Influenza 101

1. Influenza 101

2. Influenza • The flu (influenza) is an infection of the nose, throat, and lungs that is caused by influenza virus • The flu is not a stomach bug • Most people with flu are sick for about a week, but then feel better

3. Did you know? • Some people can get very sick and some can die from the flu • Especially young children, pregnant women, older people, and people with chronic health problems like diabetes, heart disease, and asthma. • 3,000 to 49,000 people die from flu-related complications each year • More than 220,000 people are hospitalized from flu complications each year • During the 2009 H1N1 pandemic, American Indian and Alaska Native people were 4 times more likely to die from H1N1 than other race/ethnic groups* *CDC. Deaths Related to 2009 Pandemic Influenza A (H1N1) Among American Indian/Alaska Natives (AIAN) — 12 States, 2009. MMWR 2009;58:1341-44.

4. Symptoms of the Flu • Flu can cause mild to severe illness, and at times can lead to death • Most people with the flu… • feel tired - have a fever • have a headache - have a dry cough • have a sore throat - have sore muscles • have a runny or stuffy nose • Some people, especially children, may also have stomach problems and diarrhea

5. Influenza is highly contagious.

6. Flu Virus • The flu virus spreads: • Mainly from person to person through coughing or sneezing of people with the flu • By touching something with flu viruses on it and then touching your mouth or nose • You can spread the flu before you even know you are sick • You can infect others 1 day before you know you are sick and up to 5-7 days after becoming sick

7. Available at: http://www.cdc.gov/flu/freeresources/media-psa.htm

8. Types of Flu Viruses • There are two important types of flu viruses in humans: Aand B. • Influenza A viruses can infect birds, animals and humans • There can be up to 144 different subtypes of influenza A virus – e.g. H1N1, H3N2, etc. • Influenza B virus are only found in humans • Two main types • Flu vaccines protect against two different Influenza A subtypes and one or two Influenza B types

9. Flu Vaccine Recommendations Everyone 6 months and older should get a flu vaccination every year Including: • Pregnant women • Protects the mother AND the baby • People with chronic health problems like diabetes, heart disease and asthma • People 65 years and older Getting a flu vaccine every year is the best way to protect against the flu

10. Pregnant women and flu vaccines • Pregnant women pass on protection to their newborn • Studies have shown babies born to moms who were vaccinated with flu • Are less likely to get admitted to the hospital for flu than babies of unvaccinated mothers 1 • Have a lower chance of catching the flu and getting admitted to the hospital for Influenza-Like-Illness 2 Poehling, et. al. (2011). Impact of maternal immunization on influenza hospitalizations in infants. American Journal of Obstetrics and Gynecology. Supplement to June 2011, p. S141-148. Eick, et.al. (2011). Maternal Influenza vaccination and effect on influenza virus infection in young infants. Arch PediatrAdolesc Med. 165(2), p. 104-111.

11. Flu Vaccines • There are many different strains of the flu virus, and the ones that infect people can change every year • Flu vaccines contain flu viruses that have been killed or weakened so they cannot give you the flu • “Trivalent” vaccines are flu vaccines that have 3 (tri) different strains of flu • “Quadrivalent” vaccines are flu vaccines that have 4 (quad) different strains of flu

12. Flu Vaccine Strains • The trivalent flu vaccine for the 2013-2014 influenza season protects against: • Influenza A H3N2 • Influenza A H1N1 • One type of Influenza B • The quadrivalent vaccine also protects against a 2nd B strain

13. Types of flu vaccine • The flu shot • Is made with inactivated (killed) influenza virus • Everyone 6 months and older can get it • Is usually injected into the muscle • For adults 18 – 64 years, there is a flu vaccine called the “intradermal flu vaccine” • Uses much smaller needle than the regular flu shot • Is injected into the skin rather than the muscle • The flu nasal spray • Is made with live influenza virus that has been weakened so it can’t grow • Healthy* people 2 through 49 years of age who are not pregnant can get it * Healthy indicates people who do not have an underlying medical condition such as asthma and diabetes

14. New Flu Vaccines • There are some new kinds of flu vaccines, as well as the kinds that have been used before, available this year • These new flu vaccines include: • Quadrivalent vaccines – vaccines that protect against 4 strains of the flu • Vaccines that are made without eggs (cell culture and recombinant vaccines)

15. Flu vaccines are safe • The vaccine has been used for 50 years and has been given safely to hundreds of millions of people in the U.S. and around the world • People with chronic health problems CAN and SHOULD receive influenza vaccine • Including people with diabetes, heart disease and asthma • Pregnant women CAN and SHOULD receive influenza vaccine • Studies have shown when a pregnant woman gets her flu vaccine she passes the protection on to her baby

