influenza
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Etiology
- influenza A
- epidemic during winter months
- influenza A pneumonia is associated with underlying heart disease
- influenza B
- more endemic than influenza A
- 20-30% of influenza infections
- parainfluenza viruses 15%
- risk factors for severe disease & complications
- COPD
- heart disease
- diabetes mellitus
- kidney disease
- chronic anemia or other hematologic disease
- debilitated condition
- > 64 years of age[19]
- immunocompromised patients
- premature birth[45]
- pregnancy or delivery within 2 weeks[19]
- very young children[19]
- morbid obesity (BMI > 40)[93]
- long-term aspirin therapy in patients < 19 years[93]
Epidemiology
- annual winter outbreaks (October-April)
- influenza A is most common & generally produces the most serious disease
- infection is highly contagious spread via exhaled breath[73], aerosolized droplets of nasal secretions or contaminated hands
- an individual may be contagious 1 day prior to onset of symptoms to 5 days after resolution[9]
- persons with influenza are likely most contagious during the first 3-4 days of illness[96]
- air samples yield small-particle viral RNA as far as 6 feet from infected patients[29]
- aerosolized infectious RNA is contained in particles small enough to elude standard surgical masks[29]
- children are the main sources of influenza transmission[56]
- vaccinating children provides the most effective method achieving disease control[56]
- an individual may be contagious 1 day prior to onset of symptoms to 5 days after resolution[9]
- major pandemics have occurred when there has been a change in both neuraminidase & hemagglutinin antigens
- estimated 290,000-650,000 seasonal influenza-associated respiratory deaths annually in 33 countries[71]
- Sub-Saharan Africa, western Pacific, & southeast Asia with highest rates of flu-related respiratory deaths[71]
- 2012-2013 season
- influenza A (H3N2) > influenza B > pandemic A/H1N1
- 6.1% of outpatient visits during peak activity
- among people >= 65 years of age, hospitalization rate was 2 per 1000
- death related to pneumonia & influenza peaked at 9.9%
- 149 deaths among children; more than 1/2 associated with influenza B
- 2013-2014 season
- 2009 H1N1 influenza A is dominant strain
- nearly all hospitalizations due to H1N1
- 47% of hospitalized patients obese[34]
- 2013-2014 vs 2012-2013
- lower rates of death & outpatient visits for influenza- like illness[41]
- higher hospitalization rates among patients aged 50-64
- nearly all viruses analyzed were antigenically similar to the components of the 2013-2014 influenza virus vaccine[41]
- 2014-2015 season
- 90% of cases in 2014 due to H3N2 virus
- circulating H3N2 strains not well matched to the H3N2 strain included in 2014-2015 flu vaccine
- all strains susceptible to neuraminidase inhibitors [CDC FluView][68]
- 2015-2016 season[61]
- 60% of cases due to influenza A(H1N1)pdm09
- influenza A(H3N2), influenza B/Yamagata lineage, & influenza B/Victoria lineage in lesser frequencies
- most circulating viruses matched the components of the seasonal influenza virus vaccine
- 1% of influenza A(H1N1)pdm09 virus were resistant to oseltamivir & peramivir; all were susceptible to zanamivir
- cumulative hospitalization rate for confirmed flu was 31.3 per 100,000 population[61]
- 2016-2017 season
- predominant circulating strain is influenza A H3 which is covered by the vaccine [CDC FluView][68]
- 2017-2018 season
- predominant circulating strain is influenza A H3N2[70]
- all viruses tested sensitive to oseltamivir, zanamivir, & peramivir
- Jan 12, 2018 widespread & intense but may be peaking[72]
- 2017-2018 season as intense as 2009 pandemic[76]
- influenza activity increasing again, all states but Hawaii reporting high flu activity (Jan 26, 2018)[75]
- 63 deaths in children reported as of Feb 9, 2018[76]
- 3 of 4 children had not been vaccinated[77]
- 43% of patients presenting with laboratory-confirmed influenza had been vaccinated[77]
- 2018-2019 season[83]
- influenza A(H1N1)pdm09 viruses predominant in most regions
- influenza A(H3N2) viruses most common in the Southeast.
- most circulating viruses are genetically similar to the reference viruses used for this year's flu vaccines.
