{"id":17675,"date":"2026-03-03T00:10:36","date_gmt":"2026-03-02T23:10:36","guid":{"rendered":"https:\/\/valintermed.com\/?p=17675"},"modified":"2026-03-03T00:10:36","modified_gmt":"2026-03-02T23:10:36","slug":"pochemu-gripp-vozvraschaetsya-kazhdyy-god-mehanizm-mutatsii-virusa","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/","title":{"rendered":"Why the flu returns every year: the mechanism of virus mutation"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p>Influenza is not just a \"cold with a fever.\" It is an acute viral respiratory disease that claims tens of thousands of lives worldwide each year and threatens the operation of schools, hospitals, and even entire sectors of the economy. Its characteristic feature is the ability to return every season, like clockwork, even in the presence of a vaccine. Why does this happen? The answer lies not in the laziness of the immune system or in \"bad weather,\" but in the astonishing, almost cunning biology of the virus itself: its genetic structure constantly changes, \"deceiving\" the body's defense mechanisms. And if you think that last year's vaccination should protect you \u2014 you are mistaken. The virus has already changed. And it is this mutation mechanism that makes influenza one of the most difficult infectious agents to control on the planet.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%9A%D0%BB%D0%B0%D1%81%D1%81%D0%B8%D1%84%D0%B8%D0%BA%D0%B0%D1%86%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D0%BE_%D0%9C%D0%9A%D0%91\" >Classification of the disease according to ICD<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\" >History of the disease and interesting historical facts<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F_%D1%81%D1%82%D0%B0%D1%82%D0%B8%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Epidemiology (statistics of disease occurrence)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E_%D0%B2%D0%BE%D0%B2%D0%BB%D0%B5%D1%87%D1%91%D0%BD%D0%BD%D1%8B%D0%B5_%D0%B3%D0%B5%D0%BD%D1%8B_%D0%B8_%D0%BC%D1%83%D1%82%D0%B0%D1%86%D0%B8%D0%B8\" >Genetic predisposition to the disease (involved genes and mutations)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Risk factors for the development of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Diagnosis of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Treatment<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >List of medications used to treat this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BA%D0%BE%D0%BD%D1%82%D1%80%D0%BE%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5_%D1%8D%D1%82%D0%B0%D0%BF%D1%8B_%D0%BF%D1%80%D0%BE%D0%B3%D0%BD%D0%BE%D0%B7_%D0%BE%D1%81%D0%BB%D0%BE%D0%B6%D0%BD%D0%B5%D0%BD%D0%B8%D1%8F\" >Disease monitoring (control stages, prognosis, complications)<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Age-related features of the disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\" >Questions and Answers<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%A2%D0%B8%D0%BF%D0%B8%D1%87%D0%BD%D1%8B%D0%B5_%D0%BE%D1%88%D0%B8%D0%B1%D0%BA%D0%B8_%D0%BF%D1%80%D0%B8_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B8_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D0%B8_%D0%BA%D0%B0%D0%BA_%D0%B8%D1%85_%D0%B8%D0%B7%D0%B1%D0%B5%D0%B6%D0%B0%D1%82%D1%8C\" >Typical mistakes in treating influenza and how to avoid them<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/why-does-the-flu-return-every-year-the-mechanism-of-virus-mutation\/#%D0%97%D0%B0%D0%BA%D0%BB%D1%8E%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Conclusion<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9A%D0%BB%D0%B0%D1%81%D1%81%D0%B8%D1%84%D0%B8%D0%BA%D0%B0%D1%86%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BF%D0%BE_%D0%9C%D0%9A%D0%91\"><\/span>Classification of the disease according to ICD<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>According to the International Classification of Diseases 11th Revision (ICD-11), influenza falls under the category \"Respiratory infections,\" code J09\u2013J11. Specifically:<br \/>\n&#8212; <strong>J09<\/strong> \u2014 influenza caused by a new virus that has not previously been detected in humans (for example, a pandemic strain like H1N1 in 2009);<br \/>\n&#8212; <strong>J10<\/strong> \u2014 influenza caused by an identified influenza virus (usually seasonal, for example, A\/H3N2 or B\/Victoria);<br \/>\n&#8212; <strong>J11<\/strong> \u2014 influenza, unspecified (when laboratory confirmation is unavailable, but the clinical picture is typical).