1. INFLUENZA (FLU) INFLUENZA (FLU) I. Overview: Affects 5% - 10% of the population yearly. Affects 5% - 10% of the population yearly. Directly attributable to an average of 36,000 deaths each year in the U.S. Directly attributable to an average of 36,000 deaths each year in the U.S. Over 90% of flu-related deaths occur in people > 65 years of age. Over 90% of flu-related deaths occur in people > 65 years of age. The rest occur mostly in children < 2 years old and in people with high-risk medical conditions (diabetes, cancer, etc.) The rest occur mostly in children < 2 years old and in people with high-risk medical conditions (diabetes, cancer, etc.)

2. INFLUENZA (FLU) INFLUENZA (FLU) II. Modes of transmission: Inhalation of the virus while it is in the air.Inhalation of the virus while it is in the air. Contact with the virus from the droplets (from coughing, sneezing, touching by the contaminated hands) on the surfaces:Contact with the virus from the droplets (from coughing, sneezing, touching by the contaminated hands) on the surfaces: –Keyboards –Phones –Door knobs –Others

3. INFLUENZA (FLU) INFLUENZA (FLU) III. INFECTIOUS PERIODS: How long can an infected person shed the virus (and be contagious)? Adults: from ONE day before the symptoms occur until FIVE days after the onset. Adults: from ONE day before the symptoms occur until FIVE days after the onset. Children: can remain infectious for up to 10 days after symptoms appear. Children: can remain infectious for up to 10 days after symptoms appear. People with weakened immune system: Can shed the virus for weeks or even months. People with weakened immune system: Can shed the virus for weeks or even months.

4. INFLUENZA (FLU) INFLUENZA (FLU) IV. SYMPTOMS: Is it a Cold or a Flu? SYMPTOMSCOLDFLU FeverRareUsual (100F - >102F) ChillsRareCommon HeadacheRareCommon Body achesSlightUsual: often severe Fatigue/weakness SometimesUsual Stuffy noseCommonSometimes SneezingCommonSometimes Sore throatCommonSometimes CoughMild – moderateCan be severe

5. INFLUENZA (FLU) INFLUENZA (FLU) V. PROGNOSIS: What happens next to the flu victims? Flu is a self-limited disease in most people. Flu is a self-limited disease in most people. Uncomplicated cases resolve in 3 – 7 days. Uncomplicated cases resolve in 3 – 7 days. Cough and fatigue may last for up to 2 wks. Cough and fatigue may last for up to 2 wks. Complications (please see the next slide) may develop in certain groups of flu victims. Complications (please see the next slide) may develop in certain groups of flu victims.

6. INFLUENZA (FLU) INFLUENZA (FLU) VI. COMPLICATIONS Occur mainly in the high-risk groups: Occur mainly in the high-risk groups: – Children 6 months – 5 years old. – Pregnant women – The elderly – People with chronic medical conditions (diabetes, HIV, COPD, cancer, etc.)

7. INFLUENZA (FLU) INFLUENZA (FLU) VI. COMPLICATIONS – continued Pneumonia – the most common complication. Pneumonia – the most common complication. Middle ear infections. Middle ear infections. Acute sinusitis. Acute sinusitis. Bronchitis. Bronchitis. Death. Death.

8. INFLUENZA (FLU) INFLUENZA (FLU) VII. TREATMENT A. General measures: Increase fluid intake.Increase fluid intake. Activities: as tolerated.Activities: as tolerated. B. Symptomatic treatments: –Acetaminophen (first line) or Ibuprofen (second line) for fever & aches. –DO NOT use Aspirin in children < 16 years of age. –Cough syrup.

9. INFLUENZA (FLU) INFLUENZA (FLU) VII. TREATMENT – Cont.’d C. Antiviral medications: Must be taken within the first 24-30 hours of symptom onset to be effective. Must be taken within the first 24-30 hours of symptom onset to be effective. Shorten the flu symptoms by 1 day. Shorten the flu symptoms by 1 day. May reduce the complications of flu. May reduce the complications of flu. Types of antiviral medications recommended for the 2008 -2009 flu season: Types of antiviral medications recommended for the 2008 -2009 flu season: 1. Oseltamivir 2. Zanamivir

10. INFLUENZA (FLU) INFLUENZA (FLU) VIII. PREVENTION A. GENERAL MEASURES: Maintain good health: -Good, nutritious foods -Plenty of sleep -Minimize stress level -Exercise regularly -Avoid smoking -Avoid or minimize alcoholic drinks

11. INFLUENZA (FLU) INFLUENZA (FLU) VIII. PREVENTION – Cont.’d A. GENERAL MEASURES – cont.’d: Minimize the risk of contracting the virus: -Wash hands frequently. -Avoid touching the mouth, nose or eyes unnecessarily. -Avoid (or minimize spending time in) the crowded places (shopping malls, crowded waiting rooms, etc.) during the flu season.

12. INFLUENZA (FLU) INFLUENZA (FLU) VIII. PREVENTION – Cont.’d B. VACCINATION: Two types are available: Two types are available: – Attenuated (nasal spray): Contains weakened but live virus. May cause the flu in those with weakened immune system. – Inactivated (injectable, aka “flu shot”): Contains killed virus. Used by the Wellness Center Is generally safe. Prevents the flu in about 80% of vaccinated healthy adults 65 and younger. Reduces hospitalization & death in elderly people. Does NOT cause the flu.

13. INFLUENZA (FLU) INFLUENZA (FLU) The Final Thoughts…. The flu is: The flu is: – Much better prevented than treated. – Both widespread and expensive for patients and the health care system. Vaccination is: Vaccination is: – The cornerstone of prevention. – Still available at the Wellness Center for PBG employees and their spouses/domestic partners. Although complications are rare among healthy adults, dealing with fever, chills, cough, bad headaches & body aches for 3 – 7 days is not a fun and easy task, and is so unnecessary, especially when the flu shot is readily available and generally safe! Although complications are rare among healthy adults, dealing with fever, chills, cough, bad headaches & body aches for 3 – 7 days is not a fun and easy task, and is so unnecessary, especially when the flu shot is readily available and generally safe! It’s NOT TOO LATE YET to get the flu shot. So, please drop by the Wellness Center if you haven’t got it yet. No appointment necessary! It’s NOT TOO LATE YET to get the flu shot. So, please drop by the Wellness Center if you haven’t got it yet. No appointment necessary! Thank you, Sokan