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, MMWR 2009;58:

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: 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

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. S
Eick, et.al. (2011). Maternal Influenza vaccination and effect on influenza virus infection in young infants. Arch Pediatr Adolesc Med. 165(2), p

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 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 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

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
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
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 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.

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 to find out where you can get vaccinated

27. CDC Flu Materials for American Indian/ Alaska Native Communities
To order free copies:

28. Influenza Educational Resources
IHS Website – Information specific to IHS, resource materials for Native people
CDC Website - Free resources section with E-cards, posters, flyers

29. Influenza Public Service Announcements
Protect the Circle of Life
Featuring the voice of Harlan McKosato
Available at:

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