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:
- loss of appetite
- sore throat
- nausea, vomiting and diarrhea may also occur, especially in children
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.
- 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.
- 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)
|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
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.
- 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.
- Influenza (Flu) Fact Sheet for Patients
- Influenza (Flu) Vaccines for Children Fact Sheet for Patients
- Influenza (Flu) Vaccines for Adults Fact Sheet for Patients
- Flu Shot Coverage Rates in Healthcare Facilities
- Ontario’s Universal Influenza Immunization Program
- Centers for Disease Control (CDC) Influenza Information for Health Professionals
- Public Health Ontario (PHO) Antiviral Medications for Influenza: Information for Health Care Providers.
- Association of Medical Microbiology and Infectious Disease Canada (AMMI) Canada Guideline: The Use of Antiviral Drugs for Influenza: A Foundation Document for Practitioners.
- Provincial Infectious Diseases Advisory Committee (PIDAC) Routine Practices and Additional Precautions in All Health Care Settings