July 24, 2016
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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 2015-2016

  1. All people aged ≥6 months should receive influenza vaccine annually. Influenza vaccination should not be delayed to procure a specific vaccine preparation if an appropriate one is already available.
  2. For healthy children aged 2 through 8 years who have no contraindications or precautions, either LAIV (nasal spray live attenuated vaccine) or IIV (injection vaccine) is an appropriate option. No preference is expressed for LAIV or IIV for any person aged 2 through 49 years for whom either vaccine is appropriate. An age-appropriate formulation of vaccine should be used.
  3. LAIV should not be used in the following populations:
    • People aged <2 years or >49 years;
    • People with contraindications listed in the package insert:
      • Children aged 2 through 17 years who are receiving aspirin or aspirin-containing products;
      • People who have experienced severe allergic reactions to the vaccine or any of its components, or to a previous dose of any influenza vaccine;
    • Pregnant women;
    • Immunocompromised people (see also "Vaccine Selection and Timing of Vaccination for Immunocompromised People");
    • People with a history of egg allergy;
    • Children 2-4 years of age who have asthma or who have had a wheezing episode noted in the medical record within the past 12 months, or for whom parents report that a health-care provider stated that they had wheezing or asthma within the last 12 months. For people ≥5 years of age with asthma, recommendations are described in item 4 of this list;
    • People who have taken influenza antiviral medications within the previous 48 hours.
  4. In addition to the groups for whom LAIV is not recommended above, the "Warnings and Precautions" section of the LAIV package insert indicates that people of any age with asthma might be at increased risk for wheezing after administration of LAIV. The package insert also notes that the safety of LAIV in people with other underlying medical conditions that might predispose them to complications after wild-type influenza virus infection (for example, chronic pulmonary, cardiovascular [except isolated hypertension], renal, hepatic, neurologic, hematologic, or metabolic disorders [including diabetes mellitus]) has not been established. These conditions, in addition to asthma in people ≥5 years of age, should be considered precautions for the use of LAIV.
  5. People who care for severely immunosuppressed people who require a protective environment should not receive LAIV or should avoid contact with such people for seven days after receipt, given the theoretical risk for transmission of the live attenuated vaccine virus to close contacts.

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 4/28/2016

Source: MedicineNet.com

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