<br \/>\nIt is important to understand: the diagnosis of \"influenza\" in medical documentation requires either laboratory confirmation (PCR, ELISA, rapid test) or a clear clinical picture during an epidemic rise. Simply \"fever + cough\" is not yet influenza \u2014 it could be ARVI, adenovirus, or even the initial stage of pneumonia. Therefore, when consulting a doctor, it is important not to call your condition \"influenza\" until confirmed \u2014 this affects the treatment and prevention strategy.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\"><\/span>History of the disease and interesting historical facts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Influenza has been known to humanity since ancient times. The first reliable descriptions resemble the modern picture: a sudden rise in temperature, headache, body aches, cough. But a real breakthrough in understanding came only in the 20th century.<br \/>\nIn 1918, the most terrible pandemic in history broke out \u2014 the \"Spanish flu.\" Despite the name, it most likely started in the USA, not in Spain. Spain was a neutral country in World War I at the time, and its media freely reported on outbreaks, while other countries concealed the scale. Over two years, the pandemic claimed between 50 and 100 million lives \u2014 more than the entire war. It particularly affected young healthy people aged 20\u201340, which contradicted the usual picture of influenza. DNA studies from burials showed: the virus was a strain of A\/H1N1, but with unique mutations that enhanced the inflammatory response of the immune system \u2014 the so-called \"cytokine storm.\"<br \/>\nAnother important point: in 1933, scientists first isolated the influenza virus \u2014 this was done by British researcher William Smith along with colleagues. Before that, influenza was considered a bacterial infection. The discovery of its viral nature became the starting point for the creation of the first vaccines in the 1940s.<br \/>\nAn interesting fact: in 1976, panic arose in the USA due to a new strain A\/New Jersey\/76 (H1N1), allegedly as dangerous as the \"Spanish flu.\" A mass vaccination campaign was launched, but an epidemic did not occur. However, some vaccinated individuals developed Guillain\u2013Barr\u00e9 syndrome \u2014 a rare autoimmune nerve disorder. This case became a lesson: vaccination should be based not on fear, but on scientific data about real risk.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F_%D1%81%D1%82%D0%B0%D1%82%D0%B8%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Epidemiology (statistics of disease occurrence)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>According to WHO, annually, influenza affects between 51 million to 101 million adults worldwide and between 201 million to 301 million children. This amounts to about 1 billion cases per year. Of these, 3\u20135 million are severe forms requiring hospitalization, and 290,000\u2013650,000 deaths. Most deaths occur in people over 65 years old, as well as in those with chronic diseases: cardiovascular, pulmonary, diabetes, immunodeficiencies.<br \/>\nIn Russia, the flu season usually begins in November\u2013December, peaks in January\u2013February, and subsides by April. According to Rospotrebnadzor, in the 2023\/2024 season, over 12 million cases of ARVI were registered, of which about 15\u201320% were confirmed as influenza (by PCR). The highest incidence is among children under 14 years old (up to 400 cases per 10,000 population), then it decreases for those aged 25\u201344 and rises again after 65 years.<br \/>\nImportant: flu statistics heavily depend on the level of laboratory monitoring. In countries with a developed testing system (for example, Japan or Canada), more confirmed cases are recorded than in regions with limited access to diagnostics. Therefore, global figures are an estimate, not an exact count.