Influenza-like illness Activity
During week 9 2012 (week ending March 4th), the general practitioner consultation rate for influenza-like illness (ILI) in Ireland was 34.6 per 100,000 population. This rate exceeds the Irish baseline threshold (used to assess influenza activity during the 2011/2012 influenza season in Ireland) of 25.9/100,000 above which the use of antiviral drugs for defined risk groups is recommended. To date this season, influenza A (H3) has been the dominant influenza virus detected. The flu report for week 9 is available here.
Due to the levels of influenza activity seen last week in Ireland, antiviral drugs for the treatment and/or prevention of influenza in at-risk patients are recommended in line with the Interim guidelines on the use of antivirals for the treatment and prophylaxis of influenza which are available here.
The defined risk groups for influenza are:
a) Age 65 years and over
b) Children aged <2 years
c) Chronic respiratory disease including people on medication for asthma
d) Chronic heart, kidney, liver or neurological disease
e) Diabetes mellitus
g) Immunosuppression (whether due to treatment or disease)
h) Pregnancy (including up to two weeks post partum).
i) Morbid obesity (BMI ≥40)
j) Children with any condition (e.g. cognitive dysfunction, spinal cord injury, seizure disorder or other neuromuscular disorder) that can compromise respiratory function, especially those attending special schools/day centres
Algorithms for management of influenza when it is circulating in the community
- The Interim Algorithm for the Emergency Department Management of Adults who may have influenza is available here
- The Interim Algorithm for the Emergency Department Management of Children who may have influenza is available here
- The Interim Algorithm for the Primary Care Management of persons with influenza is available here
Guidelines on the use of antivirals in pregnancy for patients with influenza are available here
As ILI rates are increasing and influenza viruses are circulating, it is also important that persons in at-risk groups for influenza are vaccinated as these groups are at higher risk of developing complications from influenza.
Risk groups for influenza vaccine are outlined below as per the Immunisation Guidelines for Ireland 2008 (Chapter 7-updated in September 2011). They are as follows:
- All those aged 50 years and older1
- Adults and children over 6 months of age with any of the following:
- chronic illness requiring regular follow up (e.g. chronic respiratory disease including cystic fibrosis, moderate or severe asthma, chronic heart disease, diabetes mellitus, chronic liver disease, chronic neurological disease including multiple sclerosis hereditary and degenerative disorders of the central nervous system)
- those who are immunosuppressed due to disease or treatment including those with missing or non functioning spleens
- Children with any condition (e.g. cognitive dysfunction, spinal cord injury, seizure disorder, or other neuromuscular disorder) that can compromise respiratory function especially those attending special schools/day centres
- Children and teenagers on long-term aspirin therapy (because of the risk of Reyes syndrome)
- Those with morbid obesity i.e. Body Mass Index ≥ 40
- All pregnant women. The vaccine can be given at any stage of pregnancy. This year influenza vaccine is not recommended for those women up to six weeks post partum
- Healthcare workers
- Residents of nursing homes, and other long stay institutions
- People who have close, regular contact with pigs, poultry or water fowl
Details of Influenza Activity in Ireland are available on the HPSC website at: http://www.hpsc.ie/hpsc/A-Z/Respiratory/Influenza/SeasonalInfluenza/Surveillance/
See also: http://www.hpsc.ie/hpsc/A-Z/Respiratory/Influenza/SeasonalInfluenza/
Details of Influenza Information for Health Professionals on the HPSC website at: http://www.hpsc.ie/hpsc/A-Z/Respiratory/Influenza/SeasonalInfluenza/Guidance/
Details of Influenza Activity in Europe are available on the ECDC website here
Details of international influenza websites are available at:
1 The National Immunisation Advisory Committee has recommended the influenza vaccine for all those aged 50 years and older. Influenza vaccine is free for all persons aged 65 years and over and for those aged 50 to 64 years in risk groups for influenza.