Manifestaciones respiratorias de la gripe aviar

Viejo Bañuelos, José Luis

doi:10.1016/S0210-5705(09)71003-9

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La producida por el subtipo H5N1 se está extendiendo en la actualidad y es motivo de preocupación porque afecta a humanos, con brotes altamente mortales sobre todo en Vietnam y Tailandia. La transmisión del virus de las aves a las personas es muy poco eficiente. El mecanismo de transmisión es la vía respiratoria por inhalación de productos procedentes de las aves enfermas. La transmisión de persona a persona se ha dado en muy pocos casos y no se ha propagado más allá de una persona. Hasta el momento se han registrado 252 casos con 148 fallecidos. Los síntomas van desde los típicos de la gripe ¿fiebre, tos, dolor de garganta y dolor muscular¿ hasta la infección ocular, neumonía, distrés respiratorio y otras complicaciones que pueden producir la muerte del paciente. Todos los pacientes presentan signos clínicos y radiológicos de neumonía, con cambios radiológicos tales como infiltrados difusos y consolidaciones lobulares o segmentarias con broncograma aéreo. La mortalidad es elevada. El tratamiento más activo son los inhibidores de la neuraminidasa; entre ellos, el oseltamivir, que ha sido el más empleado, consigue reducir la replicación vírica y mejorar la supervivencia. Los casos humanos han coincidido con epidemias en las aves. La gravedad de esta enfermedad justifica un estrecho seguimiento y estudio." ] "en" => array:1 [ "resumen" => "Avian infuenza is caused by type A influenza virus and occurs naturally among wild birds. Influenza A virus subtype H5N1 is currently spreading and is causing concern due to infection in humans, with highly lethal outbreaks mainly in Vietnam and Thailand. Transmission of the virus from birds to humans is highly inefficient. The mechanism of transmission is through the respiratory tract due to inhalation of products from infected birds. Person-to-person transmission has occurred in only a few cases and infection has not been spread to more than one person. To date, 252 cases have been registered with 148 deaths. The symptoms of avian influenza range from typical influenza symptoms ¿ fever, cough, sore throat and muscle ache ¿ to eye infection, pneumonia, respiratory distress and other, sometimes fatal, complications. All patients show clinical and radiological signs of pneumonia with radiological alterations that include diffuse infiltrates and lobar or segmentary consolidations on air bronchogram. Mortality is high. The most active treatment consists of neuraminidase inhibitors, among which oseltamivir is the most widely used, achieving a reduction in viral replication and improving survival. Human cases have coincided with epidemics in birds. 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Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 42. Issue S2.

Pages 12-18 (December 2006)

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Pages 12-18 (December 2006)

DOI: 10.1016/S0210-5705(09)71003-9

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Manifestaciones respiratorias de la gripe aviar

Respiratory manifestations of avian influenza

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José Luis Viejo Bañuelosa

a Servicio de Neumología. Hospital General Yagüe. Burgos. España.

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La gripe aviar está causada por virus de la gripe tipo A que se presentan de manera natural entre las aves silvestres. La producida por el subtipo H5N1 se está extendiendo en la actualidad y es motivo de preocupación porque afecta a humanos, con brotes altamente mortales sobre todo en Vietnam y Tailandia. La transmisión del virus de las aves a las personas es muy poco eficiente. El mecanismo de transmisión es la vía respiratoria por inhalación de productos procedentes de las aves enfermas. La transmisión de persona a persona se ha dado en muy pocos casos y no se ha propagado más allá de una persona. Hasta el momento se han registrado 252 casos con 148 fallecidos. Los síntomas van desde los típicos de la gripe ¿fiebre, tos, dolor de garganta y dolor muscular¿ hasta la infección ocular, neumonía, distrés respiratorio y otras complicaciones que pueden producir la muerte del paciente. Todos los pacientes presentan signos clínicos y radiológicos de neumonía, con cambios radiológicos tales como infiltrados difusos y consolidaciones lobulares o segmentarias con broncograma aéreo. La mortalidad es elevada. El tratamiento más activo son los inhibidores de la neuraminidasa; entre ellos, el oseltamivir, que ha sido el más empleado, consigue reducir la replicación vírica y mejorar la supervivencia. Los casos humanos han coincidido con epidemias en las aves. La gravedad de esta enfermedad justifica un estrecho seguimiento y estudio.

Palabras clave:

Gripe aviar

Manifestaciones respiratorias

Antivíricos

Avian infuenza is caused by type A influenza virus and occurs naturally among wild birds. Influenza A virus subtype H5N1 is currently spreading and is causing concern due to infection in humans, with highly lethal outbreaks mainly in Vietnam and Thailand. Transmission of the virus from birds to humans is highly inefficient. The mechanism of transmission is through the respiratory tract due to inhalation of products from infected birds. Person-to-person transmission has occurred in only a few cases and infection has not been spread to more than one person. To date, 252 cases have been registered with 148 deaths. The symptoms of avian influenza range from typical influenza symptoms ¿ fever, cough, sore throat and muscle ache ¿ to eye infection, pneumonia, respiratory distress and other, sometimes fatal, complications. All patients show clinical and radiological signs of pneumonia with radiological alterations that include diffuse infiltrates and lobar or segmentary consolidations on air bronchogram. Mortality is high. The most active treatment consists of neuraminidase inhibitors, among which oseltamivir is the most widely used, achieving a reduction in viral replication and improving survival. Human cases have coincided with epidemics in birds. Because of the severity of this disease, close follow-up and investigation are warranted.

Keywords:

Avian influenza

Respiratory manifestations

Antiviral drugs

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