Influenza information for health professionals

Medical practitioners are required to notify influenza to the Communicable Disease Control Branch (South Australia) ONLY where:

1. they suspect a person has died from the condition, or
2. they have conducted a point of care test that has returned a positive result which is not also reported by a pathology service.

If one or both of these scenarios apply, notify online or download and fax the purple notification form (PDF 1028KB) to (08) 7425 6696.

Note: there is a still a requirement for medical practitioners to notify avian influenza in humans. Telephone: 1300 232 272.

Influenza complications in this age group requiring hospitalisation are more likely than other ages and include serious respiratory complications. This age group repeatedly have the highest number of reported cases each year second only to children aged 5-9 years.

First Nations people are at higher risk of complications and being hospitalised from influenza.

Pregnant women who get an influenza infection late in their pregnancy are more likely to experience complications or have a preterm baby.

Vaccinating during pregnancy also protects babies < 6 months of age who are at high risk of serious complications and hospitalisation from influenza.

The Managing pregnant women with suspected influenza fact sheet (PDF 100KB) provides health professionals with information on influenza prevention, testing, treatment and prophylaxis in pregnant women. 

Important considerations in influenza management during each trimester, delivery and in the post-partum period are also discussed.

Adults over 65 years are more likely to be hospitalised and affected by complications from influenza, such as pneumonia.

People with certain medical conditions are more likely to have serious complications from an influenza infection: 

• cardiac disease
• chronic respiratory conditions (including severe asthma)
• chronic neurological conditions that increase the risk of respiratory infection (including hereditary and degenerative central nervous system diseases and seizure disorders)
• immunocompromising conditions (including immunocompromised due to disease or treatment)
• diabetes and other metabolic disorders
• renal disease
• haematological disorders (including haemoglobinopathies)
• children aged 6 months to 10 years on long term aspirin therapy who are at increased risk of Reye's syndrome following influenza infection.
• People with Trisomy 21 (Down Syndrome).
  

For more information see the People with medical conditions that increase their risk of influenza section of the Influenza chapter in the Australian Immunisation Handbook.

People with Down Syndrome may have a medical condition making them eligible for a free influenza vaccine under the NIP (refer the People aged 6 months and older with certain medical conditions section).

People with Down Syndrome aged 5 years to less than 65 years not otherwise eligible under the NIP are eligible for a free influenza vaccine funded by the Government of South Australia.

Adults and children who are experiencing homelessness are also eligible to receive the funded vaccines under the state funded program.  

*If a person experiencing homelessness is pregnant or in one of the at-risk age groups, they should receive the funded NIP influenza vaccines instead.

Two (2) age-appropriate influenza vaccine doses spaced (4) four weeks apart are required for children receiving an influenza vaccine for the first time for:

• Children aged 6 months to less than 2 years
• Children aged 2 years to less than 9 years of age with a medical risk condition.

This recommendation is the same regardless of the vaccine administered.

If vaccinated against influenza early in their pregnancy in the previous influenza season pregnant women are recommended to receive the current seasonal vaccine dose if it is available before their baby is born.

Pregnant women vaccinated against influenza prior to becoming pregnant are recommended to receive the current seasonal vaccine dose during their pregnancy to protect their baby.

Two doses may be required from some people with certain immune compromising conditions. 

Severe disease is also more common for older people living in residential aged care facilities (RACF). See Influenza guidelines and resources for health professionals.

• In healthcare settings follow standard and transmission based precautions as outlined in Australian Guidelines for the Prevention and Control of Infection in Healthcare
• Encourage respiratory etiquette and hand hygiene:
  • cover a cough or sneeze with a tissue or elbow (not hands)
  • drop used tissues immediately into a rubbish bin
  • wash hands with soap and running water, or use an alcohol-based hand rub, after sneezing, coughing or touching used tissues.
• Display infection prevention and control posters for staff, patients and visitors. See Influenza guidelines and resources for health professionals.

Spread is via respiratory droplets and direct contact with respiratory secretions.

Incubation period is one to four days (average two days).

People infected with influenza are considered infectious from one day before onset of symptoms up to seven days from onset of symptoms. Viral shedding is greatest in the first three to five days of illness. After five days, the level of infectiousness is probably very low. Young children may shed virus for longer, up to seven to ten days. Viral shedding may continue for longer in severely immunocompromised persons.

Laboratory testing is not always necessary in the case of mild illness.

Take a deep nasal or throat swab, or sputum for respiratory viral testing. Use appropriate personal protective equipment when obtaining the sample.

To prevent the spread of influenza, exclude cases from childcare, preschool, school or work until there has been no fever for 24 hours (without using an antipyretic).

Consider prescribing antivirals for post exposure prophylaxis. Prophylactic antivirals are usually only used in persons at high risk of severe influenza. If used, prophylaxis should be commenced within 48 hours of exposure.

Medically assess the need for hospital presentation/admission.

Consider antivirals for treatment in:

• people with established complications or severe illness (for instance, needing hospitalisation)
• people from groups at risk of complications of disease
• people not in the at-risk groups and not severely unwell if commenced within 48 hours of onset.