- all tested viruses susceptible to neuraminidase inhibitors (oseltamivir, zanamivir, peramivir & baloxavir)
- all tested isolates have been susceptible to zanamivir
- < 1% have shown reduced susceptibility to oseltamivir
- late surge in H3N2 influenza March 2019[85]
- 28 influenza-related pediatrics deaths. 1/2 with underlying condition[84]
- 2019-2020 season
- earliest start in the U.S. in 15 years, South hit hardest
- influenza B/Victoria more common early than influenza A
- Influenza B/Victoria & A(H1N1)pdm09 most common[89]
- 2022-2023 season
- H3N3 is the predominant early circuating strain[95]
- outbreaks may still occur despite vaccination[44]
Pathology
- replication in ciliated columnar epithelial cells
- pharynx
- tracheobronchial tree
- acute mucosal necrosis
- major immunological antigens are neuraminidase & hemagglutinin
- spontaneous resolution in 4-5 days is most common
- protection after natural infection is primarily mediated by hemagluttin & neuraminidase-specific antibodies in serum (IgG) & mucosa (IgA), & possibly other conserved influenza proteins[33]
- T-cell responses also play a role in immunity[33]
Genetics
- point mutation in NS1 gene (glutamic acid at position 52) in fatal H5N1 flu virus in Hong Kong 1997[5]
Clinical manifestations
- incubation period 1-4 days[19]
- fever*, generally abrupt onset
- cough*, non-productive
- nasal congestion without sneezing[13]
- sore throat
- parotitis
- headache, frontal or retro-orbital[93]]
- myalgias
- weakness, fatigue, malaise, lethargy
- increased risk of hallucinations, delirium, abnormal behavior early in the illness[47]
- common symptoms may be absent in severely immunocompromised patients[35]
- asymptomatic in most people (seasonal or pandemic)[37]
- clinical diagnosis: sensitivity 36%, specificity 78%[53]
* combination with 99% negative predictive value[24]
* decision guide for laboratory testing based on
- new or increased cough (2 points)
- headache, subjective fever, & triage temperature >100.4 F (each 1 point)[85]
- score >= 3 92% sensitive, 35% specific
Laboratory
- during a confirmed local outbreak, diagnosis is clinical with laboratory testing reserved for patients at high risk for complication[19]
- influenza virus antigen in tissue[66]
- antigens
- assays
- direct fluorescent antibody (DFA)
- enzyme immunoassays (EIA) for influenza A antigen detection
- specificity = 98% but sensitivity = 54% in adults & 67% in children[26][66]
- RT-PCR* for influenza A virus RNA [4,53, 27]
- sensitivity 92% (best among tests), specificity 98%[66]
- RT-PCR* for influenza B virus RNA
- sensitivity 95% (best among tests), specificity 98%[66]
- RT-PCR* able to identify influenza A virus RNA, influenza B virus RNA & SARS-CoV2 RNA[96]
- this is a point-of-care test[97]
- Influenza A & B Point of Care Test (Alere)[48]
- influenza virus serology
- influenza virus identified by culture
- 1st 2-3 days of illness when viral shedding is maximal
- 2-7 days for results of culture
- centrifugation-enhanced shell vial cultures with 1-2 day incubation times
- specimens
- nasopharyngeal secretions
- throat swabs less sensitive
- if patient is hospitalized, tracheal aspirate or bronchoalveolar lavage specimen should also be obtained
* RT-PCR recommended vs antigen testing by Infectious Disease Society of America for diagnosis if testing is likely to change management[19]
Radiology
- chest X-ray
- bronchiolitis & bronchopneumonia
- interstitial infiltrate
- presence of lobar consolidation suggests bacterial coinfection[98]
Complications
- extension of viral-mediated necrosis to involve alveoli
- severe viral pneumonia (ARDS)
- potentially fatal
- secondary bacterial pneumonia
- cause of most influenza-related deaths[12]
- oropharyngeal bacteria
- vulnerable at greatest risk
- severe influenza with admission to the ICU predicts risk for invasive pulmonary aspergillosis[79]
- increased virulence of the flu & higher incidence of pneumonia in severely immunocompromised patients[35]
- increased risk of bipolar disorder in offspring of pregnant women with influenza (RR=5)[36]:
- children's medical visits for respiratory tract infection (within 3 days) confer 12-fold increase in risk for ischemic stroke[42]
- editorialist not impressed
- absolute risk is very low
- no evidence that attempt to treat would mitigate risk[42]
