2017 HCHB_digital

Influenza
Influenza (flu) is a common contagious viral infection that spreads quickly and
can cause serious illness and sometimes death. Older people, young children,
pregnant women and people with certain medical conditions (such as heart
disease, asthma, or an autoimmune disease) are at a higher risk of developing
serious complications from influenza.
Influenza can be spread through the air – coughing and sneezing releases
tiny droplets – or by direct contact with an infected person. People are infectious
usually one day before the symptoms start and up to five days after they become
sick. Flu season in New Zealand is usually from May to September, although can
start earlier or last longer. Each year, the majority of influenza cases are caused
by three to four major viruses. Our flu season tends to reflect that experienced
in the Northern hemisphere. The seasonal influenza vaccine for 2017 includes a
different H1N1-like strain to last year (see Immunisation box opposite).
Symptoms usually come on suddenly and commonly include high fever (38.8–
40°C), body chills, headache, dry cough, sore throat, runny or stuffy nose, chest
discomfort, muscle and joint aches and pains, tiredness and weakness. Stomach
symptoms, such as nausea, vomiting and diarrhoea, are more common in children
than in adults. Secondary infections (eg, bronchitis, pneumonia) are common.
Medicines are available over the counter to help improve flu symptoms,
such as fever, body aches, headaches, coughs and joint pains. Oseltamivir is an
antiviral which is available as a pharmacist–only medicine year round. Oseltamivir
can shorten the time to flu resolution and reduce the risk of hospitalisation and
complications from influenza; however, the occurrence of nausea and vomiting
is increased (see Treatment options next page).
masks readily available should you need to don one when talking with customers
who are actively coughing. Run through the Refer to Pharmacist questions to
help you decide which customers are amenable to self-treatment and who needs
to be referred to the pharmacist.
Advice for customers
• Consider yearly influenza vaccinations, which are free for some people
from their doctor (see text box Immunisation, next page for specific
recommendations).
• Recommend bedrest, increased fluid intake and symptom control using
analgesics and other treatment options for people who have already
contracted the flu.
• Warn sufferers the flu is contagious and they should refrain from going to
work and avoid public places where possible for up to five days.
• Refer patients to the doctor if symptoms worsen or persist for longer than a
week.
• Many cold and flu remedies contain paracetamol, a decongestant and/or a
cough suppressant. Watch for double-dosing with these products.
• Turn to page 98 to see Treatment options.
Initial assessment
During the flu season, you will be exposed on a daily basis to people with the
flu. However, determining whether a customer has the flu or a cold can be
challenging. Colds generally do not present with fever, joint pains, or body chills,
and can occur at any time throughout the year (see also Colds). Sneezing is
common with colds, and coughs associated with colds are more likely to be
productive. The symptoms of a cold usually take a few days to develop, compared
with flu symptoms that usually come on within three to four hours.
Always take precautions to protect your own health during flu season. Yearly
vaccination is the best form of protection, and you should always wash your
hands before and after direct contact with customers. Consider having face
Important note: Cough, cold and flu medicines in
children
Parents or caregivers should not give cough, cold or flu medicines to children aged less than six
years, and should seek pharmacist advice before using these preparations in children aged less
than 12 years. Instead, paracetamol may be used to relieve any pain or discomfort, and natural
remedies containing ingredients such as glycerol, honey, or lemon can be suggested to help
soothe irritated throats or coughs in children older than one year.
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Page 96 HEALTHCARE HANDBOOK 2017-2018 Common Disorders