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E_%D0%B2%D0%BE%D0%B2%D0%BB%D0%B5%D1%87%D1%91%D0%BD%D0%BD%D1%8B%D0%B5_%D0%B3%D0%B5%D0%BD%D1%8B_%D0%B8_%D0%BC%D1%83%D1%82%D0%B0%D1%86%D0%B8%D0%B8\"><\/span>Genetic predisposition to the disease (involved genes and mutations)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>There is no direct \"flu gene.\" However, studies show that some people's immune systems recognize viral antigens less effectively due to the characteristics of genes coding for major histocompatibility complex (HLA) proteins. For example, carriers of the allele <strong>HLA-B*27<\/strong> tend to experience milder flu, while holders of <strong>HLA-DRB1*15:01<\/strong> have a higher risk of complications.<br \/>\nThere are other genetic markers as well:<br \/>\n\u2014 Polymorphisms in the gene <strong>IFITM3<\/strong> (interferon-induced transmembrane protein 3) affect the ability of cells to block virus entry. In people with the rs12252-C variant, the risk of severe influenza increases by 6 times.<br \/>\n\u2014 Mutations in the gene <strong>MBL2<\/strong> (mannose-binding lectin) reduce innate immunity to viruses, including influenza.<br \/>\n\u2014 The gene <strong>CCR5<\/strong>, known from HIV, also plays a role: its delta-32 variant may partially protect against severe forms of influenza, although the data is still inconclusive.<br \/>\nBut! Genetics is not destiny. Even with an \"unfavorable\" set of genes, the risk can be significantly reduced through vaccination, hygiene, and a healthy lifestyle. Genes set the potential, but the environment and behavior determine the outcome.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Risk factors for the development of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Risk factors are divided into modifiable and non-modifiable. The latter are age, gender, genetics. The former are those we can influence.<br \/>\n**Non-modifiable factors:**<br \/>\n\u2014 Age: children under 5 years and people over 65 years;<br \/>\n\u2014 Chronic diseases: bronchial asthma, COPD, heart failure, type 1 and type 2 diabetes, kidney failure;<br \/>\n\u2014 Immunodeficiencies: HIV, oncological diseases, use of cytostatics or glucocorticoids;<br \/>\n\u2014 Pregnancy (especially the II\u2013III trimester) \u2014 due to changes in the immune system and lung function.<br \/>\n**Modifiable factors:**<br \/>\n\u2014 Refusal of vaccination \u2014 the most significant. Even if the vaccine does not provide 100% protection, it reduces the risk of hospitalization by 40\u201360%;<br \/>\n\u2014 Smoking \u2014 damages the cilia in the airways, reducing mechanical protection;<br \/>\n\u2014 Lack of sleep and chronic stress \u2014 suppress the production of interferons;<br \/>\n\u2014 Poor ventilation of premises, overcrowding (schools, offices, public transport);<br \/>\n\u2014 Vitamin D deficiency is associated with increased susceptibility to respiratory viruses.<br \/>\nThe special risk is \"secondary exposure\": when a person has had an acute respiratory viral infection, immunity is temporarily weakened, and the flu virus easily takes hold. This is why in autumn and winter, after the first colds, the number of flu cases sharply increases.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Diagnosis of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The diagnosis of influenza is based on three pillars: clinical picture, epidemiological history, and laboratory confirmation.<br \/>\n**Main symptoms:**<br \/>\n\u2014 Sudden onset (within 1\u20132 hours);<br \/>\n\u2014 Temperature 38.5\u201340 \u00b0C;<br \/>\n\u2014 Severe headache, muscle and joint pain;<br \/>\n\u2014 Dry cough, sore throat;<br \/>\n\u2014 Weakness, adynamia (\"I can't get out of bed\");<br \/>\n\u2014 Sometimes \u2014 nausea, vomiting, especially in children.<br \/>\nUnlike ARVI, during influenza, runny nose and nasal congestion are often weakly expressed or absent in the first days.<br \/>\n**Laboratory studies:**<br \/>\n&#8212; <strong>Rapid antigen tests<\/strong> (nasal\/throat swab): result in 15 minutes, sensitivity 50\u201370%. Suitable for quick decision-making \u2014 whether to prescribe oseltamivir or not.