Influenza (Additional infos) Contraindications with vaccinations

1. Pts with anaphylactic hypersensitivity reactions to eggs

 Influenza A and B can cause epidemics
 affects all ages
 persons aged ≥50 years, young children, and persons
of any age with certain underlying health conditions
 healthy children under two years old were more likely to
be hospitalized for serious complications of influenza
 pneumonia, acute bronchiolitis, acute otitis media
and myositis than older, healthy children.
2. Pts with acute febrile illness until their symptoms have
subside.
Timing for Vaccinations
1. Once a year around February to June
2. Must be given to pts who undergo chemotherapy after
2weeks of discontinuation
3. Delayed for children in high-dose steroid therapy
(2mg/kg/day) of more than 2 weeks

Diagnosis of Influenza
 Influenza-like illness (ILI) - Acute respiratory illness with
fever and other systemic manifestations within the past
three days.
 Influenza - abrupt onset of constitutional and respiratory
signs and symptoms
 fever,
 Myalgia
 Headache
 severe malais
 nonproductive cough
 sore throat
 Rhinitis
 typically resolves after a limited number of days for
the majority of persons, although cough and malaise Route of Administration
can persist for >2 weeks. - Either IM or SQ in the anterolateral part of thigh (infants)or
 Confirmed by viral culture, antigen detection or Deltoid muscle
polymerase chain reaction (PCR).
*Vaccine can be administered along with other vaccines
Vaccination/ Immunization *It takes approximately 2 weeks for antibodies to develop after
 Influenza vaccine has been shown to prevent illness in vaccination is given
approximately 70-90% of healthy persons less than 50
years old. Medications
 the vaccine lowers the risk of severe disease and  Use of antiviral drugs is not a replacement to vaccination
complications in elderly adults. in the prevention of influenza.
 Children age as young as 6 months can develop
protect ion after influenza vaccination preventing Supportive Mgt
complications of influenza.  Patients with uncomplicated influenza, patient is advised
 Vaccine is inactivated influenza vaccine to rest at home, rehydration, and antipyretics for fever
Target Groups for vaccinations of >37.5
1. At risks for complications  Avoid aspirin
a) >/= 50yo Antibiotics
b) Children from 6 - 23 months old  Not usually given unless there’s bacterial respiratory
c) Pts with risks factors: complications
i. Chronic CVD  If patient show signs of secondary lung infection within 72
ii. Chronic Lung dse hours
iii. Chronic Metabolic dse Antiviral Agents
iv. Chronic Renal dysfunction  Amantadine and Rimantadine is only effective against
v. Hemoglobinopathies influenza A
d) Immunosuppressed pts  Oseltamivir is only effective against influenza A and B.
e) Those who are receiving long-term aspirin therapy  Indicated ans chemoprophylaxis agaainst influenza A
f) Residents of nursing homes and care facilities and B for individuals 13yo and above
g) Pregnant pts on 2nd or 3rd trimester w/o flu vaccine **Only amantadine and oseltamivir are listed in the Philippine
within last 12 mos. National Drug Formulary and are available in the Philippines.
2. Other groups
a) Especially those who are working in poultry farms
b) Healthcare workers (See table)
Patients who may be given antiviral agents
1. Children and nonpregnant adolescents at high risk of complications
2. Children and adolescents with severe influenza
3. Those who are in contact with people at high risk

Timing and Duration

 should be given within the first 48 hours of illness to reduce the duration of uncomplicated influenza.
 High-risk or severely ill patients seen after 48 hours may still be given an antiviral agent.
 Treatment should be continued for 5 days or for 24 to 48 hours after acute symptoms resolve in immunocompetent patients.
 Antiviral treatment may be prolonged for immunocompromised patients.