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INFLUENZA SEASON AHEAD! 2018-2019 Influenza Information Hamilton County Health Department Health Education Division www.hamiltoncounty.in.gov ---PAGE BREAK--- The Reader Will Be Able To… • List three of influenza. • Describe three ways influenza can be transmitted. • Name three types of influenza vaccines. • Identify three reasons why people can not receive the influenza vaccine. • Recall three ways influenza can be prevented. ---PAGE BREAK--- Influenza Information… • Influenza is a contagious respiratory illness caused by influenza viruses that infect the: – Nose – Throat – Lungs • It can cause mild to severe illness and at times can lead to death. • Influenza is also called the flu. ---PAGE BREAK--- How Is Influenza Transmitted? • Influenza is spread mainly by droplets made when people with flu cough, sneeze or talk. • These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. • Less often, a person might also develop influenza by touching a surface or object that has the virus on it and then touching his or her own mouth or nose. • People with influenza can spread it to others up to about 6 feet away. ---PAGE BREAK--- Period Of Contagion… • You may be able to pass influenza on to someone else before you know you are sick, as well as while you are sick. • Most healthy adults may be able to infect others beginning 1 day before develop and up to 5 to 7 days after becoming sick. • Some people, especially young children and people with weakened immune systems, might be able to infect others for an even longer time. ---PAGE BREAK--- • People who have influenza often feel some or all of these – Fever or feeling feverish/chilled – Cough – Sore throat – Runny or stuffy nose – Muscle or body aches – Headaches – Fatigue (very tired) – Some people may have vomiting and diarrhea, though this is more common in children than adults. • It’s important to note that not everyone with influenza will have a fever. Signs and of Influenza… ---PAGE BREAK--- When Does Flu Season Start ? • Seasonal flu activity usually peaks in January or February, but it can occur as early as October and as late as May. • The best way to prevent the flu is by getting a flu vaccine each year. ---PAGE BREAK--- Is The Stomach Flu Influenza? • Many people use “stomach flu” to describe illness with nausea, vomiting or diarrhea. • Many different viruses, bacteria, or parasites can cause these • While influenza can sometimes cause vomiting, diarrhea, and nausea—more commonly in children than adults — these problems are rarely the main of influenza. • Influenza is a respiratory disease and NOT a stomach or intestinal disease. Source: www.flu.gov ---PAGE BREAK--- Cold Or Flu Cold Flu Fever Rare Usually, can last 3-4 days. Headache Rare Common General aches and pains Slight Usually; often severe Fatigue, weakness Sometimes Usually; can last up to 2 to 3 weeks Extreme exhaustion Never Usually; at the beginning of the illness Stuffy nose Common Sometimes Sneezing Usually Sometimes Sore throat Common Sometimes Chest discomfort, cough Mild to moderate; hacking cough Common; can become severe Source; National Institute of Allergy and Infectious Disease ---PAGE BREAK--- People At High Risk For Developing Influenza… • All children 6 months to 5 years of age. • Adults over the age of 50 years old.. • Pregnant women or who will become pregnant during the 2018-2019 flu season. • Residents of nursing homes and other long-term care facilities. • American Indians and Alaskan Natives ---PAGE BREAK--- Other Groups At Risk For Developing Influenza… • People who have: – Asthma & Lung Disease – Heart Disease & Blood Disorders – Neurological Disorders – Kidney and Liver Disease – Diabetes – Weakened Immune Systems – Morbidly Obese – People under the age of 18 who are on long-term Aspirin Therapy. ---PAGE BREAK--- • People who live with or care for those at high risk for complications from influenza include: – All healthcare workers – Household contacts of persons at high risk for complications from the flu. – Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated). Groups In Contact With Persons At High Risk… ---PAGE BREAK--- Who Needs To Be Vaccinated… • Routine annual influenza vaccination is recommended for all person over the age of 6 months old who do not have contraindications. • Emphasis should be placed on the following groups to receive the influenza vaccine: – Children 6-59 months – Adults over the age of 50 – Persons with: • Chronic pulmonary, cardiovascular disorders • Neurological, hematologic or metabolic disorders • Women who are or will be pregnant during the influenza season. ---PAGE BREAK--- Who Should Not Receive An Influenza Vaccine? • People who have a severe allergy to chicken eggs. • People who have previously had a severe reaction to an influenza vaccination. • People who developed Guillain-Barré (GBS) within 6 weeks of getting an influenza vaccine. • Children less than 6 months