- cardiovascular events in adults with influenza
- acute myocardial infarction can be triggered by influenza[74]
- cardiovascular events are common among adults hospitalized with influenza[91]
- antiviral treatment & vaccination lower risk[91]
- risk factor: long-term aspirin therapy in patients < 19 years[93]
* most common causes of secondary bacterial pneumonia[52][53]
Differential diagnosis
- respiratory syncytial virus (RSV)[4]
- over 200 viruses cause influenza-like illness[43]
- influenza A & unfluenza B represent ~ 10% of all circulating viruses[43]
- common cold vs influenza vs Covid-19
Management
- uncomplicated influenza
- bedrest
- cough suppressants
- antipyretic agents
- acetaminophen may be of no benefit[57]
- antiviral agents
- indications:
- hospitalized patients
- severe, complicated or progressive infection
- high risk of influenza complications[19]
- start within 2 days of symptom onset[19]
- regardless of immunization status[82]
- regardless of symptom duration in hospitalized patients[19]
- neuraminidase inhibitors
- of marginal benefit[38]
- for 2014-2015 season high-risk patients should be given a neuraminidase inhibitor before confirmatory test results are in[49]
- zanamivir (Relenza)[30]
- associated with bronchospasm[19]
- contraindicated with pulmonary disease or cardiovascular disease
- emergence of resistance[19]
- early treatment for high-risk patients[23]
- may provide a net benefit over no treatment[27]
- oseltamivir (Tamiflu)[30]
- early treatment for high-risk patients[23][27]; patients with underlying respiratory disease
- may prevent hospitalization in elderly patients, both vaccinated & unvaccinated[7]
- may improve survival in hospitalized elderly[16]
- not associated with reduced risk of hospitalization[100]
- may provide a net benefit over no treatment[27]; shortens duration of influenza symptoms (4 vs 5 days)[50]; lowers risk of hospitalization (0.6 vs 1.7%)[50]
- older, sicker patients with flu-like syndrome may benefit from oseltamivir with or without confirmed influenza infection[90]
- antiviral of choice for influenza outbreaks in long-term care facilities[6]
- resistance of influenza A to oseltamivir is emerging[10]
- may be used in children & infants < 1 year of age[23]
- does not reduce viral shedding or transmission among household contacts[54]
- zanamivir or oseltamivir may be continued for the entire influenza season for high-risk patients[82]
- baloxavir marboxil is about as effective as oseltamivir[80]
- consider if high-risk of complications[92]
- CDC does not recommend use of baloxavir for treatment of influenza in pregnant women, breastfeeding mothers, or immunosuppressed persons[93]
- combination therapy may be of benefit
- oseltamivir, amantadine, & ribavirin[18]
- associated with reduced viral load but no clinical improvement over oseltamivir monotherapy[67]
- clarithromycin-naproxen-oseltamivir combination reduced mortality of patients hospitalized for Influenza A(H3N2)[65]
- favipiravir + oseltamivir better than oseltamivir alone for treatment of severe influenza[86]
- avoid combination antiviral therapy[82]
- oseltamivir, amantadine, & ribavirin[18]
- may reduce duration of symptoms & decrease risk of complications[19]
- adamantanes
- amantadine (Symmetrel) 100 mg PO BID for 5 days
- not recommended due to high rate of resistance[19]
- rimantadine (Flumadine) 100 mg PO BID for 5 days - not recommended due to high rate of resistance[19]
- resistance to adamantanes in 2005-2006 season[14]
- adamantanes active against influenza A only
- not recommended by CDC due to resistance of circulating strains[23]
- no longer considered useful[82]
- amantadine (Symmetrel) 100 mg PO BID for 5 days
- indications:
- herbal/homeopathic remedies[8]
- complicated influenza
- primary viral pneumonia
- hospitalization
- oxygenation (see ARDS)
- peramivir 300-600 mg IV (once)[82]
- secondary bacterial pneumonia
- empiric antibiotic treatment directed at most common organisms (see above)
- ceftriaxone + azithromycin
- vancomycin for MRSA not recommended unless admitted to ICU or identified MRSA risk factors other than prior influenza infection[99]
- Reye's syndrome
- intensive care support to manage hypoglycemia, increased blood ammonia & cerebral edema
- glucocorticoids not considered useful[82]
- coinfection with SARS-Cov2
