With the turn of the leaves and cooler weather on the horizon, one of the illnesses that comes to the front lines of primary care, urgent care, and emergency rooms is influenza, “the flu.” Influenza is one of the most contagious respiratory infections and affects millions of people every year both in the United States and around the world. It is reported that there are 3-5 million severe influenza infections per year and 20,000 deaths. In children, there are up to 200,000 who will be hospitalized each year because of the flu or flu-related complications.
While the influenza virus can affect any age group, rates of influenza infection are typically highest in school-age children. Groups that are most at risk are:
- children < 2 years
- people with chronic medical conditions (i.e. asthma or diabetes)
- pregnant women
- adults over age 65
Influenza is very contagious and can be spread by person-to-person contact (coughing or sneezing) or from indirect contact with contaminated surfaces. The best protection from influenza is receiving an annual influenza vaccine. CDC influenza information includes recommendations for influenza vaccines for all persons over age 6 months, but especially for those who are most at risk as mentioned above. In addition to vaccination, frequent hand washing with soap and water or using alcohol-based hand sanitizers if soap and water are unavailable are important to help prevent the spread of influenza.
Medical calculators can assist all members of the healthcare team during peak periods of influenza activity – typically October to March (or later). Suggestions from the Medical Algorithm Company’s knowledge base are below:
- Determine if a patient is experiencing flu-like symptoms
- Evaluate an adult with pneumonia and flu-like symptoms for H1N1 influenza (swine flu)
Prior to the 2016-2017 flu season, an additional option for vaccination was Flumist, an intranasal live-attenuated, vaccination. However, because of recent studies showing less than adequate protection from Flumist, the Advisory Committee on Immunization Practices (ACIP) recommended against its use for this year’s flu season.
- When Flumist is reformulated and again and can be provided to patients, there are contraindications to receiving Flumist.
For severe cases of H1N1 influenza A, leading to adult respiratory distress syndrome requiring ECMO, the ECMOnet score can help identify patients who may be at greatest risk for mortality.
- Evaluate a patient with H1N1 influenza A and ARDS prior to starting venovenous ECMO using the ECMOnet score.
Whether evaluating a patient with a flu-like illness or recommending influenza vaccination, the medical calculators can assist doctors, nurses, and other members of the healthcare team with their clinical decision making to improve the care of their patients.
