Flu is transmitted from an ill person to another person through droplets expelled when coughing and sneezing. The transmission period starts from the day before symptoms appear and persists for five days afterwards.

It is estimated that seasonal flu may affect between 5% and 20% of the general population, and that approximately 25% of febrile respiratory processes may be produced by the flu. This increased morbidity gives rise to a large number of medical consultations and absences from work as a consequence of the disease. Moreover, some people, such as older people, those with chronic illnesses, immuno-suppressed people and pregnant women, among others, may suffer more from the illness and it is common for them to experience complications during its evolution. Flu thus continues to be a major public health issue.

Symptoms 

Flu presents heightened fever, dry cough, headache and neck ache, muscle pain and general illness. It can also cause diarrhoea, nausea and vomiting, especially in young children. In most cases, people recover in 7-10 days.

Who is affected by the condition?

Flu may affect anyone, but the most vulnerable to suffering complications are children under the age of 2, people aged 60 or above, pregnant women, morbidly obese people and people of any age who suffer from one of the following types of illness: cardiovascular, pulmonary (including bronchopulmonary dysplasia, cystic fibrosis and asthma), neurological, neuromuscular, metabolic (including diabetes mellitus), kidney failure, immunosuppression, cancer, chronic liver diseases, asplenia and iron deficiencies.

Diagnosis

Flu diagnosis is normally clinical and does not require laboratory tests. Despite that fact, microbiological diagnosis is fundamental to be able to obtain aetiological confirmation in patients with risk factors and those with serious illnesses. The detection of the virus in respiratory samples can be done using cultures, antigen detection techniques and molecular methods.

Typical treatment

There is no specific treatment for flu. Treatment with analgesics and antipyretics (paracetamol) is recommended to alleviate or treat some of the symptoms associated with flu, such as fever or headache.

Antibiotics do not cure the flu. Only in cases where there is an overlying bacterial infection, such as pneumonia, or in those with chronic illnesses, may preventive antibiotic treatment be indicated to avoid complications.

Antivirals, such as oseltamivir or zanamivir, may be indicated in people at high risk of complications to reduce the duration of the flu and the possibility of complications, but they should begin to be taken within 48 hours from the outbreak of symptoms.

Prevention

The best way of protecting yourself from the flu is vaccination and following good hygiene practices to prevent the spread of the virus. The purpose of anti-flu vaccination each year is to generate protection against the flu viruses that circulate in the flu season. Health authorities and scientific associations around the world unanimously recommend seasonal anti-flu vaccination for people at high risk. Anti-flu vaccinations are very safe and well-tolerated with effectiveness that ranges from 30% to 70% to prevent hospitalisation due to flu and pneumonia. In older people living in institutions, vaccinations have proven to be between 50% and 60% effective to prevent hospitalisation or pneumonia, and 80% to prevent death by flu.

Who is affected by aortic stenosis?

Aortic stenosis makes up 3% to 6% of congenital heart diseases detected during childhood. In occurs in 3% to 4% of men and women.

Diagnosis

Patients are usually children who do not show any symptoms and develop normally but who are discovered to have a heart murmur during a routine examination. Aortic stenosis may also be detected through the following tests:

Echocardiogram: this is the most effective way to confirm diagnosis. This also enables the valve morphology to be defined and the level of severity evaluated.

Stress test or ergometry: this shows whether the child has symptoms such as high blood pressure, angina, syncope and signs of ischemia, which help to determine the severity of the condition.

Typical treatment

The type of treatment will depend on the severity of the condition.

• Mild or moderate stenosis: conservative treatment will be carried out.
• Severe stenosis: percutaneous or surgical valvotomy is recommended even if the patient shows no symptoms. In this case, the atomic characteristics of the valve must be examined.

If the percutaneous or surgical valvotomy does not manage to stop the insufficiency or obstruction, then valve replacement is performed. This replaces the aortic valve with a graft from the same patient’s pulmonary valve, or one from a donor.

Patients who have undergone this treatment have a similar quality of life to the rest of the population. Despite this, however, around 20 % will live with mild stenosis for 30 years and 20 % will require surgery on the valve. 

Symptoms

The most common symptoms are:

• dysphagia
• food impaction
• thoracic pain
• heartburn (pyrosis)

If the inflammation of the oesophagus and related symptoms are left untreated, they will continue from childhood to adulthood. This inflammation causes structural changes to the oesophagus by remodelling the tissue. This can lead to fibrosis and oesophageal stricture. This means functional deterioration that significantly affects the patient’s quality of life.

Who is affected by eosinophilic oesophagitis?

From the first recorded case in 1993, eosinophilic oesophagitis has been found to affect 45 out of every 100,000 people, and has an incidence rate of 3.7 cases for every 100,000 people a year. This makes it the most common cause of dysphagia, spontaneous oesophageal perforation and food impaction in young patients.

Diagnosis

For appropriate diagnosis, a gastroscopy must be carried out to take multiple biopsies from the oesophagus, since inflammatory alterations can be distributed unevenly. This technique also allows the response to treatment to be assessed.

Endoscopic analysis of the oesophageal mucous membranes is not sufficient to reach a firm diagnosis, as 10-15% of patients will have normal results of a endoscopy.

Typical treatment

Treatment for EoE is based on three alternative therapies:

• Pharmacological therapy (proton pump inhibitors and topical corticosteroids)
• Dietary treatment with evidence-based diets that eliminate the foods most frequently involved in EoE.
• Endoscopy therapy to urgently treat any bouts of food impaction or to treat oesophageal stricture (oesophageal dilatation).

Prevention

Early diagnosis is important to prevent complications arising from EoE. Early treatment and clinical and endoscopic monitoring is also essential.