- remdesivir may be safely coadministered with oseltamivir[96]
- primary viral pneumonia
- prophylaxis
- influenza vaccination
- annual influenza vaccination recommended for all persons > 6 months of age
- vaccination mid-October to mid-November[6]
- for patients & health care workers[6]
- consistently poor response in the elderly[28]
- serious influenza can develop despite vaccination & can cause considerable mortality in the elderly[16]
- live attenuated influenza virus vaccine (FluMist)
- not recommended for 2016-17 flu season[62]
- surgical mask as effective as N95 respirator in protecting healthcare workers from influenza[20]
- hand hygiene & surgical masks can reduce transmission of influenza in households & in healthcare systems[22][63]
- baloxavir marboxil (Xofluza) FDA-approved for post-exposure prophylaxis for adults & chilren >= 12 years within 48 hours of exposure
- influenza vaccination
Comparative biology
- genes for broadly neutralizing antibodies inserted into an adenoviral gene-therapy vector in mice & ferrets infected many respiratory tract cells & resulted in secretion of Ab that protected the animals from lethal inocula of several strains of influenza virus[19]
More general terms
More specific terms
Additional terms
- influenza A virus
- influenza antigen test
- influenza B virus
- influenza C virus
- influenza D virus
- influenza virus vaccine, inactivated (Fluogen, Fluzone, Fluvirin, Flushield, Fluarix, Flulaval, Agriflu, Afluria, Flublok Quadrivalent, FluCelVax, Fluad, RIV4)
References
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1092
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 877-78
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 794-95
- ↑ 4.0 4.1 Journal Watch 21(24):192, 2001 Zambon MC et al Contribution of influenza and respiratory syncytial virus to community cases of influenza-like illness: an observational study. Lancet 358:1410, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11705487
- ↑ 5.0 5.1 Journal Watch 22(20):149, 2002 Seo H et al Lethal H5N1 influenza viruses escape host anti-viral cytokine responses. Nat Med 8:950, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12195436
- ↑ 6.0 6.1 6.2 6.3 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - ↑ 7.0 7.1 Journal Watch 23(20):158, 2003 Rothberg MB et al Management of influenza in adults older than 65 years of age: cost-effectiveness of rapid testing and antiviral therapy. Ann Intern Med 139(Sep 2):321, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12965940
- ↑ 8.0 8.1 Influenza Antiviral Medications: Interim Chemoprophylaxis and Treatment Guidelines Prescriber's Letter 11(1):1 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200101&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 9.0 9.1 Prescriber's Letter 11(9): 2004 Influenza Virus Vaccine: New Recommendations Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200907&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 10.0 10.1 Kiso M, Mitamura K, Sakai-Tagawa Y, Shiraishi K, Kawakami C, Kimura K, Hayden FG, Sugaya N, Kawaoka Y. Resistant influenza A viruses in children treated with oseltamivir: descriptive study. Lancet. 2004 Aug 28;364(9436):759-65. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15337401
Moscona A. Oseltamivir-resistant influenza? Lancet. 2004 Aug 28;364(9436):733-4. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15337382 - ↑ Prescriber's Letter 11(11): 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=201109&pb=PRL Influenza Antiviral Medications: Interim Chemoprophylaxis and Treatment Guidelines (subscription needed) http://www.prescribersletter.com
- ↑ 12.0 12.1 Scott A. Harper, Keiji Fukuda, Timothy M. Uyeki, Nancy J. Cox, Carolyn B. Bridges, MD Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR July 13, 2005 / 54(Early Release);1-40
- ↑ 13.0 13.1 Call SA, Vollenweider MA, Hornung CA, Simel DL, McKinney WP. Does this patient have influenza? JAMA. 2005 Feb 23;293(8):987-97. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15728170