<br \/>\n&#8212; <strong>PCR (polymerase chain reaction)<\/strong>: gold standard. Detects viral RNA, determines subtype (A\/H1N1, A\/H3N2, B). Sensitivity &gt;95%.<br \/>\n&#8212; <strong>Serology<\/strong> (ELISA for IgM\/IgG antibodies): used retrospectively, for example, to confirm the diagnosis in a patient who sought help on day 5\u20137 of the illness.<br \/>\n**Radiological examinations** are not needed in typical cases. But if there is suspicion of pneumonia (worsening cough, shortness of breath, confusion), a chest X-ray or CT is performed. Typical signs: focal or diffuse infiltrates, more often in the lower lobes of the lungs.<br \/>\n**Differential diagnosis** includes:<br \/>\n\u2014 ARVI (adenovirus, rhinovirus) \u2014 milder symptoms, without body aches;<br \/>\n\u2014 Coronavirus infection (SARS-CoV-2) \u2014 often with loss of smell, less pronounced fever;<br \/>\n\u2014 Bacterial pneumonia \u2014 progressive shortness of breath, purulent sputum;<br \/>\n\u2014 Mononucleosis (Epstein\u2013Barr) \u2014 swollen lymph nodes, sore throat with plaque;<br \/>\n\u2014 Pulmonary tuberculosis \u2014 persistent cough, weight loss, night sweats.<br \/>\nIf you need to quickly determine: \"is it the flu or not?\" \u2014 focus on the combination of acute fever + aches + epidemic season. In doubtful cases \u2014 do a rapid test.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treating the flu is not about \"curing the virus,\" but helping the body cope with it and preventing complications. It is divided into etiological (antiviral), symptomatic, supportive, and preventive.<br \/>\n**Etiological treatment** is based on drugs that block key viral enzymes:<br \/>\n&#8212; <strong>Oseltamivir<\/strong> (Tamiflu) \u2014 neuraminidase inhibitor. Prevents new viral particles from exiting the cell;<br \/>\n&#8212; <strong>Zanamivir<\/strong> (Relenza) \u2014 an analogue of oseltamivir, but in the form of inhalations;<br \/>\n&#8212; <strong>Umifenovir<\/strong> (Arbidol) \u2014 blocks the fusion of the viral envelope with the cell membrane;<br \/>\n&#8212; <strong>Baloxavir marboxil<\/strong> (Chofitol) \u2014 inhibits the cap-dependent endonuclease of the virus, stopping viral RNA synthesis.<br \/>\nImportant: antiviral drugs are effective **only in the first 48 hours** from the onset of symptoms. After that, their benefit sharply decreases. The exception is severe forms and at-risk groups: there, the course may start up to 5 days.<br \/>\n**Symptomatic treatment:**<br \/>\n\u2014 Antipyretics: paracetamol (up to 4 g\/day) or ibuprofen. Aspirin is prohibited for children under 15 years old \u2014 risk of Reye's syndrome.<br \/>\n\u2014 Cough suppressants \u2014 only for dry, painful cough without phlegm (codeine, butamirate). For wet cough \u2014 expectorants (ambroxol, acetylcysteine).<br \/>\n\u2014 Abundant warm drinks \u2014 not for \"detoxifying,\" but to compensate for fluid loss during fever and to keep mucous membranes moist.<br \/>\n**Supportive therapy:**<br \/>\n\u2014 Bed rest for the first 3\u20135 days \u2014 even with normal temperature. The heart and lungs are still under strain.<br \/>\n\u2014 Saturation monitoring (pulse oximetry) \u2014 if below 94%, hospitalization is needed.<br \/>\n\u2014 Oxygen therapy for hypoxia.<br \/>\nSurgical treatment for influenza is not used \u2014 except in extremely rare cases when a lung abscess or empyema of the pleura develops as a complication of bacterial superinfection.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>List of medications used to treat this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Here is the current list of medications approved for use in the Russian Federation as of 2026, indicating the form of release and application features:<\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<table border=\"1\" cellpadding=\"5\" cellspacing=\"0\" style=\"border-collapse: collapse;width: 100%\">\n<tr>\n<th>Preparation<\/th>\n<th>Active ingredient<\/th>\n<th>Release form<\/th>\n<th>Features of use<\/th>\n<\/tr>\n<tr>\n<td>Tamiflu<\/td>\n<td>Oseltamivir<\/td>\n<td>Capsules 75 mg, powder for suspension<\/td>\n<td>Course of 5 days. For children from 1 year old. Not recommended in cases of severe renal failure without dose adjustment.