Autumn is in the Air... So is Influenza

As seen in Consultant Connection October 2012 Issue
By Mary Burkart, RN, ICP Nurse Coordinator

The leaves are starting to change colors. Morning air is cool & crisp. Football fans are sporting their team colors. Autumn is here! Unfortunately, autumn is the harbinger of flu season. 

Influenza is a respiratory-borne viral illness causing acute symptoms in a variety of  people. The very young and elderly are most at risk, as are those with chronic illnesses.  Caregivers in the long-term care industry are very in-tune to the fragile health of many of our residents and want to protect them by preventing additional illnesses.

Since the 2012-2013 Infl uenza vaccine is available from many manufacturers now, the Centers for Disease Control (CDC) recommend administering fl u vaccines (flu shots), even before the fl u season historically begins (October). It can take up to 2 weeks to gain full antibody protection from the flu vaccine.

The World Health Organization (WHO) & CDC work with organizations around the world to determine the best combination of strains for the annual vaccine. The 2012-2013 vaccine contains different strains than last year due to antigen shift, the frequent mutation of the infl uenza virus.

Since the early 1980’s, fl u vaccines have been trivalent-meaning they contain 3 components. On February 23, 2012 the WHO recommended that the Northern Hemisphere’s 2012-2013 seasonal infl uenza vaccine be made from the following three vaccine viruses:
  • an A/California/7/2009 (H1N1)pdm09-like virus;
  • an A/Victoria/361/2011 (H3N2)-like virus;
  • a B/Wisconsin/1/2010-like virus (from the B/Yamagata lineage of viruses).
While the H1N1 virus used to make the 2012-2013 fl u vaccine is the same virus that was included in the 2011-2012 vaccine, the recommended infl uenza H3N2 and B vaccine viruses are different from those in the 2011-2012 infl uenza vaccine for the Northern Hemisphere. (http://www.cdc.gov/flu/about/season/vaccine-selection.htm)

In the US, the Food & Drug Administration (FDA) determines which viruses will be used in the US-licensed vaccine and informs the manufacturers of that decision.

WHO & CDC, along with other world organizations, are very adept at predicting which strains of the fl u virus are most likely to spread. Eighteen of the last Twenty-two annual influenza vaccinations have corresponded to the spreading strains.

WHO & CDC recommend vaccinating everyone six months of age & over, especially those with chronic illnesses such as diabetes, COPD, asthma, cardiovascular disease, cerebral vascular disease, etc. and anyone living with or caring for those at high risk. An annual vaccine is required to provide protection from the currently spreading strains. It’s also shown that antibody protection declines over a period of time.

Even in the event the vaccine does not match the strains seen in the community, the flu vaccine offers some protection against the flu.

Flu symptoms appear suddenly. High fever, body aches, fatigue, malaise, cough, and congestion are just a few of the symptoms. Many people describe it as “feeling like I’ve been run over by a semi”. Anti-viral medications can help make the symptoms milder and help you feel better quicker. They can also help prevent complications such as pneumonia.

Other treatments are based on symptoms; antipyretics can help control the high fever; analgesics help with the body aches; frequent rest periods can help the fatigue & malaise; and maintaining good hydration can help thin the mucous, thereby relieving congestion.

Secondary bacterial infections are a serious complication of infl uenza. As the fl u virus weakens the body’s defenses, pathogenic bacteria start to multiply. It’s not unusual for someone with the flu to later develop pneumonia. The elderly & fragile patients in long-term care may not recover from these illnesses.

MDS 3.0 manual states, “The Infl uenza season varies annually. Information about current Infl uenza season can be obtained by accessing the CDC Seasonal Infl uenza (Flu) website. This website provides information on Infl uenza activity and has an interactive map that shows geographic spread of Influenza: http://www.cdc.gov/fl u/weekly/fluactivitysurv.htm and http://www.cdc.gov/flu/weekly/usmap.htm.

Facilities can also contact their local health department website for their local Infl uenza surveillance information. The Influenza season ends when Infl uenza is no longer active in your geographic area. Once the infl uenza vaccination has been administered to a resident for the current infl uenza season, this value is carried forward until the new infl uenza season begins.” There are no difinitive dates for administering the vaccine, i.e. October 1 to May 1. LTCF’s must continue to give flu shots until
influenza is no longer active in your geographical area.

While the flu vaccine is the best way to prevent the spread of infl uenza, other common infection control practices can help as well. Handwashing continues to be vital, especially after coughing, sneezing or blowing a nose. Isolating people who are ill can also help, especially if symptoms seem to be on one particular floor or unit. Asking visitors to wear a mask may also help prevent the spread of the f u. Encourage your residents and staff to get the fl u shot and watch for signs of the flu.

The beauty of autumn should be enjoyed by all; so let’s prevent the flu!

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