Influenza resident survival guide

WikiDoc Resources for Influenza resident survival guide
Articles
Most recent articles on Influenza resident survival guide Most cited articles on Influenza resident survival guide Review articles on Influenza resident survival guide Articles on Influenza resident survival guide in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Influenza resident survival guide Images of Influenza resident survival guide Photos of Influenza resident survival guide Podcasts & MP3s on Influenza resident survival guide Videos on Influenza resident survival guide
Evidence Based Medicine
Cochrane Collaboration on Influenza resident survival guide Bandolier on Influenza resident survival guide TRIP on Influenza resident survival guide
Clinical Trials
Ongoing Trials on Influenza resident survival guide at Clinical Trials.gov Trial results on Influenza resident survival guide Clinical Trials on Influenza resident survival guide at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Influenza resident survival guide NICE Guidance on Influenza resident survival guide NHS PRODIGY Guidance FDA on Influenza resident survival guide CDC on Influenza resident survival guide
Books
Books on Influenza resident survival guide
News
Influenza resident survival guide in the news Be alerted to news on Influenza resident survival guide News trends on Influenza resident survival guide
Commentary
Blogs on Influenza resident survival guide
Definitions
Definitions of Influenza resident survival guide
Patient Resources / Community
Patient resources on Influenza resident survival guide Discussion groups on Influenza resident survival guide Patient Handouts on Influenza resident survival guide Directions to Hospitals Treating Influenza resident survival guide Risk calculators and risk factors for Influenza resident survival guide
Healthcare Provider Resources
Symptoms of Influenza resident survival guide Causes & Risk Factors for Influenza resident survival guide Diagnostic studies for Influenza resident survival guide Treatment of Influenza resident survival guide
Continuing Medical Education (CME)
CME Programs on Influenza resident survival guide
International
Influenza resident survival guide en Espanol Influenza resident survival guide en Francais
Business
Influenza resident survival guide in the Marketplace Patents on Influenza resident survival guide
Experimental / Informatics
List of terms related to Influenza resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mounika Reddy Vadiyala, M.B.B.S.[2]

Overview

Influenza, commonly known as the flu, is an infectious disease caused by the RNA virus called the influenza viruses A and B.

Causes

Common Causes

• Influenza A
• Influenza B

Complete Diagnostic Approach

Characterize the symptoms: ❑ Fever ❑ Abrupt onset ❑ Ranges from 37.8 to 40.0°C, but it can get as high as 41.1°C (106°F) ❑ Associated with chills ❑ Headache ❑ Cough ❑ Non-productive ❑ Myalgia ❑ Chills ❑ Rhinorrhea ❑ Nasal congestion ❑ Sore throat ❑ Fatigue ❑ Pleuritic chest pain ❑ Malaise Less common symptoms: ❑ Vomiting ❑ Diarrhoea ❑ Abdominal pain ❑ Loss of appetite ❑ Dizziness ❑ Weakness

Obtain a detailed history: ❑ Age ❑ List of medications Identify persons who are at high risk of complications from Influenza: ❑ Children aged younger than 2 years ❑ Adults aged 65 years and older ❑ Persons with the following comorbidities: ❑ Chronic pulmonary disorders (including asthma) ❑ Cardiovascular disorders(except hypertension alone) ❑ Renal, hepatic, hematological (including sickle cell disease) or metabolic disorders (including diabetes mellitus) ❑ Neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy, stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury) ❑ Persons with immunosuppression, including that caused by medications or by HIV infection ❑ Women who are pregnant or postpartum (within 2 weeks after delivery) ❑ Children and adolescents through 18 years who are receiving aspirin- or salicylate-containing medications and who might be at risk for experiencing Reye syndrome after influenza virus infection ❑ American Indians/Alaska Natives ❑ Persons who are morbidly obese (BMI ≥40 kg/m2) ❑ Residents of nursing homes and other chronic-care facilities.

Examine the patient: Appearance ❑ Fatigue Vital signs ❑ Fever ❑(100-104° F) ❑ Heart rate ❑ Tachycardia ❑ Respiratory rate ❑ Tachypnea Skin ❑ Flushing may be present ❑ Rash may be present ❑ Increased sweating Eyes ❑ Watery eyes ❑ Redness Nose ❑ Nasal congestion ❑ Runny nose Throat ❑ Erythema and inflammation may be present ❑ Pharyngitis Lungs ❑ Usually, lung examination is normal ❑ Findings of severe disease include: ❑ Dry cough ❑ Rales ❑ Focal wheezing

.

Which Patients Should Be Tested for Influenza?

During influenza activity (defined as the circulation of seasonal influenza A and B viruses among persons in the local community)

During low influenza activity

Outpatients (including emergency department patients)

Hospitalized Patients

Outpatients (including emergency department patients)

Hospitalized Patients

❑ High-risk patients, including immunocompromised persons who present with influenza-like illness, pneumonia, or nonspecific respiratory illness (eg, cough without fever) if the testing result will influence clinical management ❑ patients who present with acute onset of respiratory symptoms with or without fever, and either exacerbation of chronic medical conditions (eg, asthma, chronic obstructive pulmonary disease, heart failure) or known complications of influenza (eg, pneumonia) if the testing result will influence clinical management ❑ Patients not at high risk for influenza complications who present with influenza-like illness, pneumonia, or nonspecific respiratory illness (eg, cough without fever) and who are likely to be discharged home if the results might :❑ influence antiviral treatment decisions or  :❑ reduce use of unnecessary antibiotics,  :❑ reduce further diagnostic testing, and :❑ reduce time in the emergency department, or :❑ influence antiviral treatment or chemoprophylaxis decisions for high-risk household contacts.

❑ All patients requiring hospitalization with acute respiratory illness, including pneumonia, with or without fever ❑ All patients with acute worsening of chronic cardiopulmonary disease (eg, COPD, asthma, coronary artery disease, or heart failure), as influenza can be associated with exacerbation of underlying conditions ❑ All patients who are immunocompromised or at high risk of complications and present with acute onset of respiratory symptoms with or without fever, as the manifestations of influenza in such patients are frequently less characteristic than in immunocompetent individuals ❑ All patients who, while hospitalized, develop acute onset of respiratory symptoms, with or without fever, or respiratory distress, without a clear alternative diagnosis

❑ Patients with acute onset of respiratory symptoms with or without fever, especially for immunocompromised and high-risk patients

❑ All patients requiring hospitalization with acute respiratory illness, with or without fever, who have an epidemiological link to a person diagnosed with influenza, an influenza outbreak or outbreak of acute febrile respiratory illness of uncertain cause, or who recently traveled from an area with known influenza activity. ❑ Patients with acute, febrile respiratory tract illness, especially children and adults who are immunocompromised or at high risk of complications, or if the results might influence antiviral treatment or chemoprophylaxis decisions for high-risk household contacts

Management

Symptomatic Relief

OTC medicines provide relief for 'flu symptoms

Symptom(s)	OTC Medicine
Fever, Aches, Pains, Sinus pressure, Sore throat	Analgesics
Nasal congestion, Sinus pressure	Decongestants
Sinus pressure, Runny nose, Watery eyes, Cough	Antihistamines
Cough	Cough suppressant
Sore throat	Local anesthetics

Do's and Dont's

• Children and teenagers with flu symptoms (particularly fever) should avoid taking aspirin as taking aspirin in the presence of influenza infection (especially Influenzavirus B) can lead to Reye's syndrome, a rare but potentially fatal disease of the liver.