Influenza Update for the 2020 - 2021 Flu Season

Publication Date: March 13, 2019

Key Points

Key Points

  • Seasonal influenza A and B virus epidemics are associated with significant morbidity and mortality each year in the United States and worldwide. During 2010-2019, annual seasonal influenza epidemics of variable severity were associated with an estimated 9.3 million to 45 million illnesses, 140,000 to 810,000 hospitalizations, and 12,000 to 61,000 deaths in the U.S. Source: [ cdc.gov/flu/about/burden/index.html ]
  • Most people recover from uncomplicated influenza, but influenza can cause complications that result in severe illness and death, particularly among very young children, older adults, pregnant and postpartum women within 2 weeks of delivery, people with neurologic disorders, and people with certain chronic medical conditions including chronic pulmonary, cardiac, and metabolic disease, and those who are immunocompromised.
  • Early treatment with antivirals reduces the duration of symptoms and risk of some complications (bronchitis, otitis media, and pneumonia) and hospitalization, and may decrease mortality among high-risk populations.
  • Annual vaccination is the best method for preventing or mitigating the impact of influenza, but in certain situations chemoprophylaxis with antiviral medications can be used for pre-exposure or post-exposure prevention and can help control outbreaks in certain populations.
  • Because prevention and control of influenza is a dynamic field, clinicians should consult the website of the Centers for Disease Control and Prevention (CDC) [ cdc.gov/flu/index.htm ] for the latest information about influenza vaccines, influenza tests, and approved antiviral medications.

Testing and Treatment of Influenza When SARS-CoV-2 and Influenza Viruses are Co-circulating


Prevention

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...e 2. Contraindications and Precaut...


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...fluenza Vaccine Dosing Algorithm for Child...


...vention...

...hemoprophyl...

...drugs should NOT be used for routine o...

...Clinicians can consider antiviral c...

Clinicians can consider antiviral chemoproph...

...can consider short-term antiviral chemoprophylaxi...

...Clinicians can consider short-term anti...

...Clinicians can consider educating patients...

...cians should use an NAI (oral oseltamivir or inhal...

...nicians should administer pre-exposu...

...ould test for influenza and switch...

...ians can consider post-exposure antivira...

...can consider post-exposure antiviral chemo...

...can consider educating patients and arranging f...

...ylaxis is given, clinicians should administ...

...ians should not administer once-daily post-expo...

...s should administer post-exposure antiviral chem...

...should test for influenza and switch to an...

Clinicians should administer an N...


Treatment

Treatme...

Antiviral Do...

...ersons of any age who are hospitalized with influe...

...tients of any age with severe or progressive ill...

...ho are at high risk of complications from influ...

...younger than 2 years and adults ≥65 years ( A...

...women and those within 2 weeks postp...

...atients with illness onset ≤2 days bef...

...atic outpatients who are household contacts of...

...tomatic healthcare providers who care for patients...


...ntiviral Treatment for Suspected or Confi...

...cians should start antiviral treatment as so...

...Clinicians should NOT routinely use highe...

...Clinicians should treat uncomplicated...

...s can consider longer duration of...


...erial Coinfection

...Clinicians should investigate and empiricall...

Clinicians should investigate and empiri...

...can consider investigating bacter...


...iviral Failure

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...esistant Infection Testing...

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...atients with an immunocompromising condit...

Patients with laboratory-confirmed influenza wh...

...th severe influenza who do not improve with NAI...

...should remain informed on current CDC and Worl...


...djunctive Therapy...

...Clinicians should NOT administer cor...

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Institutional Outbreak Control

Institutional Outbreak Control

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...When an influenza outbreak has been iden...

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...le 5. Control Measures for Managing Instituti...


Diagnosis

Diagno...

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...linicians should test for influenza on admission...

...linicians can consider testing for influenz...


...and Symptoms of Uncomplicated Influe...


...ble 7. Clinical Manifestations and Complic...


...8. Persons Who Are at High Risk of Compli...


...ps in Whom to Consider a Diagnosis of InfluenzaaH...


...10. Influenza Diagnostic Tests for Respiratory S...


...11. Multiplex Assays Authorized for...


...Interpretation of Influenza Testing Results o...


...of Differential Diagnoses to Consider for Pati...


...re 2. Guide for Considering Influenza T...


...ecimens...

...inicians should collect upper respiratory tract...

...Clinicians should collect nasophary...

...nicians should collect endotracheal a...

...ans should NOT collect or routinely test spe...

...Clinicians should NOT collect serum s...


...gnostic Tests...

...hould use rapid molecular assays (i.e.,...

...Clinicians should use reverse-transcription p...

...icians should use multiplex RT-PCR...

...cians can consider using multiplex RT-PCR assays...

...ans should NOT use immunofluorescence assays...

...-up testing with RT-PCR or other molecu...

...should NOT use RIDTs in hospitalized...

...testing with RT-PCR or other molecular assays sho...

...ians should NOT use viral culture for ini...

...viral culture can be considered to con...

...ns should NOT use serologic testing for diagnosis...