16. Flu Vaccine Side effects • Serious side effects are rare • Most side effects are minor and resolve in 1-2 days Flu Shot • Soreness, redness, or swelling where the shot was given • Fever (low grade) • Aches Nasal Spray • Children • runny nose • wheezing • headache • muscle aches • fever • Adults • runny nose • headache • sore throat • cough

17. Who should see their healthcare provider before getting vaccinated with the flu vaccine? • People who have a severe allergy to chicken eggs • People who have had a severe reaction to an influenza vaccination in the past • People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated) • People with a history of Guillain-Barre Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine

18. Can you get the flu from the flu vaccine? • You CANNOT get the flu from the flu vaccine • The vaccine is made up of either killed (inactivated) virus (shot), or live virus (nasal spray) that has been weakened so that it can’t grow • Some people may already be sick with the flu when they are vaccinated • You are fully protected two weeks after you received the flu shot

19. I got vaccinated last year, do I need to get vaccinated again this year? • YES, a flu vaccine is the best way to protect against the flu • Flu viruses change every year • The vaccine also changes every year to protect against new flu viruses • That is why you need to get a flu vaccine each year • Get vaccinated as soon as vaccine is available • The flu vaccine will protect you throughout the flu season even if you get it early or late • You are fully protected two weeks after you receive the flu vaccine

20. I got vaccinated last year, but I got the flu anyway. Flu vaccines don’t work • Some people may still get the flu because • They were already infected with the flu when they got vaccinated • They were infected with another virus like a cold virus • Flu vaccines only protect against the flu virus • They were infected with a flu strain not contained in the vaccine • They may not respond well to the vaccine because of their age or poor health • If you get the flu, the flu vaccine may make the flu less serious • The flu vaccine is the BEST way we have to prevent influenza

21. Other ways of preventing the flu • Cover your nose and mouth with a tissue when you cough or sneeze • Throw the tissue away after you use it • Wash your hands often with soap and water, especially after you cough or sneeze. If you are not near water, use an alcohol-based hand cleaner. • Wash hands for as long as it takes to sing the Happy Birthday song twice • Gels should be rubbed into your hands until they are dry • Stay away as much as you can from people who are sick • If you get the flu, stay home from work • Do not go near other people, so you don't make them sick • Try not to touch your eyes, nose, or mouth. Germs often spread this way

22. If you get the flu … • Stay home and avoid contact with other people • Most people with the flu have mild illness and do not need medical care • However, some people may develop severe illness from the flu • Know the warning signs • Anyone concerned about their illness should consult a health care provider, who may prescribe medicines called antivirals

23. Emergency Warning Signs in Children • Fast breathing or trouble breathing • Bluish skin color • Not drinking enough fluids • Not waking up or not interacting • Being so irritable that the child does not want to be held • Flu-like symptoms improve but then return with fever and worse cough • Fever with a rash If you see these signs, get medical care right away

24. Emergency Warning Signs in Adults • Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness • Confusion • Severe or persistent vomiting • Flu–like symptoms that improve but then return with fever and worse cough If you see these signs, get medical care right away

25. Flu vaccines help… • Protect yourself • Reduces sick days by 28% • Protect your family • If you are infected with influenza at work, you will also expose your family • Children < 6 months of age cannot get vaccinated • Everyone around them should get vaccinated • Pregnant women who are vaccinated pass this protection on to their babies • Protect others around you • Patients, co – workers, etc.

26. Employee flu vaccination • Flu vaccine is available at your facility • Most facilities offer the flu vaccine free of charge to all healthcare personnel • Contact your Employee Health Nurse and/or Infection Control Coordinator for more information • You can also get vaccinated at many pharmacies for a low fee ($20 - $30) • Visit the Flu Vaccine Finder at www.flu.gov to find out where you can get vaccinated

27. CDC Flu Materials for American Indian/Alaska Native Communities To order free copies: http://www.cdc.gov/flu/freeresources/print.htm

28. Influenza Educational Resources • IHS Website – Information specific to IHS, resource materials for Native people www.ihs.gov/flu • CDC Website - Free resources section with E-cards, posters, flyers www.cdc.gov/flu

29. Influenza Public Service Announcements Protect the Circle of Life Featuring the voice of Harlan McKosato Available at: www.ihs.gov/flu

30. 2013 Certificate of Completion for Influenza 101 This certifies that Name Has completed the training module for Influenza 101 _____________________ _______________ Name, Title, LocationDate