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Influenza
Prevention and Control
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Typical influenza illness
is characterized by abrupt onset of fever, myalgia, sore throat, and nonproductive
cough. Unlike other common respiratory illnesses, influenza can cause
severe malaise lasting several days. More severe illness can result if
either primary influenza pneumonia or secondary bacterial pneumonia occurs.
During influenza epidemics, high attack rates of acute illness result
in both increased numbers of visits to physicians offices, walk-in clinics,
and emergency rooms and increased hospitalizations for management of lower
respiratory tract complications, to say nothing of huge numbers of absences
from school and work.
Rates of influenza for children ages 5-14 years have ranged from approximately
20 per 100,000 population for those without high-risk conditions to 200
per 100,000 population for those with high-risk conditions.
In the United States, two measures are available that can reduce the impact
of influenza: immunoprophylaxis with inactivated (killed-virus) vaccine
and chemoprophylaxis or therapy with an influenza-specific antiviral drug
(amantadine or rimantadine). Vaccinating persons at high risk before the
influenza season each year is the most effective measure for reducing
the impact of influenza. Vaccination can be highly cost effective when
it is a) directed at persons who are most likely to experience complications
or who are at increased risk for exposure and b) administered to persons
at high risk during hospitalizations or routine health-care visits before
the influenza season, thus making special visits to physicians offices
or clinics unnecessary. Groups at Increased Risk for Influenza-Related
Complications:
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persons aged 65
years and older
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residents of nursing
homes and other chronic-care facilities housing persons who have chronic
medical conditions
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adults and children
who have chronic heart or lung disorders, including children with
asthma
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adults and children
who have required regular medical follow-up or hospitalization during
the preceding year because of chronic metabolic diseases (diabetes,
renal
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dysfunction, hemoglobinopathies,
or immunosuppression).
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children and teenagers
who are receiving long-term aspirin therapy and, therefore, might
be at risk for developing Reye syndrome
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women who will be
in the second or third trimester of pregnancy during the influenza
season
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Groups
that Can Transmit Influenza to Persons at High Risk
physicians, nurses, and other personnel in both hospital and outpatient-care
settings household members (including children) of persons in high-risk
groups, employees of nursing homes and chronic-care facilities who have
contact with patients or residents providers of home care to persons at
high risk (e.g., visiting nurses and volunteer workers)
Side Effects of Vaccine
Fever, malaise, myalgia, and other systemic symptoms can occur following
vaccination and most often affect persons who have had no exposure to
the influenza virus antigens, especially young children. Influenza vaccine
should not be administered to persons known to have anaphylactic hypersensitivity
to eggs or to other components of the influenza vaccine without first
consulting a physician.
(Anonymous. Prevention and control of influenza. Morbidity and Mortality
Weekly Report 1998; 47(RR-6):1-28)
Comment: Influenza vaccine can be
given to HIV+ individuals and breastfeeding mothers. School nurses should
urge parents of severe asthmatics to obtain this vaccine.
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