<\/td>\n<\/tr>\n<tr>\n<td>Relenza<\/td>\n<td>Zanamivir<\/td>\n<td>Powder for inhalation (Diskhaler)<\/td>\n<td>Not suitable for a history of bronchial asthma\/COPD \u2014 risk of bronchospasm.<\/td>\n<\/tr>\n<tr>\n<td>Arbidol<\/td>\n<td>Umifenovir<\/td>\n<td>Capsules 100\/200 mg, tablets, suspension<\/td>\n<td>Course of 5\u20137 days. Effectiveness is questionable, but approved by the Ministry of Health for prevention and treatment.<\/td>\n<\/tr>\n<tr>\n<td>Hofitol<\/td>\n<td>Baloxavir marboxil<\/td>\n<td>Tablets 20\/40 mg<\/td>\n<td>One dose per day, course 1 day. The fastest effect \u2014 reduction of viral load within 24 hours.<\/td>\n<\/tr>\n<tr>\n<td>Paracetamol<\/td>\n<td>Paracetamol<\/td>\n<td>Tablets, suppositories, syrup<\/td>\n<td>Max. 4 g\/day. In case of liver failure \u2014 reduce the dose.<\/td>\n<\/tr>\n<tr>\n<td>Ambroxol<\/td>\n<td>Ambroxol<\/td>\n<td>Tablets, syrup, solution for inhalations<\/td>\n<td>Stimulates secretion and reduces the viscosity of sputum. Do not give in case of stomach ulcer in the acute stage.<\/td>\n<\/tr>\n<\/table>\n<p>Note: self-treatment with antibiotics for influenza is a mistake. They do not act on viruses. Antibiotics are prescribed only in case of confirmed bacterial superinfection (for example, with radiological signs of pneumonia and leukocytosis).<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%BA%D0%BE%D0%BD%D1%82%D1%80%D0%BE%D0%BB%D1%8C%D0%BD%D1%8B%D0%B5_%D1%8D%D1%82%D0%B0%D0%BF%D1%8B_%D0%BF%D1%80%D0%BE%D0%B3%D0%BD%D0%BE%D0%B7_%D0%BE%D1%81%D0%BB%D0%BE%D0%B6%D0%BD%D0%B5%D0%BD%D0%B8%D1%8F\"><\/span>Disease monitoring (control stages, prognosis, complications)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Monitoring of influenza is not only observation of the patient but also epidemiological surveillance at the national level. In the Russian Federation, this is handled by Rospotrebnadzor in conjunction with the Federal State Budgetary Institution \"National Research Center for Epidemiology and Microbiology named after G. N. Gabrichevsky.\"<br \/>\n**Control stages for the patient:**<br \/>\n\u2014 Day 1\u20132: assessment of severity (temperature, saturation, respiratory rate);<br \/>\n\u2014 Day 3\u20134: if the temperature does not decrease, or shortness of breath appears \u2014 re-evaluation, possible hospitalization;<br \/>\n\u2014 Day 5\u20137: disappearance of fever, transition to recovery. If the cough worsens, purulent discharge appears \u2014 check for bacterial pneumonia;<br \/>\n\u2014 Day 10\u201314: monitoring for residual phenomena (asthenia, cough, fatigue). In 10\u201315% of patients, symptoms persist for up to 3 weeks.<br \/>\n**Prognosis:** in healthy adults \u2014 favorable, complete recovery in 7\u201310 days. In at-risk groups \u2014 complications may occur. Mortality with timely treatment \u2014 less than 0.1%. Without treatment \u2014 up to 1\u20132% in at-risk groups.<br \/>\n**Main complications:**<br \/>\n\u2014 Viral pneumonia (more common in the elderly);<br \/>\n\u2014 Bacterial pneumonia (Streptococcus pneumoniae, Staphylococcus aureus);<br \/>\n\u2014 Acute respiratory distress syndrome (ARDS);<br \/>\n\u2014 Myocarditis, pericarditis;<br \/>\n\u2014 Neurological complications: meningitis, encephalitis, Guillain\u2013Barr\u00e9 syndrome;<br \/>\n\u2014 Exacerbation of chronic diseases (heart failure, asthma).<br \/>\nSpecial concern is raised by influenza in pregnant women: the risk of premature birth, low birth weight in newborns, and intrauterine hypoxia. Therefore, vaccination in the 2nd-3rd trimester is not a recommendation, but a mandatory measure.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Age-related features of the disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Influenza in children, adults, and the elderly is three different clinical scenarios.