Lecture Notes on Influenza and Hepatitis

Influenza (Flu)

• 2025 Statistics:
  • 580,000 hospitalizations
  • 20,000 deaths
  • 168 pediatric deaths
• Vaccinations have improved the situation, but hesitancy remains a problem.
• Nurses play a crucial role in educating people about the flu and the importance of vaccination.

Symptoms

• Flu hits suddenly, unlike a cold which develops gradually.
• Common symptoms:
  • Headache
  • Fever (often high)
  • Body aches and joint aches
  • Runny or stuffy nose and nasal congestion
  • Sore throat
  • Cough
  • Sometimes vomiting, especially in children.

Types of Influenza

• Four types: A, B, C, and D
  • A, B, and C affect humans.
  • A and B are the most common.
  • Influenza C typically causes mild respiratory infections and isn't usually tested for.
  • Influenza D affects cattle (non-human).
• Influenza A and B are responsible for yearly flu epidemics and are what rapid flu tests detect.

Transmission

• Spread through droplet transmission: coughing, sneezing, talking.
• Touching contaminated surfaces (desks, doorknobs) also spreads the virus.

At-Risk Populations

• Elderly (65+): Vaccination is highly recommended.
• Young children: Known for spreading germs.
• Compromised immunity: People with weakened immune systems.
• Respiratory diseases: Individuals with asthma need to be cautious.
• Pregnant women: Flu can be particularly harmful.
• Myth: Getting the flu vaccine gives you the flu.
  • The vaccine can cause side effects but not the actual flu.

Prevention and Treatment

• Prevention:
  • Frequent hand washing
  • Covering mouth when coughing or sneezing
  • Vaccinations
• Treatment:
  • Antiviral medications (e.g., Tamiflu) are effective if started within three days of symptom onset.
  • Rest and fluids
  • Treat the symptoms.
  • Antibiotics are not needed unless a bacterial pneumonia develops (rare, mainly in the very young or old).

Diagnostic Tests

• Rapid flu test: Common in ERs, urgent care, and doctor's offices.
• RT-PCR (gold standard): Confirms the diagnosis.
  • Analogy: Similar to rapid strep test followed by a throat culture for confirmation.

Nursing Interventions

• Prioritize airway, breathing, and circulation (ABCs).
• Medications:
  • Analgesics (Tylenol, ibuprofen) for body aches and fever.
    • Ibuprofen lasts longer (6 hours) compared to Tylenol (4 hours).
• Rest, hydration, and comfort.
• Hydration is more crucial than forcing food.
• Infection control and patient education on hygiene and spread.

Hepatitis

• Inflammation of the liver, most commonly caused by viral infection.
• Other causes: alcohol, toxins, autoimmune diseases, and medications.

Modes of Transmission for Viral Hepatitis

• Hepatitis A:
  • Fecal-oral route: poor handwashing after changing diapers, consuming contaminated food or water.
  • Common in daycare settings and areas with poor sanitation.
• Hepatitis B and C:
  • Blood and body fluids: sharing needles (substance abuse), sexual contact, mother to child transmission during childbirth.

Types of Hepatitis

• Hepatitis A: Self-limiting, usually doesn't cause significant damage. Transmitted through contaminated food and water.
• Hepatitis B: Can be acute or chronic. If untreated, can lead to liver damage.
• Hepatitis C: Can be acute or chronic, higher risk for cirrhosis and liver cancer. Requires treatment.

Signs and Symptoms

• Jaundice: Yellowing of the skin and sclera (whites of the eyes).
  • Look for jaundice in the eye sclera and mucous membranes.
• Fatigue
• Right upper quadrant pain (where the liver is located)
• Dark urine: due to bilirubin buildup
• Nausea and vomiting
• Loss of appetite
• Diarrhea
• Fever
• Joint pain: associated with viral syndromes.

Diagnostic Tests

• LFTs (Liver Function Tests): Monitor liver function.
  • Hepatitis A: IgM antibodies
  • Hepatitis B: Hep B surface antigen, Hep B core antibody, anti-HB surface antibody
  • Hepatitis C: HCV antibody and RNA (viral load testing)
• Imaging: Ultrasound, CT scan, MRI
• Liver biopsy: possible if cirrhosis or advanced disease present to examine tissue sample.

Treatment

• Supportive care: rest, hydration, diet
• Avoid alcohol and certain medications that can cause liver cellular changes.
• Hepatitis B: antiviral medications (e.g., interferon injections), liver transplant if liver failure occurs.
• Hepatitis C: direct-acting antivirals (DAAs), liver transplant if severe disease progresses.

Nursing Interventions

• Pain management: medications for pain and discomfort
• Emotional support: address stigmas associated with hepatitis, especially hepatitis C.
• Health promotion and lifestyle changes: stop smoking, avoid alcohol, etc.
  Patients typically must get the Hep B vaccine for job and health facilities due to how hepatitis can be transmitted (blood, needle sticks, etc.).