the body. The disease can result in pulmonary and cerebral edema and death.

What to do at the first symptoms?

If a person experiences the first signs of the flu, the first thing to do is call a doctor at home. The main reason to call a doctor is a high temperature - over +38 ºС. Going to the clinic on your own with such a temperature is dangerous not only for the patient himself, but also for the people around him, whom the patient can infect. Children and the elderly, people suffering from cardiovascular diseases and kidney diseases are especially vulnerable to infection. However, die from toxic flu even adults can healthy people. Such a development of events is completely possible.

Before the doctor arrives, you must remain in bed. It is better not to take antipyretic and anti-inflammatory drugs if the patient’s condition is satisfactory, since their use may distort clinical picture. The doctor must examine the patient and decide whether he should be treated at home or in a hospital setting. If the treatment is carried out at home, the doctor will prescribe all the necessary medications.

The following can be used to treat influenza:

• etiotropic drugs,
• immunomodulators,
• symptomatic drugs (anti-inflammatory and antipyretic drugs).

Expectorants and mucolytic drugs are taken to treat cough. To treat a throat and runny nose, rinses, inhalations, and nasal medications are useful.

Great value for speedy recovery have also proper diet, taking vitamins, drinking plenty of fluids, staying in bed.

What is the difference between influenza and ARVI

Flu is a less common disease than the common cold. But at the same time it is more dangerous. In everyday life, the flu is often called any acute respiratory infection accompanied by an increase in temperature. But this is absolutely not true. Various bacteria and viruses can attack the body, including the respiratory tract, but influenza is only a disease caused by the influenza virus and no other.

The viruses that cause so-called acute respiratory viral diseases (ARVI) include:

• rhinoviruses,
• adenoviruses,
• enteroviruses,
• parainfluenza viruses.

The likelihood of contracting an illness caused by any of these viruses is much higher than contracting the flu. Moreover, an individual person may not get the flu every year, while he may suffer respiratory diseases caused by other viruses every year.

This situation gives rise to a somewhat lenient attitude towards the disease. They say, last winter I had the flu - I sneezed, coughed, had a fever for a couple of days, but what’s terrible, I didn’t die! So why are vaccinations and other measures to prevent influenza necessary? Meanwhile, this person may not even have encountered the influenza virus as such.

Most people who have encountered the flu, and not an acute respiratory viral infection, can distinguish the symptoms of influenza from the symptoms of an acute respiratory viral infection. However, in some cases this may be difficult. Viruses such as the parainfluenza virus, as reflected in its name, can produce symptoms very similar to those of mild and medium degree gravity. Therefore, it would not be superfluous to remind you which symptoms are more typical of influenza than of ARVI.

Firstly, this is a sharp rise in temperature to high values, +39-40 ºС, over a short period of time, literally in a few hours. With most other respiratory diseases, the rise in temperature occurs much more slowly, that is, for half a day or one day a person has a low-grade fever, and it rises to values ​​of +38ºС or even +39ºС only the next day. This feature of the disease is very dangerous, since fever can often take a person by surprise, for example, when he is at work.

Secondly, this is the temperature level itself. With most acute respiratory viral infections, the temperature still does not exceed +39 ºС. With the flu, +39 ºС is by no means the limit. Often the temperature can jump to a level of +40 ºС. However, with some other infectious diseases such a high temperature is also possible, for example, at enterovirus infection. However, it is more common in summer.

Thirdly, this is the time when respiratory symptoms, such as cough, appear. With the flu, symptoms of this type usually appear only after the temperature rises. With ARVI, a person may have a sore throat all day, and only after that the temperature will rise.

Fourthly, this is the severity and quantity of the respiratory symptoms. With real flu, the patient is usually only tormented by a cough, which, however, can be very strong, and chest congestion. Pharyngitis, laryngitis and rhinitis occur rarely. They are usually associated with a later bacterial infection.

Fifthly, this general signs intoxication - headache and aches throughout the body, especially in the muscles of the legs. For ARVI, such symptoms, as a rule, are not typical, unlike influenza. Also, importantly, similar symptoms of influenza can appear even before the temperature rises and the appearance of respiratory symptoms, and, thus, are the very first signs of an impending disease. Symptoms such as severe malaise, fatigue and weakness are also not typical for ARVI.

Sixthly, this is the duration of the illness and the recovery period. With ARVI, the temperature usually lasts for 2-3 days, and after the temperature drops the person usually feels well. With the flu, the temperature lasts 4-5 days, but even after the fever has passed, a person may feel weak and unwell for a couple of weeks.

A short reference book for a local doctor, ed. L. S. Schwartz, B. A. Nikitin
Saratov, 1963

Published with some abbreviations

TOXIC FLU (Gripp toxicus). As is known, it is customary to divide influenza diseases into viral flu(varieties A, A1, A2, B, C, D, AFC, etc.) and acute catarrh of the respiratory tract. In both groups of diseases there is a wide variety of clinical manifestations. When calling a seriously ill patient, a detailed questioning of parents about the onset and development of the disease, data on diseases among others, taking into account epidemic outbreaks, will help in diagnosis.

Severe influenza in children is rare. However, cases with a fatal outcome on the 2-3rd day of illness were observed in outbreaks beyond recent years among children not only older, but also younger. Among newborns, outbreaks of influenza were observed with a picture of a toxicseptic condition.

Symptoms In young and older children, toxic flu occurs with severe damage to the nervous system, begins with an increase in temperature to 39-40°, headache, agitation, delirium, vomiting, and ends with adynamia and meningeal phenomena.
Noteworthy are the pallor of the face, less often with slight cyanosis, scleral injection, dry lips, coated tongue, rapid breathing, small, rapid pulse, muffled heart sounds. Catarrhal symptoms from the upper respiratory tract are usually not observed in the first days. Later, pneumonia may occur, and otitis is common.
In children early age phenomena arise more easily false croup. The presence of toxicosis distinguishes it from diphtheria croup.

Urgent Care. Hospitalization and isolation of the patient. It is recommended to administer blood serum from a convalescent person or a person who has been ill during a given influenza outbreak (10-30 ml for young children), or a blood transfusion from such a person with a preliminary test for the blood group of the donor and the patient.
It is necessary to give antibiotics (tetracycline, terramycin), especially to prevent complications. Bed rest, prescribing a diet with increased amount vitamins, fruits, drinks. Aeration of the room, warm bath.

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