Good Morning and Welcome Applicants! February 11, 2011.
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Transcript of Good Morning and Welcome Applicants! February 11, 2011.
Good Morning andWelcome Applicants!
February 11, 2011
Influenza Complications
• Otitis media• Lower respiratory tract
• Interstitial PNA• Croup• Bronchitis• Bacterial tracheitis• Asthma exacerbation
Influenza Complications
• PNA• Sinusitis• Neurologic
• Aseptic meningitis• Acute cerebellar ataxia• Transverse myelitis• Guillian-Barre• Encephalitis
Influenza Complications
• Myositis
• Less common• Myocarditis• Pericarditis• Toxic Shock Syndrome
Influenza
• Transmission• Person to person primarily through
large-particle respiratory droplet • Close contact between source and
recipient persons• droplets generally travel only short
distances (approximately ≤6 feet) through the air
• Other• Indirect contact transmission via hand
transfer
Influenza
• Incubation• 1-4 days
• Shedding• Day before symptoms begin through
5-10 days after onset• Decreases rapidly by 3-5 days after
illness onset• Children typically shed longer
Symptoms
• Fever• Myalgia• Headache• Malaise• Nonproductive cough• Sore throat• Rhinitis
Symptoms
• Children • Otitis media• Nausea/vomiting
• Resolution• 3-7 days for the majority of persons• Cough and malaise can persist for >2
weeks
Testing
• Rapid antigen tests• Low sensitivity (20%-70%)
• Particularly for H1N1• Nasal swab is more sensitive• Should not be used to rule out
influenza
• Viral Culture or RT-PCR
Treatment
Treatment
Treatment
• Who gets treated?• Any hospitalized child• High risk• Healthy children whom a decrease in
duration of clinical symptoms is felt to be warranted
• Start ASAP• Use clinical judgment
Prophylaxis
• Children at high risk for whom influenza vaccine is contraindicated
• Children at high risk during the 2 weeks after immunization
• Family members or health care providers who are unimmunized and are likely to have ongoing, close exposure to:• Unimmunized children at high risk• Infants and toddlers <24 months
Prophylaxis
• Control of influenza outbreaks for unimmunized staff and children in a closed institutional setting with pediatric residents at high risk
• Supplement to immunization for immunocompromised
• PEP for family members and close contacts of an infected individual
• Children at high risk and their family members and close contacts when circulating strains are not matched with the vaccine
Immunization• Annual vaccination for all children
and adolescents 6 months of age and older
• Specifically• Conditions that increase the risk of
complications• Chronic medical conditions
Immunization
• Increased risk of complications• Asthma or other chronic pulmonary disorders• Hemodynamically significant cardiac disease• Immunosuppressive disorders or therapy• HIV• Sickle cell anemia or other hemoglobinopathies• Long-term aspirin therapy• Chronic renal dysfunction• Chronic metabolic disease (DM)• Any condition that can compromise respiratory
function or handling of secretions
Immunization
• Specifically• Household contacts and out-of-home
providers of • Children with high-risk conditions• Healthy children <5y
• Pregnant women• Health care personnel• Close contacts of immunosuppressed
Immunization
• This year• Trivalent
• H1N1• H3N2• B/Brisbane/60/2008
• How many this year??
Immunization• TIV
• Inactivated vaccine• Viral antigens but no virus• IM• Adverse effects
• Local pain• Tenderness• Fever • Mild systemic
• Nausea, lethargy, headache, muscle aches, chills
Immunization• LAIV
• Live-attenuated influenza vaccine• Intranasal• Ages 2-49• Not recommended
• Wheezing, high risk medical condition, nasal congestion
• Adverse effects• Runny nose, HA, wheezing, vomiting,
muscle aches and fever
Immunization
• Contraindications to TIV• Anaphylactic rxn to chicken, egg, or
vaccine• <6 months• Moderate to severe febrile illness• GBS within 6 weeks after a flu vaccine
Immunization
• Contraindications to LAIV• Same as TIV plus:• <2y• Other live vaccines within past 4
weeks• Can give other vaccines on same day
• Chronic medical conditions• Pregnancy• Contact with severely
immunocompromised
When in doubt . . .
• Check with the CDC!• www.cdc.gov
• Standard and Droplet precautions• Wash your hands• Get vaccinated
Don’t forget . . .