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ABSTRACT: Vaccination is the primary measure for preventing morbidity and mortality from influenza. During the influenza season, family physicians must distinguish influenza from the common cold and other flu-like illnesses. Signs and symptoms of influenza include abrupt onset of fever, severe myalgias, anorexia, sore throat, headache, cough, and malaise. Clinical diagnosis can be difficult or nonspecific when patients have other symptoms (e.g., stuffy nose, sneezing, cough, sore throat) that can be caused by various respiratory viruses or bacterial pathogens. Family physicians can improve diagnostic accuracy by being aware of the epidemiology of influenza. During outbreaks of influenza, commercially available rapid assays can be used to identify type A and B viruses. On average, rapid in-office tests are more than 70 percent sensitive and 90 percent specific for viral antigens. The assays vary in complexity, specificity, sensitivity, time to obtain results, specimen analyzed, and cost. The results of rapid viral tests can guide treatment decisions.
ABSTRACT: The American Academy of Family Physicians now recommends that all persons 50 years of age and older receive an annual influenza vaccination, because the rates of morbidity and mortality associated with influenza are high and vaccination is cost-effective. Reasons for lowering the recommended age for routine vaccination from 65 to 50 years of age include reductions in office visits, hospitalizations, time taken off work and associated costs. In working adults 18 to 64 years of age, the cost savings were estimated at $46.85 per person vaccinated. Furthermore, the fatality rate from influenza begins to rise at age 45 and is highest in persons with multiple chronic medical conditions. As in the past, recommendations target persons at high risk for complications, such as those with cardiac disease, lung disease and diabetes, as well as health care workers and residents of nursing homes. Severe allergy to eggs is a contraindication to influenza vaccination.
Influenza Vaccine: Got It, Give It! - Editorials
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ACIP Releases Guidelines on the Prevention and Control of Influenza - Practice Guidelines