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Annual immunization is recommended for healthcare workers. During the 2005-6 influenza season, CDC recommended oseltamivir or zanamivir for the treatment and prophylaxis of influenza. Birds, swine, and other mammals are reservoirs for the origin of new human subtypes. The disease is spread mainly by airborne transmission, but transmission by direct contact also occurs. Avian influenza of the A(H3N1) type was identified in 1997. Human cases with a high fatality rate have been reported in Thailand and Vietnam after transmission from infected poultry. [CCDM, p. 281-7] Complications of influenza include viral pneumonia, bacterial pneumonia, encephalitis, Reye's syndrome, and myositis followed by acute renal failure. [ID, p. 1990-1] Chest x-rays are usually normal unless patients have secondary infections. [5MCC] Arthralgia is common. Other symptoms are dry cough, sore throat, rhinorrhea, congestion, and slightly enlarged, tender cervical lymph nodes. Fever usually lasts for 3 days, sometimes 4-8 days. Children tend to have higher fevers and more prominent cervical lymphadenopathy. Some older patients present with high fever and confusion without respiratory symptoms. Primary influenza viral pneumonia is rare. Myocarditis and pericarditis are rare complications. [PPID, p. 2069-70] |
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