Influenza Information for Health Professionals

Influenza occurs globally with an annual attack rate estimated at five to 10 per cent in adults and 20 to 30 per cent in children. In Canada, influenza generally occurs each year in the late fall or winter months.

The tabs below offer health professionals key information about influenza vaccination, infection prevention and control, diagnosis, and treatment of seasonal influenza.

Clinical Signs and Symptoms

sudden onset of high fever, chills, cough and muscle aches
other common symptoms include:
- headache
- chills
- loss of appetite
- fatigue
- sore throat
nausea, vomiting and diarrhea may also occur, especially in children

Surveillance

For local, provincial and national influenza surveillance information:

Toronto Public Health’s Weekly Influenza Bulletin
- The Weekly Influenza Bulletin is produced weekly during periods when there is influenza activity in Toronto. The intent of the weekly bulletin is to provide descriptive epidemiologic data on influenza activity in the City of Toronto for health professionals and administrators of institutions. You can subscribe to the Weekly Influenza Bulletin here.
Public Health Ontario’s Laboratory Respiratory Pathogen Surveillance Reports
- The Laboratory Respiratory Pathogen Surveillance Reports are published regularly and summarize patients’ specimens tested at Public Health Ontario Laboratories for influenza and other respiratory pathogens.
Government of Canada’s Flu Watch
- Government of Canada’s Flu Watch is Canada’s national surveillance system for monitoring the spread of flu and flu-like illnesses.

Laboratory Testing

Obtain laboratory testing (nasopharyngeal swab collected in a respiratory virus collection kit) in all persons with suspected influenza who are admitted to hospital.
Influenza testing is not currently available through the Public Health Ontario (PHO) Laboratory for patients in ambulatory settings, including those at high risk for influenza complications or patients in emergency department settings who will not be admitted to hospital.
Coming soon: PHO’s November 2018 Respiratory Viral Testing Algorithm will be available on PHO’s Labstracts.

Vaccine

High-Dose Fluzone® is now publicly funded for seniors, age 65 years+
Quadrivalent vaccine is available for adults and children, ages six months and older

2018/2019 Universal Influenza Immunization Program (UIIP) Vaccines

Influenza Vaccines	QIVs (Quadrivalent Inactivated Vaccines)	Q-LAIV (Quadrivalent – Live Attenuated Influenza Vaccine)	High-Dose TIV (Trivalent Inactivated Vaccine)
Age Eligibility	6 months and older	2 to 17 years	65 years and older
Trade Names	FluLaval® Tetra, Fluzone®	FluMist®	High-Dose Fluzone®
Dosage	0.5 mL	0.2 mL (0.1mL in each nostril)	0.5 mL
Route	IM injection	Intranasal spray	IM injection
Common Allergens	Thimerosal in multi-dose vial	Arginine, gelatin, gentamicin

Influenza vaccine strains

A H1N1
A H3N2
B Victoria
B Yamagata lineage – added strain in quadrivalent

More Information

Infection Prevention and Control

When caring for people with influenza or influenza-like illness, follow Provincial Infectious Diseases Advisory Committee’s Routine Practices and Additional Precautions in all Health Care Settings including:

droplet and contact precautions
facial protection (which may include a mask in conjunction with eye protection, or a face shield that covers eyes, nose and mouth) within two metres of a patient on droplet precautions
isolation in a single room or cohorted with another lab-confirmed case
continued precautions for five days after onset of illness

In addition, advise patients with influenza-like illness to stay home from work or school while ill, and to practise frequent hand washing and cough etiquette.

Treatment

Reporting

Report confirmed cases of influenza to Toronto Public Health.
Report respiratory infection outbreaks in institutions and public hospitals to Toronto Public Health.
To report call 416-392-7411 during business hours and 3-1-1 on evenings and weekends.