Influenza (cont.)
When should a person go to the emergency department for the flu?
The CDC has recently published guidelines on who should go to the emergency department for flu symptoms and who should not go. The CDC published these guidelines to avoid a crush of people going to the emergency department during the H1N1 flu pandemic and utilizing limited resources needed for true emergency patients such as cardiac or trauma patients and to avoid transmitting the virus to high-risk patients. The CDC guidelines are as follows for children and adults. The CDC urges normally healthy people that get either the conventional or novel H1N1 swine flu to stay home as the large majority of infected individuals will recover without antiviral medications or other treatments.
The CDC urges people to seek emergency medical care for a sick child with any of these symptoms:
1. Fast breathing or trouble breathing
2. Bluish or gray skin color
3. Not drinking enough fluids
4. Severe or persistent vomiting
5. Not waking up or not interacting
6. Being so irritable that the child does not want to be held
7. Flu-like symptoms improve but then return with fever and cough
The following is the CDC's list of symptoms that should trigger emergency medical care for adults:
1. Difficulty breathing or shortness of breath
2. Pain or pressure in the chest or abdomen
3. Sudden dizziness
4. Confusion
5. Severe or persistent vomiting
6. Flu-like symptoms improve but then return with fever and worse cough
7. Having a high fever for more than three days is another danger sign, according to the WHO, so the CDC has also included this as another serious symptom.
Who should receive the flu vaccine? When should someone get the flu shot?
In the United States, the flu season usually occurs from about November until April. Officials have decided each new flu season will start on Oct. 4. Typically, activity is very low until December, and peak activity most often occurs between January and March. Ideally, the conventional flu vaccine should be administered between September and mid-November. It takes about one to two weeks after vaccination for antibodies against influenza to develop and provide protection. Groups at increased risk of conventional influenza complications include:
- people aged 65 years or older;
- residents of nursing homes and other chronic-care facilities housing
patients of any age who have chronic medical conditions;
- adults and children with chronic disorders of the pulmonary,
cardiovascular, or immune systems, including children with asthma;
- adults and children who have required regular medical follow-up or
hospitalization during the preceding year because of chronic metabolic
diseases (including diabetes mellitus), renal dysfunction,
hemoglobinopathies, or immunosuppression (including immunosuppression caused by
medications);
- children and teenagers (6 months to 18 years of age) who are receiving
long-term aspirin therapy and therefore may be at risk for developing
Reye syndrome after
influenza; and
- women in the third trimester of pregnancy or in the early postpartum
period. There is some evidence to suggest that women who are in the third
trimester of pregnancy or in the early postpartum period may be at
increased risk for serious medical complications after influenza
infection. Pregnant women who will be in the third trimester of
pregnancy between December and April should consult their health-care
provider about receiving influenza vaccine during the period from September
to mid-November.
Unfortunately, because the novel H1N1 flu virus is not following the conventional flu pattern for time of disease appearance (appeared in April and increased over the summer and fall of 2009) or susceptible populations, the CDC has had to alter somewhat the recommendations this year. Consequently, the CDC has listed these groups as being at high risk for novel H1N1 flu and should obtain the novel H1N1 vaccine as soon as it is available to them:
- pregnant women,
- people who live with or care for children younger than 6 months of age,
- health-care and emergency-services personnel,
- people between the ages of 6 months through 24 years of age and children 5-18
years of age who have chronic medical problems, and
- people from 25-64 years of age who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.
In addition, the following groups should be vaccinated because they may transmit
influenza to people who are at high risk for complications if they become
infected with either the conventional or novel H1N1 flu.
- Physicians, nurses, and other health-care personnel in both hospital and
outpatient-care settings
- Employees in nursing homes and chronic-care facilities who have contact
with patients or residents
- Providers of home care to people at high risk (for example, visiting nurses
and volunteer workers)
- Household members (including children) of high-risk people
Furthermore, the CDC advises that all children 6-59 months of age get a yearly
conventional flu vaccination since each year there are over 20,000 children
who require hospitalization because of the flu and flu is easily passed from child to child.
Finally, the flu vaccine, both the conventional and H1N1, may be administered to any person who wishes to reduce his or her chances of acquiring influenza infection. People who provide essential community services should be considered for vaccination to minimize disruption of essential activities during influenza outbreaks. Students or other people in institutional settings, such as those who reside in dormitories, should be encouraged to receive the vaccine to minimize the disruption of routine activities during epidemics. Such outbreaks have been reported for H1N1 in 2009. People needing further information regarding the use and availability of the influenza vaccine should consult with their health-care provider or their local health department or the CDC at the flu.gov
Web site.
Next: What is the bird (avian) flu? »
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