<br \/>\n**In children under 5 years:**<br \/>\n\u2014 Often starts with vomiting and diarrhea \u2014 \"stomach flu\" (although this is an incorrect term);<br \/>\n\u2014 Temperature can reach 40.5 \u00b0C, febrile seizures are possible;<br \/>\n\u2014 High risk of otitis media (up to 30% cases) and bronchiolitis;<br \/>\n\u2014 Children under 2 years may not have a pronounced cough \u2014 instead, there may be apathy, refusal to eat, respiratory failure.<br \/>\n**In adults aged 18\u201365:**<br \/>\n\u2014 Classic picture: fever, body aches, cough;<br \/>\n\u2014 The risk of complications is lower, but not zero \u2014 especially with overexertion or chronic diseases;<br \/>\n\u2014 Often underestimate the severity and go to work \u2014 becoming a source of spread.<br \/>\n**In individuals over 65 years old:**<br \/>\n\u2014 Temperature may be subfebrile (37.2\u201338.0 \u00b0C) or even normal \u2014 \"afebrile flu\";<br \/>\n\u2014 Main symptoms \u2014 weakness, confusion, shortness of breath;<br \/>\n\u2014 Very high risk of pneumonia and decompensated heart failure;<br \/>\n\u2014 Mortality in this group \u2014 up to 90% of all fatal cases.<br \/>\nImportant: in elderly people, the immune response is \"blunter\" \u2014 fewer interferons, slower antibody production. Therefore, vaccination should not just be done, but done correctly: it is better to use adjuvanted or high-dose vaccines (for example, Fluad\u00ae or Fluarix Tetra\u00ae with adjuvant MF59).<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\"><\/span>Questions and Answers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong>Question 1: Why does the flu vaccine not provide 100% protection?<\/strong><br \/>\nBecause the virus mutates in two ways: antigenic drift (small changes in hemagglutinin and neuraminidase) and antigenic shift (sharp change of subtype during recombination in pigs or birds). The vaccine is prepared 6\u20138 months before the season, based on WHO forecasts. If the virus is \"guessed\" inaccurately \u2014 effectiveness drops to 40\u201350%. But even in this case, the vaccine reduces the severity of the disease and the risk of hospitalization.<br \/>\n<strong>Question 2: Can you get the flu twice in one season?<\/strong><br \/>\nYes. First, there are two types of virus \u2014 A and B. Several subtypes circulate during the season (for example, A\/H1N1 and A\/H3N2, plus two lines of B). Having contracted flu A, you are not protected from B. Secondly, if you were ill at the beginning of the season, and then a new strain with antigenic drift appears \u2014 immunity may not recognize it. This is especially relevant for children and the elderly.<br \/>\n<strong>Question 3: How to distinguish flu from ARVI without tests?<\/strong><br \/>\nCompare based on three points:<br \/>\n1. Onset: flu \u2014 acute (1\u20132 hours), ARVI \u2014 gradual (1\u20132 days);<br \/>\nTemperature: flu \u2014 38.5\u201340 \u00b0C, ARVI \u2014 up to 38.5 \u00b0C;<br \/>\nSymptoms: flu is dominated by aches, headache, weakness; ARVI \u2014 runny nose, sneezing, scratchy throat.<br \/>\nIf the symptoms correspond to the flu and it is currently the epidemic season \u2014 the probability is high. But a test is needed for an accurate diagnosis.<br \/>\n<strong>Question 4: Is it necessary to take antivirals if the temperature has already dropped?<\/strong><br \/>\nIf more than 48 hours have passed since the onset of symptoms \u2014 the benefit is minimal. Exception: a patient from a risk group (pregnant, elderly, with chronic diseases) and there are signs of deterioration (shortness of breath, decreased saturation). Then the doctor may prescribe a course even on days 3\u20135 \u2014 for the prevention of complications.<br \/>\n<strong>Question 5: Why is flu more common in winter?<\/strong><br \/>\nNot directly because of the cold. It is due to three factors:<br \/>\n1. The virus is more stable at low temperatures and low humidity (the air in heated rooms \u2014 20\u201330% humidity, ideal for the virus's survival in aerosol);<br \/>\n2. People spend more time in enclosed spaces, closely interacting;<br \/>\n3. Sunlight is weaker \u2014 less vitamin D, reduced production of interferons.