influenza%20(pediatric)
INFLUENZA (PEDIATRIC)
Influenza may present as a mild respiratory illness similar to the common cold or it may present without characteristic signs and symptoms.
The main type of influenza virus are types A, B & C virus. Types A&B are the main causes of influenza outbreaks.
Patient may appear flushed and have pain on eye movement. Non-exudative pharyngitis, scattered rales or rhonchi may be present.

Introduction

Epidemiology

  • The main types of influenza virus are types A, B & C virus
  • Types A & B are the main causes of influenza outbreak 

Follow local program for control of priority diseases, if available

Timing of Vaccination

  • All children 6 months -18 years are recommended to be given Influenza vaccine annually
    • Influenza vaccine is safe for school-aged children
    • Influenza substantially affects school-aged children & their contacts
  • Influenza vaccine must be administered yearly because vaccines decline in efficacy with time & in the emergence of newly circulating strains
    • For the 2016-2017, the Advisory Committee on Immunization Practices (ACIP) & American Academy of Pediatrics (AAP) prefer the use of inactivated or recombinant influenza vaccine over live attenuated influenza vaccine (LAIV4)
      • Quadrivalent live attenuated influenza vaccine (nasal spray) is not recommended for the 2016-2017 flu season due to poor efficacy ratings of LAIV4 in the past season
  • Attack rates of influenza are higher in children during outbreaks & are a major cause of transmission within communities

Northern Hemisphere

  • Typically administer annual vaccinations to high-risk individuals & their close contacts between October-February

Southern Hemisphere

  • Typically administer annual vaccinations to high-risk individuals & their close contacts between March-September

Tropical or Subtropical Regions

  • Laboratory confirmed influenza can occur anytime throughout the year
    • Peaks of influenza activity can occur 1-2x/year, during rainy/winter season
  • Public health programs where high-risk individuals & their close contacts are vaccinated should be performed at the same time each year if >1 peak of influenza activity occurs within a year
    • Latest available vaccine formulation should be used

 

Signs and Symptoms

Most Commonly Presented Clustered Symptoms

  • Abrupt onset of fever (37.7- 40°C)
  • Severe myalgia &/or arthralgia
  • Severe dry cough
  • Loss of appetite
  • Headache

Other Common Symptoms

  • Chills
  • Malaise
  • Weakness, fatigue
  • Chest discomfort

Symptoms that Occasionally Occur

  • Stuffy nose
  • Sore throat
  • Sneezing

Risk Factors

  • High-risk groups are more likely to suffer severe illness & premature death related to influenza

Targeted Pediatric Populations

  • 6 months-4 years
  • Ages 6 months to 18 years, on long-term Aspirin therapy & at risk of Reye’s Syndrome after influenza infection
  • Patients with chronic pulmonary, cardiovascular (CV), renal, hepatic, hematologic or metabolic diseases
  • Patients with any condition compromising respiratory function
  • Immunosuppressed children
  • Children living in the community with ≥1 of the above disease states

Caregivers or Other Individuals Who Live with High-Risk Individuals

  • Healthy household contacts & caregivers of children ≤5 years
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