Influenza 2017 -18: What You Should Know
By CareerSmart® Learning Contributor, as published by Healthcare Hot Spot
It’s that time of year again—flu season. Is that sneezing, sniffling, sore throat and headache just a cold, or is it the flu? It’s important to know the answer. As people cough, sneeze, talk, and unknowingly share their bounty, tiny droplets of flu virus can find a home in someone else’s mouth or nose, or land on a surface or object nearby. Once a healthy person has touched a surface or object that harbors the flu virus, it only takes a swipe to their own nose, mouth, or eyes to be the next victim.
Colds and flu are both respiratory illnesses with similar symptoms, but caused by different viruses. Rhinoviruses are most often to blame for the common cold. On the other hand, flu viruses are constantly changing.
What about the symptoms? Colds are characterized by a gradual onset of symptoms that include runny or stuffy nose, sore throat, sneezing, mild to moderate chest discomfort and cough; and rarely, a headache or fever. On the other hand, influenza has an abrupt onset of symptoms usually within one to four days after exposure. Flu symptoms generally include fever for three to four days, chills, chest discomfort and cough that can be severe, muscle and body aches that can be severe, fatigue or weakness, headaches, and sometimes, sneezing, stuffy nose and sore throat. Vomiting and diarrhea may also occur, but are more common in children. Most people with the flu are contagious in the first three to four days after symptoms begin, but a person can infect others one day before they have symptoms, and up to five to seven days after illness starts. For some children and others with lowered immunity, flu virus may remain active even longer.
Healthcare providers may diagnose influenza based on physical symptoms combined with clinical assessment. If there is a flu outbreak, of if flu is suspected in someone who is pregnant, has a weakened immune system, or has other comorbidities of concern, the healthcare provider may perform a flu test for a more accurate diagnosis. The most common flu tests involve swabbing the back of the throat or inside of the nose. Rapid influenza diagnostic tests (RIDTs) can provide results within 10-15 minutes, but may not be as accurate as other tests, sometimes returning a negative result when a person actually has the flu. Rapid molecular assays can detect viral genetic material and provide more accurate results in 15-20 minutes. More specialized influenza testing can be performed in hospitals and public health laboratories.
Those at high risk of flu-related complications should contact their healthcare provider as soon as possible after symptoms develop. The Centers for Disease Control and Prevention recommends starting antiviral drug treatment within two days of onset of symptoms for the greatest effectiveness. However, the option exists to start an antiviral drug later for someone who is very sick or at high risk for complications. Antiviral drugs can lessen influenza symptoms, shorten the severity of the illness, and help prevent serious complications, such as pneumonia.
CDC has approved three antiviral drugs for treatment of influenza this season: Oseltamivir (Tamiflu®), zanamivir (Relenza®) and peramivir (Rapivab®). The medications are available in different forms: generic oseltamivir as a pill; Tamiflu® as a pill or liquid; Relenza® as an inhaled powder, but not recommended in those with COPD or asthma; and Rapivab®, administered intravenously by a healthcare professional.
Flu-related complications can occur with anyone, but are more likely in people over the age of 64, young children, pregnant women, people who live in long-term care facilities, American Indians and Alaska Natives, and those with chronic comorbidities such as diabetes, heart disease, asthma, chronic lung disease, and those with weakened immune systems. Complications range from sinus or ear infections, to serious issues, such as pneumonia, myocarditis, encephalitis, myositis, rhabdomyolysis, sepsis, and multi-organ failure.
For otherwise healthy people who get the flu, medical care and antivirals may be unnecessary. Recommended treatment includes avoiding other people as much as possible to keep from infecting them, staying home for at least 24 hours after fever is gone, wearing a facemask if you must leave home, use of a fever-reducing medicine as necessary, covering coughs and sneezes with a tissue, and washing hands often.
The best treatment for influenza is prevention. A flu vaccine is the first line of defense in protection, and can reduce the risk of flu illness. CDC recommends an annual flu vaccine for everyone six months and older, occurring before the onset of influenza in the community, and preferably before the end of October. Flu vaccines are approved for use based on age, health, and allergies, and include inactivated influenza vaccine (IIV) or the recombinant influenza vaccine (RIV). The live attenuated influenza vaccine (LAIV), also referred to as nasal spray flu vaccine, should not be used this year.
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Centers for Disease Control and Prevention. (2017, October). Diagnosing Flu. Retrieved November 01, 2017 from https://www.cdc.gov/flu/about/qa/testing.htm
Centers for Disease Control and Prevention. (2017, October). Flu Symptoms & Complications. Retrieved November 01, 2017 from https://www.cdc.gov/flu/consumer/symptoms.htm
Centers for Disease Control and Prevention. (2017, October). How Flu Spreads. Retrieved November 01, 2017 from https://www.cdc.gov/flu/about/disease/spread.htm
Centers for Disease Control and Prevention. (2017, February). The Flu: What To Do If You Get Sick. Retrieved November 01, 2017 from https://www.cdc.gov/flu/takingcare.htm
Centers for Disease Control and Prevention. (2017, January). What You Should Know About Flu Antiviral Drugs. Retrieved November 01, 2017 from https://www.cdc.gov/flu/antivirals/whatyoushould.htm
Centers for Disease Control and Prevention. (2017, September). 2017-18 Summary of Recommendations. Retrieved November 02, 2017 from https://www.cdc.gov/flu/professionals/acip/2017-18summary.htm