May 28, 2017
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Influenza (cont.)

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When should a person go to the emergency department for the flu?

The CDC urges people to seek emergency medical care for a sick child with any of these symptoms or signs:

  1. Fast breathing or trouble breathing (shortness of breath)
  2. Bluish or gray skin color
  3. Not drinking enough fluids
  4. Severe or persistent vomiting
  5. Not waking up or not interacting
  6. Being so irritable that the child does not want to be held
  7. Flu-like symptoms improve but then return with fever and cough

The following is the CDC's list of symptoms that should trigger emergency medical care for adults:

  1. Difficulty breathing or shortness of breath
  2. Pain or pressure in the chest or abdomen
  3. Sudden dizziness
  4. Confusion
  5. Severe or persistent vomiting
  6. Flu-like symptoms improve but then return with fever and worse cough
  7. Having a high fever for more than three days is another danger sign, according to the WHO, so the CDC has also included this as another serious symptom.

Who should receive the flu vaccine, and who has the highest risk factors? When should someone get the flu shot?

In the United States, the flu season usually occurs from about November until April. Officials have decided each new flu season will start each year on Oct. 4. Typically, activity is very low until December, and peak activity most often occurs between January and March. Ideally, the conventional flu vaccine should be administered between September and mid-November. Flu season typically occurs between October and May. It takes about one to two weeks after vaccination for antibodies against influenza to develop and provide protection. The CDC has published a summary list of their current recommendations of who should get the current vaccine:

Summary of CDC influenza vaccination recommendations for 2016-2017

Routine annual influenza vaccination of all people aged ≥ 6 months without contraindications continues to be recommended. No preferential recommendation is made for one influenza vaccine product over another for people for whom more than one licensed, recommended product is otherwise appropriate. Updated information and guidance in this document includes the following:

  • In light of low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013-14 and 2015-16 seasons, for the 2016-17 season, ACIP makes the interim recommendation that LAIV4 (nasal spray) should not be used. Because LAIV4 is still a licensed vaccine that might be available and that some providers might elect to use, for informational purposes, reference is made to previous recommendations for its use.
  • The 2016-2017 U.S. trivalent influenza vaccines will contain an A/California/7/2009 (H1N1)-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (Victoria lineage). Quadrivalent vaccines will include an additional vaccine virus strain, a B/Phuket/3073/2013-like virus (Yamagata lineage).
  • Recent new vaccine licensures are discussed:
    • An MF59-adjuvanted trivalent inactivated influenza vaccine (aIIV3), Fluad (Seqirus, Holly Springs, North Carolina), was licensed by FDA in November 2015 for people aged ≥ 65 years. Regulatory information is available at http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/ucm473989.htm. aIIV3 is an acceptable alternative to other vaccines licensed for people in this age group. ACIP and CDC do not express a preference for any particular vaccine product.
    • A quadrivalent formulation of Flucelvax (cell culture-based inactivated influenza vaccine [ccIIV4], Seqirus, Holly Springs, North Carolina) was licensed by the FDA in May 2016 for people aged ≥ 4 years. Regulatory information is available at: http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm502844.htm. ccIIV4 is an acceptable alternative to other vaccines licensed for people in this age group. No preference is expressed for any particular vaccine product.
  • Recommendations for influenza vaccination of people with egg allergy have been modified, including the following:
    • Removal of the recommendation that egg-allergic recipients should be observed for 30 minutes postvaccination for signs and symptoms of an allergic reaction. Providers should consider observing all patients for 15 minutes after vaccination to decrease the risk for injury should they experience syncope, per the ACIP General Recommendations on Immunization (8).
    • A recommendation that people with a history of severe allergic reaction to egg (for example, any symptom other than hives) should be vaccinated in an inpatient or outpatient medical setting (including but not necessarily limited to hospitals, clinics, health departments, and physician offices), under the supervision of a health-care provider who is able to recognize and manage severe allergic conditions.

For more information and details too extensive to include here, the following site is recommended: http://www.cdc.gov/flu/professionals/acip/index.htm.

Medically Reviewed by a Doctor on 11/15/2016

Source: MedicineNet.com
http://www.medicinenet.com/influenza/article.htm

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