influenza - dr sing

how is flu spread?

mainly: large-particle respiratory droplets

also: touching contaminated surfaces

what is the period of contagiousness for influenza?

day 1 of becoming infected to 5-7 days after symptoms are present

you can infect another individual before signs and symptoms begin

what groups should be provided antiviral treatment?

confirmed or suspected influenza who:

-are hospitalized

-high risk of complications

-severe, progressive, or complicated illness

who may be considered for antiviral treatment?

symptomatic pts with confirmed/suspected influenza who are:

-previously healthy outpatients NOT at high risk of complications within 48 hours after symptom onset

-outpatients or healthcare providers who have contact with persons who are at high risk of complications

when do you initiate post-exposure prophylaxis?

within 48 hours of exposure to person infected with influenza virus

when do you do pre-exposure prophylaxis?

very high risk individuals (severely immunocompromised)?

who is a candidate for antiviral prophylaxis?

a. very high risk of complications who has been exposed to infected person

b. immunosuppressed pt who has NOT been exposed to infected person

c. immunosuppressed pt who has been exposed to infected person

d. institutionalized pts and unvaccinated staff of an affected unit or ward during an outbreak at the facility

a.

b.

d.

know your abbreviations!!!!

IIV

RIV

LAIV

IIV: inactivated

RIV: recombinant

LAIV: live attenuated

know your abbreviations!!!!! prefixes for IIVs

a:

cc:

HD:

SD:

a: adjuvanted

cc: cell culture-based

HD: high dose

SD: standard dose

who is an annual influenza vaccine recommended for?

≥ 6 months old without contraindications

in what population is there a vaccine preference type?

age ≥ 65 yo

HIGH DOSE

what influenza vaccines should age ≥ 65 yo get?

HD-IIV (fluzone HD)

RIV (flublok)

aIIV (fluad)

what influenza vaccines are NOT manufactured with eggs?

RIV (flublok)

ccIIV (flucelvax)

if someone has an egg allergy (mild-moderate reaction), what do you do?

administer any influenza vaccine

if someone has an egg allergy (severe reaction), what do you do?

administer any influenza vaccine

administer in a medical setting under direct supervision

what age is LAIV (FluMist) recommended for?

2 - 49 years

what route is LAIV (FluMist) administered?

intranasal sprayer

what is the main contraindication for ALL flu vaccine types?

history of a severe allergic reaction to any flu vaccine or any component of the vaccine

T/F thimerosal has no evidence of a link to autism

TRUE

DUMB ANTI-VAXXER BITCHES

what are the adverse effects of IIV?

hint: IM injection

injection site reactions

what are the adverse effects of LAIV?

hint: intranasal sprayer

runny nose

nasal congestion

respiratory distress

what is Guillan-Barre syndrome (GBS)?

rare autoimmune disorder in which the bodies immune system attacks the nervous system

what is GBS more likely to result from?

a. immunizations

b. infections

b.

list the antivirals that require renal dose adjustment

oseltamivir

peramivir

what is the preferred antiviral in pregnancy?

oseltamivir

how is zanamivir administered?

who needs to avoid it?

inhalation

avoid in underlying airway disease: asthma/COPD

how is peramivir administered?

IV x 1 dose

how is baloxavir administered?

oral x 1 dose

what antivirals are indicated for prophylaxis of influenza?

oseltamivir

zanamivir

what is the treatment duration for oseltamivir and zanamivir?

5 days

what is the treatment duration for peramivir and baloxavir?

1 dose