of age (influenza vaccine is not approved for this age group). • People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.) ---PAGE BREAK--- When Should I Get My Influenza Vaccine ? • CDC recommends that influenza vaccination begin as soon as vaccine becomes available in the community and continue throughout the flu season. • It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza. Influenza season can begin as early as October. ---PAGE BREAK--- The Influenza Vaccine… • The single best way to prevent influenza is to get a vaccine each season. • There is two type of influenza vaccine: – Inactivated Influenza Vaccine= IIV (Killed) – Live Attenuated Influenza Vaccine= (Weakened) • New for the 2018-2019 Influenza Season. ---PAGE BREAK--- Special Consideration… • People with a history of egg allergy who have experienced only hives after exposure to eggs should receive the influenza vaccine. • People who report having had reaction to eggs involving other than hives (such as swelling under the skin, respiratory distress, light headedness, recurrent vomiting, or who require epinephrine or other emergency care) may receive the vaccine. The vaccine should be given in a medical setting that can manage severe allergic conditions. Source: MMWR, August 24, 2018 ---PAGE BREAK--- Special Consideration… • The influenza vaccine should not be given if someone has a history of a severe allergic reaction to the vaccine or any of its components. • Regardless of allergy history, all vaccines should be administered in settings where personnel and equipment for rapid recognition and treatment of anaphylaxis are available. Source: Immunization Action Coalition 2017-2018 ---PAGE BREAK--- Trivalent Flu Vaccine… • Trivalent Influenza Vaccine : – Contains two different influenza type A strains and one influenza type B strain. • an A/Michigan/45/2015 (H1N1)pdm09-like virus • an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus • a B/Colorado/06/2017 (Victoria lineage) Source: MMWR August 24, 2018 Influenza Vaccine For 2018-2019 Flu Season ---PAGE BREAK--- Quadrivalent Flu Vaccine… • Quadrivalent Influenza Vaccine: – Two different influenza type A strains and two influenza type B strain. • an A/Michigan/45/2015 (H1N1)pdm09-like virus • an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus • a B/Colorado/06/2017 (Victoria lineage) • B/Phuket/3073/2013-line virus (Yamagata lineage). Source: MMWR August 24, 2018 Influenza Vaccine For 2018-2019 Flu Season ---PAGE BREAK--- The Inactivated Influenza Vaccine … • Influenza Vaccine: – Inactivated vaccine (containing killed flu virus) that is given in the muscle with a needle. – Few influenza vaccine do contain thimerosal or other preservatives. • Influenza Vaccine For People Over 65 Years Of Age: – A high-dose vaccine for people 65 and older which is also given intramuscularly. It takes two weeks for protection after the vaccine is given. ---PAGE BREAK--- Live Attenuated Influenza Vaccine… • FluMist®: – A vaccine made with live, weakened flu viruses that is given as a nasal spray (sometimes called LAIV for “Live Attenuated Influenza Vaccine”). • This vaccine does not cause influenza. • Live Attenuated Influenza vaccine is approved for use in healthy people who have no contraindications or precautions and who are not pregnant. It takes two weeks for protection after the vaccine is given. ---PAGE BREAK--- Groups That Should Not Receive Live Influenza Vaccine … • Children younger than 2 years old. • Adults 50 years and older. • People with a history of severe allergic reactions to any component of the vaccine or to a previous dose of any influenza vaccine. • Children 2 years through 17 years of age who are receiving-or salicylate- containing medication. • People with weakened immune systems. • Children 2 years through 4 years who have asthma or who have a history of wheezing in the past 12 moths. ---PAGE BREAK--- The Live Influenza Vaccine Precautions… • Asthma in people aged 5 years and older. • Underlying medical conditions: – Lung disease – Heart disease – Kidney disease – Diabetes – Neurological/neuromuscular – Metabolic disorder – Guillain-Barré within 6 weeks following a previous dose of influenza vaccine. ---PAGE BREAK--- Inactivated Influenza Vaccine… • An intradermal vaccine for people aged 18 to 64 years is also available - which is injected into the “dermis” or skin with a shorter needle. • If you are interested in this vaccine, contact your health care provider. ---PAGE BREAK--- Children And Influenza Vaccine… • Older children need one dose of the flu vaccine each year. • Children aged 6 months through 8 years (who require 2 doses) should receive their first dose as soon as possible when the vaccine becomes available and the second dose 4 weeks later. • Ask your healthcare provider for more information. ---PAGE BREAK--- Children And Influenza Vaccine… Has the child received 2 doses of flue vaccine before July 1, 2018? (Does need not have been given during same or consecutive seasons). 