Stein J, Louie J, Flanders S, Maselli J, Hacker JK, Drew WL, Gonzales R. Performance characteristics of clinical diagnosis, a clinical decision rule, and a rapid influenza test in the detection of influenza infection in a community sample of adults. Ann Emerg Med. 2005 Nov;46(5):412-9. Epub 2005 Aug 15. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16271670 - ↑ 14.0 14.1 Bright RA, Shay DK, Shu B, Cox NJ, Klimov AI. Adamantane resistance among influenza A viruses isolated early during the 2005-2006 influenza season in the United States. JAMA. 2006 Feb 22;295(8):891-4. Epub 2006 Feb 2. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16456087
Centers for Disease Control and Prevention (CDC). CDC recommends against use of amantadine and rimantadine for the treatment of prophylaxis of influenza during the 2005- 2006 flu season. CDC Health Alert Network 2006, Jan 14 http://www.cdc.gov/flu/han011406.htm Updated recommendations on the prevention and control of influenza http://www.cdc.gov/mmwr/preview/mmwrhtml/rr55e628a1.htm - ↑ Prescriber's Letter 13(9): 2006 Updates in Treatment and Prevention of Influenza Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220903&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 16.0 16.1 16.2 McGeer A et al. Antiviral therapy and outcomes of influenza requiring hospitalization in Ontario, Canada. Clin Infect Dis 2007 (Dec 15); 45:1568 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18190317
- ↑ Prescriber's Letter 15(9): 2008 Update on Influenza 2008-2009 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=240902&pb=PRL (subscription needed) http://www.prescribersletter.com
Prescriber's Letter 16(2): 2009 CDC's Interim Influenza Antiviral Guidance for 2008-09 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=250201&pb=PRL (subscription needed) http://www.prescribersletter.com - ↑ 18.0 18.1 Nguyen JT et al Triple combination of oseltamivir, amantadine, and ribavirin displays synergistic activity against multiple influenza strains in vitro. Antimicrob Agents Chemother 2009 Jul 20 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19620324 <Internet> http://dx.doi.org/10.1128/AAC.00476-09
- ↑ 19.00 19.01 19.02 19.03 19.04 19.05 19.06 19.07 19.08 19.09 19.10 19.11 19.12 19.13 19.14 19.15 Medical Knowledge Self Assessment Program (MKSAP) 14, 16, 17, 18, 19. American College of Physicians, Philadelphia 2006, 2012, 2015, 2018, 2021.
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 20.0 20.1 Loeb M et al Surgical Mask vs N95 Respirator for Preventing Influenza Among Health Care Workers JAMA. 2009;302(17) doi:10.1001/jama.2009.1466
Srinivasan A and Perl TM Respiratory Protection Against Influenza JAMA. 2009;302(17) doi:10.1001/jama.2009.1494 - ↑ 21.0 21.1 Prescriber's Letter 16(11): 2009 COMMENTARY: Supplements for Prevention and Treatment of Colds and Influenza CONTINUING EDUCATION: Natural Medicines in the Clinical Management of Colds and Flu Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=251112&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 22.0 22.1 Cowling BJ et al Facemasks and hand hygiene to prevent influenza transmission in households: A cluster randomized trial. Ann Intern Med 2009 Oct 6; 151:437. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19652172
- ↑ 23.0 23.1 23.2 23.3 23.4 Fiore AE et al Antiviral Agents for the Treatment and Chemoprophylaxis of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR January 21, 2011 / 60(RR01);1-24 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21248682 <Internet> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6001a1.htm corresponding NGC guideline withdrawn Dec 2016
- ↑ 24.0 24.1 Lee TC et al. Predictors of pandemic influenza infection in adults presenting to two urban emergency departments, Toronto, 2009. CJEM 2011 Jan; 13:7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21324291
- ↑ Sheng Z-M et al. Autopsy series of 68 cases dying before and during the 1918 influenza pandemic peak. Proc Natl Acad Sci U S A 2011 Sep 27; 108:16416. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21930918
- ↑ 26.0 26.1 Chartrand C et al Accuracy of Rapid Influenza Diagnostic Tests: A Meta-analysis Annals of Internal Medicine February 21, 2012, 156(4) <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22371850 <Internet> http://www.annals.org/content/early/2012/02/27/0003-4819-156-7-201204030-00403.abstract
- ↑ 27.0 27.1 27.2 27.3 Hsu J et al Antivirals for Treatment of Influenza: A Systematic Review and Meta-analysis of Observational Studies Annals of Internal Medicine February 21, 2012, 156(4) <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22371849 <Internet> http://www.annals.org/content/early/2012/02/27/0003-4819-156-7-201204030-00411?aimhp