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A2%D0%B8%D0%BF%D0%B8%D1%87%D0%BD%D1%8B%D0%B5_%D0%BE%D1%88%D0%B8%D0%B1%D0%BA%D0%B8_%D0%BF%D1%80%D0%B8_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B8_%D0%B3%D1%80%D0%B8%D0%BF%D0%BF%D0%B0_%D0%B8_%D0%BA%D0%B0%D0%BA_%D0%B8%D1%85_%D0%B8%D0%B7%D0%B1%D0%B5%D0%B6%D0%B0%D1%82%D1%8C\"><\/span>Typical mistakes in treating influenza and how to avoid them<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>1. <strong>Error: \"I'll take aspirin - it will quickly reduce the temperature.\"<\/strong><br \/>\n <em>Consequences:<\/em> in children - Reye's syndrome (acute liver failure + encephalopathy), in adults - gastrointestinal bleeding.<br \/>\n <em>How to avoid:<\/em> use paracetamol or ibuprofen. Aspirin - only as prescribed by a cardiologist for coronary artery disease.<br \/>\n2. <strong>Error: \"I've had a fever for three days - I urgently need antibiotics.\"<\/strong><br \/>\n <em>Consequences:<\/em> dysbiosis, resistance, allergy. Antibiotics do not work against viruses.<br \/>\n <em>How to avoid:<\/em> wait 5-7 days. If the cough has become wet, purulent sputum has appeared, the temperature has risen again - then see a doctor for assessment of bacterial infection.<br \/>\n3. <strong>Error: \"I got vaccinated last year - so I don't need it this year.\"<\/strong><br \/>\n <em>Consequences:<\/em> lack of protection against new strains, risk of severe course.<br \/>\n <em>How to avoid:<\/em> vaccination annually, ideally in September\u2013October. Even if the season has already started \u2014 the vaccine is still beneficial.<br \/>\n4. <strong>Mistake: \u201cI feel better \u2014 I\u2019m going to work.\u201d<\/strong><br \/>\n <em>Consequences:<\/em> virus spread, relapse, complications (myocarditis against the background of physical exertion)<br \/>\n <em>How to avoid:<\/em> rest for at least 5 days after normalization of temperature. Even if \u201cthe strength has returned\u201d \u2014 the heart and lungs are still recovering.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%97%D0%B0%D0%BA%D0%BB%D1%8E%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Conclusion<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The flu returns every year not because of our laziness or bad weather \u2014 but because the virus can change faster than we can \u201cremember\u201d it. Its genetic plasticity is not a weakness, but an evolutionary survival strategy. But we are not helpless. Vaccination, timely antiviral treatment, hand hygiene, and airspace hygiene \u2014 all of this works. The main thing is not to wait until it gets bad, but to act in advance: get vaccinated in the fall, know the symptoms, be able to distinguish flu from ARVI, and not be afraid to see a doctor in the first days.<br \/>\nIf you are a parent of a small child, an elderly person, or suffer from a chronic illness \u2014 your prevention should be more serious than that of others. Don\u2019t skimp on the vaccine. Don\u2019t ignore the first signs. And remember: the flu is not \u201cjust a cold.\u201d It is a serious infection that can and should be controlled. And I, Dr. Korzhikov, hope that this article will help you not just learn more \u2014 but make the right decision at the right moment.<\/p>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Influenza is not just a \"cold with a fever.\" It is an acute viral respiratory disease that annually claims tens of thousands of lives<\/p>","protected":false},"author":1,"featured_media":24337,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[298],"tags":[],"class_list":["post-17675","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medlibrary"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/17675","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=17675"}],"version-history":[{"count":2,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/17675\/revisions"}],"predecessor-version":[{"id":19414,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/17675\/revisions\/19414"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media\/24337"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=17675"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=17675"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=17675"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}