Acute respiratory infections (ARIs) are classified as upper respiratory tract infections (URIs) or lower respiratory tract infections (LRIs). The upper respiratory tract consists of the airways from the nostrils to the vocal cords in the larynx, including the paranasal sinuses and the middle ear.

1. ACUTE RESPIRATORY
INFECTION
Submitted by,
Manimegalai.G
B.Pharm IV Year
Social and PreventivePharmacy.

2. What is ARI?
Acute respiratory infection is an infection that may
interfere with normal breathing. It can affect just your
upper respiratory system, which starts at your sinuses
and ends at your vocal cords, or just your lower
respiratory system, which starts at your vocal cords
and ends at your lungs.

3. Anatomy Of Respiratory Tract

4. CAUSATIVE ORGANISMS
 Rhinoviruses,
 Respiratory syncytial virus,
 Influenza virus,
 Parainfluenza virus,
 Human metapneumovirus,
 Measles,
 Mumps,
 Adenovirus,
 Coronaviruses.

5. Symptoms of ARI
 Congestion, either in the nasal sinuses or lungs.
 Runny nose.
 Cough.
 Sore throat.
 Body aches.
 Fatigue.

9. Mode of Transmission
Airborne droplets spread when the sick person
coughs or sneezes, and inhaled into the lungs
(breathed in) by a susceptible person

10. Control of ARI
 Improving the primary medical care services and
developing better methods for early detection ,
treatment and prevention of acute respiratory
infection is the best way to control ARI .
 Mortality rate due to pneumonia is reduced if treated
correctly.
Education of mothers about pneumonia because
compliance with treatment and seeking proper care
when child suffers determine outcome of the disease.

11. Management of ARI
 WHO recommendation for management of ARI
a. Clinical assessment
b. Physical examination

12. Clinical Assessment
History taking and management are very important .
Note :
1)age
2)feeding habits
3)fever
4)convulsions
5)irregular breathing
6)history of treatment during the illness
7)activity

13. Physical examination

14. Physical Examination

15. Cont..
Malnutrition :
If malnutrition is present its high risk and case
fatality rates are higher .
In severely malnourished:
1) Children with pneumonia, fast breathing and chest
indrawing may not be evident
2) Impaired or absent response to hypoxia and a weak
or absent cough reflex
3) Careful evaluation and management

16. Prevention of ARI

17. Prevention Of ARI
Breastfeeding infants exclusively (no other food or
drinks, not even water) for the first six months breast
milk has excellent nutritional value and it contains the
mother’s antibodies which help to protect the infant
from infection.
Avoiding irritation of the respiratory tract by indoor
air pollution, such as smoke from cooking fires; avoid
the use of dried cow dung as fuel for indoor fires.

18. Immunization
• Immunization also increases control, by reducing the
reservoir of infection in the community and
increasing the level of herd immunity.
a. Measles vaccine
b. HIB vaccine
c. Pneumococcal vaccine
d. Pcv-7

19. Measles Vaccine
Pneumonia is a serious complication of measles
Reducing the incidence of measles helps reduce death
from pneumonia
 Live attenuated vaccine Freeze dried product 0.5ml
dose subcutaneously also effective intramuscularly
Schedule : 9th month

20. HIB vaccine
Haemophilus influenza B most important cause of
death due to meningitis and pneumonia in developing
countries
 Available for more than a decade Expensive Included
in the IAP immunization schedule combined
preparation with DPT and poliomyelitis
 Three or four doses are given depending on type of
vaccine Schedule: 6 ,10, 14 weeks booster dose 12-18
months Vaccine is not offered to children more than
24 months

21. Pneumococcal vaccine
ppv23: polysaccharide non conjugate vaccine
containing capsular antigen of 23 serotypes against
this infection
Children under two years and immunocompromised
do not respond well to this vaccine
 Select groups –sickle cell disease ,chronic heart
disease , DM, organ transplants etc
 Dose -0.5ml
Administration – intramuscular in the deltoid

22. PCV 7 vaccine
Pneumococcal conjugate vaccine is a new vaccine
suitable for infants and toddlers
 It is included in the IAP immunization schedule
 Induces a t- cell dependent immune response
 Prevents pneumococcal pneumonia and meningitis
moderately effective against otitis media
 Dose- 6,10,14 weeks ,booster after 12 months OR
2, 4,6 months and booster after 12 months
Administration-intramuscular

23. WHO RESPONSE
In 2003, WHO's Division of Child and Adolescent
Health convened a meeting to review data and
evidence from recent ARI case-management studies
and to suggest the following revisions to case-
management guidelines and future research priorities:
Improve the specificity of clinical diagnostic criteria.
Reassess WHO's current recommended criteria for
detecting and managing treatment failure, given the
high rates of therapy failure.