- ↑ 28.0 28.1 Treanor JJ et al. Effectiveness of seasonal influenza vaccines in the United States during a season with circulation of all three vaccine strains. Clin Infect Dis 2012 Oct 1; 55:951 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22843783
- ↑ 29.0 29.1 29.2 Bischoff WE et al. Exposure to influenza virus aerosols during routine patient care. J Infect Dis 2013 Apr 1; 207:1037 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23372182
Hall CB. Influenza virus: Here, there, especially air? J Infect Dis 2013 Apr 1; 207:1027 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23372181 - ↑ 30.0 30.1 30.2 Jefferson T, Jones M, Doshi P, Del Mar C, Dooley L, Foxlee R. Neuraminidase inhibitors for preventing and treating influenza in healthy adults. Cochrane Database Syst Rev. 2010 Feb 17;(2):CD001265 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20166059
- ↑ Centers for Disease Control and Prevention Influenza Activity -- United States, 2012-13 Season and Composition of the 2013-14 Influenza Vaccine. MMWR. June 14, 2013 / 62(23);473-479 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6223a5.htm
- ↑ Limberis MP et al. Intranasal antibody gene transfer in mice and ferrets elicits broad protection against pandemic influenza. Sci Transl Med 2013 May 29; 5:187ra72 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23720583 <Internet> http://stm.sciencemag.org/content/5/187/187ra72?ijkey=fab6c37f832d4a8c3b8456b1f7128df257547948&keytype2=tf_ipsecsha
- ↑ 33.0 33.1 33.2 Lambert LC, Fauci AS. Influenza vaccines for the future. N Engl J Med. 2010 Nov 18;363(21):2036-44 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21083388
- ↑ 34.0 34.1 Centers for Disease Control and Prevention (CDC) Seasonal Influenza (Flu) 2013-2014 Influenza Season Week 1 ending January 4, 2014 http://www.cdc.gov/flu/weekly/
- ↑ 35.0 35.1 35.2 Memoli MJ et al. The natural history of influenza infection in the severely immunocompromised vs nonimmunocompromised hosts. Clin Infect Dis 2014 Jan 15; 58:214 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24186906 <Internet> http://cid.oxfordjournals.org/content/58/2/214
- ↑ 36.0 36.1 Canetta SE et al. Serological documentation of maternal influenza exposure and bipolar disorder in adult offspring. Am J Psychiatry 2014 Jan 31 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24480930
- ↑ 37.0 37.1 Hayward AC et al Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respir Med 17 March 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24717637 <Internet> http://www.thelancet.com/journals/lanres/article/PIIS2213-2600%2814%2970034-7/abstract
Horby PW Community studies of influenza: new knowledge, new questions. Lancet Respir Med, 17 March 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24717636 <Internet> http://www.thelancet.com/journals/lanres/article/PIIS2213-2600%2814%2970053-0/fulltext - ↑ 38.0 38.1 Heneghan CJ et al Zanamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ 2014;348:g2547 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24811412 <Internet> http://www.bmj.com/content/348/bmj.g2547
Jefferson T et al Oseltamivir for influenza in adults and children: systematic review of clinical study reports and summary of regulatory comments. BMJ 2014;348:g2545 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24811411 <Internet> http://www.bmj.com/content/348/bmj.g2545
Loder E et al The Tamiflu trials. BMJ 2014;348:g2630 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24811414 <Internet> http://www.bmj.com/content/348/bmj.g2630
Krumholz HM and Hines HH Neuraminidase inhibitors for influenza BMJ 2014;348:g2548 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24811413 <Internet> http://www.bmj.com/content/348/bmj.g2548
Jefferson T, Jones MA, Doshi P et al Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database Syst Rev. 2014 Apr 10;4:CD008965. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24718923 - ↑ Gaillat J, Chidiac C, Fagnani F Morbidity and mortality associated with influenza exposure in long-term care facilities for dependent elderly people. Eur J Clin Microbiol Infect Dis. 2009 Sep;28(9):1077-86. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19444493
