Flu 5

Influenza
dr Dicky Wahyudi Sp.P
RSUD Raden Mattaher - FKIK Universitas Jambi

• Influenza is a highly contagious viral
infection of the nose, throat, and lungs
that occurs most often in the late fall,
winter, and early spring.
http://www.nfid.org/idinfo/influenza
• Influenza is a serious infection that
affects between 5-20% of the
US population annually.
• During the 2017-2018 season:
 An estimated 900,000
individuals were hospitalized
 Nearly 80,000 deaths
Occurred in the US from flu and flu-
related complications.
• In temperate climates:
Seasonal epidemicsoccur mainly during
winter
• In tropical regions:
Influenza may occur throughout the year,
causing outbreaks more irregularly.
• Incubation period, is about 2 days, but
ranges from one to four days
• Influenza A viruses are further classified
into subtypes according to the
combinations of the hemagglutinin (HA)
and the neuraminidase (NA), the
proteins on the surface of the virus.
http://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
• Currently circulating in humans
subtype A(H1N1) are and
influenza viruses. A(H3N2)
• Only influenza type A viruses are known
to have caused pandemics.
http://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)
• Influenza B viruses are not classified into
subtypes, but can be broken down into
lineages.
• Currently circulating influenza type B
viruses belong to either B/Yamagata or
B/Victoria lineage.
• Influenza C virus is detected less
frequently and causes mild
usually
infections, thus does not present public
health importance.
Epidemiology
• All age groups can be affected but
there are groups that are more at risk
than others.
• Pregnant women
• Children under 59 months
• The elderly
• Individuals with:
Chronic medical conditions (such as
chronic cardiac, pulmonary, renal, metabolic,
neurodevelopmental, liver or hematologic
diseases)
Immunosuppressive conditions
(such as HIV/AIDS, receiving chemotherapy or
steroids, or malignancy).
•
Health care workers are at high
risk acquiring influenza virus
infection
 due to increased exposure to
the patients
 risk further spread particularly
to vulnerable individuals.
Transmission
• Seasonal influenza spreads easily,
with rapid transmission in
crowded areas including schools
and nursing homes.
• Infect persons in close
proximity who breathe these
droplets in.
• The virus can also be spread by
hands contaminated with
influenza viruses.
• To prevent transmission, people should:
 Cover their mouth and nose with a
tissue when coughing
 Wash their hands regularly
Signs and symptoms
• Seasonal influenza is characterized by
a sudden onset of :
Fever Muscle and Joint pain
Cough Severe malaise
(usually dry)
Headache Sore throat
Runny nose
Diagnosis
• The majority of cases of human
influenza are clinically diagnosed
• Other respiratory viruses that can present
as Influenza-like Illness (ILI) include:
 Rhinovirus
 Respiratory syncytial virus
 Parainfluenza
 Adenovirus
Laboratory confirmation
• Throat, nasal and nasopharyngeal
secretions or tracheal aspirate or
washings is commonly performed
• Direct antigen detection
• Virus isolation
• Detection of influenza-specific RNA
by reverse transcriptase-polymerase
chain reaction (RT-PCR).
WHO recommended surveillance standards, Second edition
.
Treatmen
t seasonal influenza:
• Uncomplicated
 Not from a high risk group
Symptomatic treatment
 if symptomatic
Stay home in order to
minimize the
risk of infecting others in the
community
 Group at high risk
• Severe or progressive clinical illness
(associated with suspected or confirmed
influenza virus infection)
 Clinical syndromes of :
 Pneumonia
 Sepsis
 Exacerbation of chronic
underling diseases
Antiviral drug
• Neuraminidase inhibitors (i.e. Oseltamivir)
 as soon as possible (ideally, within 48
hours following symptom onset) to
maximize therapeutic benefits.
 A minimum of 5 days, but can be
extended until there is satisfactory clinical
improvement
• Corticosteroids should not be used
routinely (unless indicated for other
reasons e.g.: asthma and other
specific conditions); as it has been
associated with:
 Prolonged viral clearance
 Immunosuppression leading to
bacterial or fungal superinfection.
Prevention
• The most effective way to prevent
the disease is vaccination
• Injected inactivated influenza
vaccines are most commonly used
throughout the world.
• Vaccination is especially important
for people:
 At high risk of
influenza complications
 Who live with or care for
the people at high risk
WHO recommends annual vaccination for:
• Pregnant women at any stage of pregnancy
• Children aged between 6 months to 5 yrs.
• Elderly individuals (aged more than 65yrs.
• Individuals with chronic medical conditions
• Health-care workers.
• Personal protective measures
 Regular hand washing
 Good respiratory hygiene
 Early self-isolation of those feeling unwell,
feverish and having other symptoms of influenza
 Avoiding close contact with sick people
 Avoiding touching one’s eyes, nose or
mouth
Antiviral Treatment Recommendations
for Seasonal Influenza
Patient with Assess clinically
Flu Symptoms and investigate
. Severe Acute Respiratory Mild or Uncomplicated illness

Infection(SARI)
· Requiring hospital admission
· Pregnancy
· Severe illness
High risk* No risk
Treat with Tamiflu immediately factor
do not wait for lab
confirmation
Antiviral Treatment Recommendations
for Seasonal Influenza (Cont.)
*High Risk : Mild or Uncomplicated illness
· Children below 5 especially
<2 years
· Elderly >65 years
· Pregnant women till
2Wks post partum High No risk
· Comorbidities risk* factor
.Treat with Antiviral .Consider Antiviral if within 48 Hrs.

· Close follow up · Infection control
· Infection control · Return to care within 72 Hrs. if no
· Return to care within 72 Hrs in no improvement
improvement
Thank you

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Flu 5

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Influenza

dr Dicky Wahyudi Sp.P

RSUD Raden Mattaher - FKIK Universitas Jambi

. Severe Acute Respiratory Mild or Uncomplicated illness

.Treat with Antiviral .Consider Antiviral if within 48 Hrs.

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