5.1. Virus Infection

 
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The elderly are more likely to struggle with chronic diseases which weaken their immune system. This, in turn, increases the risk of a viral infection. Fast-mutating viruses are the most common cause of respiratory infections.

 

The main sources of respiratory viral infections

Viruses that cause respiratory infections may beairborne or may be transmitted through direct contact with a sick person.
 

Among the most common causes of respiratory viral infections are:

   Influenza A (Flu A) , Influenza B (Flu B) viruses,
 
   Metapneumovirus (MPV)
 
   RSV – Respiratory Syncytial Virus
 
   Parainfluenza virus (PIV)
 
   Adenovirus (AdV)
 
   Rynovirus (HRV A/B/C)
 
   SARS-CoV-2 Coronavirus
 
To confirm which virus has attacked the respiratory tract, it is necessary to have a nose swab and a throat swab. Taking a swab in order to verify the presence of a specific virus can be performed under laboratory conditions.
 

Characteristic symptoms of a viral infection include:

   feeling confused
 
   weakness
 
   feeling unwell
 
   pain
 
   sore throat
 
   reddening of the throat
 
   increased temperature
 
   runny nose
 
   cough
 
   shivers
 
The symptoms mentioned above are sometimes accompanied by conjunctivitis, and even nausea or vomiting. If the symptoms persist for more than 3 days, it is advised to seek medical help to determine the source of the infection (e.g. exclusion of bacteria in the body).
 

Viruses causing the flu

The flu tends to have a rapid onset. Already at the beginning there is fever ofover 38 degrees, as well as shivers, muscle pain, headaches, lack of appetite, weakness, as well as sore throat and dry cough. In the flu,runny nose is a rather moderate issue. Flu symptoms usually last up to a week, but weakness and coughing may persist longer.

The basis of the treatment involves the isolation of the ill person, resting and drinking a large amount of liquids. Symptomatically, painkillers as well as fever and sore throat medicines are also used. Treatment for viruses is also possible, but it is mostly limited to severe cases only or tothecomplications resulting from influenza. It is important that antibiotics are not used to treat influenza.
 

Viruses causing the cold

A cold tends to beshorter and milder than the flu. It can be caused by more than 200 different types of viruses, including influenza or parainfluenza, rynoviruses, metapneumovirus, adenoviruses or RSV.

Many people go through a cold asymptomatically, while others experience mild ailments. The most common ailments include headache and muscle pain, bad overall feeling, severe runny nose, sore throat and cough, which is initially dry and later becomeswet. Sporadically, a cold may causemild fever with chills. Usually the most unpleasant symptom is the runny nose, accompanied by a feeling of nasal congestion, deterioration of the sense of smell as well as nasal secretion running down the back wall of the throat, which over time gets thick and greenish.

The symptoms usually disappear after 7-10 days, with the cough lasting longer in some cases. Usually, the ailments disappear spontaneously with enough rest. Symptomatically, painkillers (e.g. paracetamol) and anti-cough medicine, as well as sea salt solutions for the nose, can be used. Medicines from the purple coneflower and zinc in doses over 75 mg may also be helpful.

In colds, it is possible to develop a bacterial superinfection, which leads to the inflammation of the paranasal sinuses, the middle ear or the lungs. Nevertheless, antibiotics should not be used preventively as they do not reduce the risk of complications.
 

Severe cases of viral infection

Viral infectionsare not always mild. In some cases, a viral infection can cause serious effects. For example, RSV or Metapneumovirus can cause severe pneumonia in the elderly with low immunity. It results in the increased shortness of breath and apnea, while numerous changes appear in the lung tissue.

The SARS-CoV-2 coronavirus is also a type of virus that can cause severe consequences and lead to dangerous complications and even death.

The elderly, do not always experience typical symptoms of COVID-19, i.e. fever, dry cough and breathing problems. There are cases where none of these common symptoms for COVID-19 appear, but there will be other symptoms that may indicate the infection with the coronavirus.

In the elderly, unusual behaviour may occur in the early stages of a COVID-19 infection, such as lack of appetite, sleeping more than usual, indifference or impaired spatial orientation. As a result, the elderly person can get dizzy and fall, stop speaking or lose consciousness. The reason for such a different reaction of the body is related to the specific response of the immune system. The elderly can react differently to infection, as advanced age weakens the body’s immune response. According to doctors, a supressed immune response happens more frequently in the case of an aging organism. Then, the ability to regulate body temperature changes, and concomitant chronic diseases mayovershadow the signs of infection. Some of the elderly have a changed cough reflex, e.g. as a result of a stroke or neurological problems. It is also important to remember that people with cognitive impairments will not be able to report their ailments and changes in theiroverall feeling.

The risk of overlooking the first symptoms of a SARS-CoV-2 infection is the main problem resulting from the unusual course of infection in the elderly. Unaware of the situation, an elderly person who is infected may then continue to spread the virus. Another, even more serious, problem is that if the initial symptoms of this coronavirus are not noticed early enough, they can suddenly trigger much more serious symptoms and complications. If this happens, the elderly person’s condition may deteriorate before he or she is given medical attention.
 

Among others, atypical signs of aSARS-CoV-2 infection in the elderly include:

   behavioural changes
 
   delirium
 
   falling down
 
   tiredness
 
   apathy
 
   low blood pressure
 
   painful swelling
 
   fainting
 
   abdominal pain
 
   diarrhoea, nausea and vomiting
 
   loss of sense of taste or smell
 
It should be kept in mind that some symptoms of a SARS-CoV-2 coronavirus infection, especially those in the atypical group, are still considered anecdotal.It is necessary to collect and systematise data on these atypical symptoms of a coronavirus infection.
 
 
 
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