Influenza 101

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

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.

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

Influenza is highly contagious.

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

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

Types of Flu Viruses There are two important types of flu viruses in humans: A and 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

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

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 Pediatr Adolesc Med. 165(2), p. 104-111.

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

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

Types of flu vaccine The flu shot The flu nasal spray 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

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)

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

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 sore throat cough

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

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

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

I got vaccinated last year, but I got the flu anyway 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

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

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

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

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

Flu vaccines help… Protect yourself Protect your family 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.

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

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

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

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

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