1 dose of 2018-2019 influenza vaccine is needed. 2 doses of 2018-2019 influenza vaccine is needed. (Must be 4 weeks apart). Yes No Source: MMWR August 24, 2018 ---PAGE BREAK--- What Are The Side Effects Of The Influenza Vaccine ? • Mild side effects include: – Soreness, redness, or swelling at the vaccination site – Hoarseness, cough – Red or itchy eyes – Fever, body aches, and fatigue – Headaches – Itching If these develop, they begin soon after vaccination and last 1-2 days. ---PAGE BREAK--- How To Prevent Influenza… • Avoid close contact with people who are sick. • When you are sick, keep your distance from others to protect them from getting sick too. • Cover your mouth and nose when coughing or sneezing. ---PAGE BREAK--- How To Prevent Influenza… • Wash your hands. – Washing your hands often will help protect you from germs. • Avoid touching your eyes, nose or mouth. – Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. • Practice other good health habits. – Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. ---PAGE BREAK--- How To Wash Your Hands… Source: City of Ottawa ---PAGE BREAK--- 1. Place a drop of alcohol-based hand antiseptic, the size of a dime in your palm. 2. Rub hands together; palm to palm. 3. Rub back of each hand with palm and interlaced fingers of the other hand 4. Rub around each thumb clasped in the opposite hand. 5. Rub fingertips of each hand backward and forward in the opposite hand. 6. Keep rubbing until your hands are dry. Paper towels are not needed Source: City of Ottawa How To Use Hand Antiseptics… ---PAGE BREAK--- Cover Your Cough… • Cover your mouth and nose with a tissue when you cough or sneeze. • Cough or sneeze into your upper sleeve, not your hands, when a tissue is not available. • Put your used tissue in the waste basket. • Clean your hands after coughing or sneezing. • Wash with soap and water or alcohol- based hand sanitizer. ---PAGE BREAK--- Antiviral Drugs And Flu… • When used for treatment, antiviral drugs can lessen and shorten the time you are sick by 1 or 2 days. • They also can prevent serious influenza complications. • Antiviral drugs work best for treatment when they are started within 2 days of getting sick. – However, starting them later can still be helpful, especially if the sick person has a high risk health condition or is very sick from the flu. • Treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness. • Developing influenza could result in a hospital stay for people with a high risk medical condition. ---PAGE BREAK--- Antiviral Drugs And Flu… • There are three antiviral drugs recommended this season. • Tamiflu®, Relenza® and Rapivab® are usually prescribed for 5 days, although people hospitalized with the influenza may need the medicine for longer than 5 days. ---PAGE BREAK--- What If I Get Sick? • Most people with influenza have mild illness and do not need medical care or antiviral drugs. • In most cases, people who get sick with influenza should STAY HOME and avoid contact with others unless they need medical care. • If you have of influenza and are very sick or worried about your illness, contact your healthcare provider. ---PAGE BREAK--- How Long Should I Stay Home ? • Stay home for at least 24 hours after your fever has subsided except to get medical care or do other things no one else can do for you. • Your fever should be gone without the use of a fever-reducing medicine. • You should stay home from work, school, travel, shopping, social events, and public gatherings. ---PAGE BREAK--- Influenza Emergencies In Infants… • If your infant has any of the following call their healthcare provider IMMEDIATELY: – Inability to eat. – Trouble breathing. – No tears when crying. – Significantly fewer wet diapers than normal. ---PAGE BREAK--- Influenza Emergencies In Children… • If your child has any of the below, call his or her healthcare provider IMMEDIATELY: – Fast or troubled breathing – Bluish skin color – Not drinking enough fluids – Not waking up or not interacting – Being so irritable that the child does not want to be held – Influenza-like improve, but then return with fever and worsened cough – Fever with rash ---PAGE BREAK--- Influenza Emergencies In Adults… • If you have any of the below, call your healthcare provider IMMEDIATELY: – Difficulty breathing or shortness of breath. – Pain or pressure in the chest or abdomen. – Sudden dizziness – Confusion – Severe or persistent vomiting – Flu-like improve, but then return with fever and worsened cough. ---PAGE BREAK--- Remember… • Wash your hands! • Cover your cough! • Stay home if you are sick! ---PAGE BREAK--- Sources… • Advisory Committee on Immunization Practices (ACIP) • Center For Disease Control and Prevention • Immunization Action Coalition • National Institute of Allergy and infectious disease • Morbidity and Mortality Weekly Report, August 24, 2018 • Vaccine Information Statement “Influenza Vaccine 2018-2019” • World Health Organization