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医者の男

インフルエンザの二峰性発熱とは

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インフルエンザというと一度高熱が出て、しばらく休むと熱が下がるというものだと思っている人が多いのではないでしょうか。

インフルエンザは、38度以上の高熱、喉の痛み、咳、鼻水、関節痛、倦怠感といったものが急激におこり、次第に治っていくとされています。しかし、時には気管支炎や肺炎といった合併症にもつながることもあるため、きちんと症状を見ておくことが大切です。

ただし、インフルエンザには一度熱が下がったと思っても再び熱が上がるものもあります。

インフルエンザの合併症と再度の発熱(二峰性発熱と呼ばれます)について知識がなければ、もう一度熱が高くなったときに、どうしたらいいのかわからずに慌ててしまうかもしれません。そこで、本記事ではインフルエンザの二峰性発熱についてご紹介していきます。

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二峰性発熱とは

医師

二峰性発熱とは「インフルエンザの治療を開始して一度解熱するも、解熱24時間以上経過した後に再度発熱を呈する経過」とされており、なんらかの病気が誘発された合併症とは異なるものです。

乳幼児がいる親御さんは、二峰性発熱という言葉を聞いたことがあるのではないでしょうか。二峰性発熱はまだインフルエンザにかかったことのない6カ月以降の乳幼児、特に1歳前後から9歳を中心に多くみられるため、子供だけの症状で大人には関係ないと思っている人がいるかもしれません。しかし、稀にですが、大人のインフルエンザでも発生することがあります。

二峰性発熱の原因は定かになってはいませんが、

  • インフルエンザウイルスそのもの
  • ウイルス抑制因子のインターフェロン
  • 免疫や炎症反応に重要なサイトカイン
  • 免疫機能の未熟さ

などが原因ではないかと言われています。

二峰性発熱の研究

ここ2年ほど話題に上がっている二峰性発熱ですが、様々な研究により少しずつ詳細がわかってきました。そこで、二峰性発熱に関するものをご紹介していきます。

インフルエンザの型による発生率

日本臨床内科医会のインフルエンザ診療マニュアルによると、ここ2シーズンのインフルエンザ患者全体の6.9%に二峰性発熱が、その中でもA型は3.7%、B型は19.0%に出ると言われています。

二峰性発熱の他に、熱が下がりにくい還延性もB型には多いとされています。B型のインフルエンザはよく治りにくいと言われていますが、このようなこととも関係が深そうです。

イナビルは二峰性発熱が出やすい?

北海道大学病院の石黒信久氏によると、同じ吸入薬であるリレンザとイナビルでは、イナビルで治療した患者に二峰性発熱が出やすいとのことです。

リレンザを使用した5~18歳の子供と、イナビルを使用した5~16歳の子供を比較すると、吸入開始から解熱までの時間は大きな差はありませんでした。しかし、二峰性発熱をした子供を比較すると、リレンザが1.8%、イナビルが8.9%と大きな差が出たのです。

このような結果が出た理由としては、リレンザが1日2回吸入するのに対し、イナビルは1日1回の吸入で済む点が関係しているのではないかと言われています。特に小さなお子さんは十分な吸入がしっかりとできないケースもあり、それが二峰性発熱につながる可能性もあるとのことでした。

服用薬と違って吸入薬は多少複雑ですが、きちんと吸入できるように説明書の指示を守って使っていきたいものですね。

二峰性発熱と合併症との違い

二峰性発熱は大体2~5日間ほど高熱が出てから半日~1日平熱に下がり、それからまた半日~1日程度発熱という形になります。発熱は一時的で、長期間熱が続くことはありませんが、もし長引くようだったり症状が酷いようなら再度病院へ行き、相談してみましょう。

二峰性発熱とは異なり、インフルエンザの合併症のときは下記のような症状を伴うことがあります。

  • 痙攣がおこる
  • 意識障害が出る
  • うわごとをいう
  • 頑固な咳が続く
  • 息が苦しい
  • 高熱が続く
  • 耳が痛くなる

このようなインフルエンザと直接関係のないような症状が出ている場合、病院で診断を受けることが推奨されます。気管支炎、肺炎、中耳炎などの細菌による二次感染は抗生物質により対処します。熱性けいれんの場合ひきつけ止めの座薬を処方されます。

他にもウイルスそのものによる肺炎などもありますが、その中でも特に恐ろしいインフルエンザ脳症は、発熱後48時間以内に発症し、命を落とすこともある重篤な病気です。短時間でけいれんを繰り返す、痙攣時間が長い、うわごとを繰り返す、意識障害が酷いといった症状があるときは早めに病院で診断を受けましょう。

一生インフルエンザにかからない体質の作り方
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まとめ:

ここまででインフルエンザの二峰性発熱についてご紹介してきました。インフルエンザの二峰性発熱について下記にまとめてみました。

  • インフルエンザは2回熱が出ることがある
  • 乳幼児に多いが、稀に大人にもおこる
  • インフルエンザB型におこりやすいとされる
  • リレンザのほうがイナビルより起こりにくい傾向がある
  • 半日~1日で熱が下がる

小さな子供はまだ身体が未熟なため、インフルエンザによる2度の発熱が多くみられます。これらの情報をもとに、インフルエンザで二峰性発熱が出たとしても、慌てずに対処できるのではないでしょうか。

しかし、二峰性発熱はまだ原因も特定できていません。そのため、これからも多くの研究が発表されていくことでしょう。私たちは、常にそれらの新しい知識へのアンテナを張り、対処することが必要になってくるのではないでしょうか。

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Check Also

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