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33 Cards in this Set
- Front
- Back
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how is flu transmitted
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direct contact
large droplet (cough/sneeze) inhalation of small particle aerosols articles recently contaminated |
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incubation of flu
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1-4 days, average 2 days
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when are people infectious with flu?
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adults: 24 before s/s until 5 days after
children until 10 days after |
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peak season for flu
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late DEC to early MARCH
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how often do pandemics of flu typically happen?
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q10yr
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main s/s of true flu
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look sick
abrupt onset fever 100-104 myalgia headache malaise nonproductive cough sore throat rhinitis |
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how long do acute s/s last for?
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3-7 days
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how long does malaise and cough last?
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up to 14 days
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what is a secondary sequela of flu
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bacterial pneumonia
primary influenza viral pneumonia |
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what percentage of children are hospitalized with the flu? why?
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20% due to seizures
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what are less common resasons why kids are hospitalized during a flu illness
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reyes
encephalopathy transverse myelitis myositis pericarditis |
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what hx to take during flu eval?
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onset, duration, character
neck/chest/muscle pain? confusion? hemoptysis? other household members ill? vaccination? medical hx? |
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PE for flu eval. what to focus?
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v/s
lethargy? hydration status/ nuchal rigidity? cervial adenopathy? EENT auscultate heart, lungs abd exam neuro in severe case or w/ symptoms |
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ddx flu
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common cold (flu more abrupt and less sneezing)
pneumonia RSV strep OM occupational/biohazard expsosure |
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flu dx
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symptoms and eli data usually significant
nasopharyngeal culture in first 72 hrs of s/s if dx unclear or if decided to tx or not cbc maybe rapid diagnostic kids available |
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when do kids get vaccine?
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6mo and older
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how long does it take for vaccine to produce immunity
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2 weeks
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flu management
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antiviral for high risk and sever regardless of vaccination status
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mild illness, no risk factors, presents w/in 48 of onset s/s tx?
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consider antiviral
provide instructions for symptomatic care, infxn control, return for care if no improvement in 72hr |
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mild illness, some risk factors, tx?
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give antiviral
provide close f/u instruct for symptomatic care, infxn control return to care if no improve in 72hr |
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how soon do you need to start antiviral tx?
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within 2 days. sooner the better. not effective if started later
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can you use antivirals for prophylaxis?
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no
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what drug to use for flu?
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oseltamivir and zanamivir
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what is the drug monograph for zanamivir?
who benefits disadvantages contraindications dose |
who: adults and kids 7 or older
benefits: few complications, low drug resistance disadvantages: higher cost contra: COPD, asthma, underlying resp dz dose: adults/elderly/kids 10mg (2 inhalations0 BID |
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tamiflu monograph
who benefits disadvantages indication dosage |
who: adults and kids >1yr
benefits: low risk drug resistance, low ADR rate disadvantages: costly indication: effective against flu B dose: adults/elderly 75mg BID reduce for renal insufficiency |
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SE of antivirals
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anxiety depression insomnia
orthostatic hypotension dizzy NV dyspepsia |
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antiviral PG category
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class C
don't take when lactating or PG |
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what class of drugs interacts with antivirals?
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those that effect CNS
antihistamine anticholinergic |
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how old do you have to be to take aspirin for fever?
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need to be 19 or older
reyes syndrome |
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how many wet diapers do kids need each day
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6
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how much illness does the flu vaccine prevent
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70-90% in those <65
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when not to vaccine
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adults with acute febrile illness
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adverse rxn of flu
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soreness at site
fever in young kids |