- ↑ Harper SA, Bradley JS, Englund JA et al Seasonal influenza in adults and children--diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2009 Apr 15;48(8):1003-32. doi:http://dx.doi.org/ 10.1086/598513. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19281331
- ↑ 41.0 41.1 41.2 Epperson S et al Influenza Activity - United States, 2013-14 Season and Composition of the 2014-15 Influenza Vaccines. MMWR. June 6, 2014 / 63(22);483-490 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a2.htm
- ↑ 42.0 42.1 42.2 Hills NK et al Timing and number of minor infections as risk factors for childhood arterial ischemic stroke. Neurology. August 20, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25142897 <Internet> http://www.neurology.org/content/early/2014/08/20/WNL.0000000000000752
Marquardt L A common cold is no stroke of luck. Risk for cerebral ischemia in Children. Neurology. August 20, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25142898 <Internet> http://www.neurology.org/content/suppl/2014/08/20/WNL.0000000000000752.DC1/WNL.0000000000000760.pdf - ↑ 43.0 43.1 43.2 Jefferson DV et al Vaccines to prevent influenza in healthy adults. Cochrane Summaries. March 2014 http://summaries.cochrane.org/CD001269/ARI_vaccines-to-prevent-influenza-in-healthy-adults
- ↑ 44.0 44.1 Aquino TL et al Influenza Outbreak in a Vaccinated Population - USS Ardent, February 2014. MMWR. October 24, 2014 / 63(42);947-949 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6342a3.htm
- ↑ 45.0 45.1 Gill PJ et al Identification of children at risk of influenza-related complications in primary and ambulatory care: a systematic review and meta-analysis. Lancet Respiry Med. December 4, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25481379 <Internet> http://www.thelancet.com/journals/lanres/article/PIIS2213-2600%2814%2970252-8/abstract
- ↑ CDC Health Advisory. Dec 3, 2014 CDC Health Advisory Regarding the Potential for Circulation of Drifted Influenza A (H3N2) Viruses. http://emergency.cdc.gov/han/han00374.asp
CDC Press Release. Dec 4, 2014 Early Data Suggests Potentially Severe Flu Season http://www.cdc.gov/media/releases/2014/p1204-flu-season.html - ↑ 47.0 47.1 FDA News Release. December 22, 2014 FDA approves Rapivab to treat flu infection http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm427755.htm
- ↑ 48.0 48.1 Lowes R Molecular 15-Minute Flu Test Cleared for Physician Offices. http://www.medscape.com/viewarticle/837638
- ↑ 49.0 49.1 Young K, Sadoughi S, Sofair A CDC Recommends Antivirals in High-Risk Flu Patients, Even Before Test Results in. Physician's First Watch, Jan 12, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
CDC Health Alert Network. Jan 9, 2015 CDC Health Update Regarding Treatment of Patients with Influenza with Antiviral Medications. http://emergency.cdc.gov/han/han00375.asp - ↑ 50.0 50.1 50.2 Dobson J et al Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet. Jan 29, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25640810 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962449-1/abstract
- ↑ Rothberg MB et al. Complications of viral influenza. Am J Med 2008 Apr 1; 121:258 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18374680
- ↑ 52.0 52.1 Chertow DS and Memoli MJ. Bacterial coinfection in influenza: a grand rounds review. JAMA 2013 Jan 17; 309:275 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23321766
- ↑ 53.0 53.1 53.2 Dugas AF et al. Clinical diagnosis of influenza in the ED. Am J Emerg Med 2015 Jun; 33:770 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25827595
- ↑ 54.0 54.1 Cheung DH et al. Association of oseltamivir treatment with virus shedding, illness, and household transmission of influenza viruses. J Infect Dis 2015 Aug 1; 212:391 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25646354 <Internet> http://jid.oxfordjournals.org/content/212/3/391
- ↑ Glezen WP. Clinical practice. Prevention and treatment of seasonal influenza. N Engl J Med 2008 Dec 17; 359:2579. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19073977
- ↑ 56.0 56.1 56.2 Baguelin M, Flasche S, Camacho A et al Assessing optimal target populations for influenza vaccination programmes: an evidence synthesis and modelling study. PLoS Med. 2013 Oct;10(10):e1001527 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24115913
- ↑ 57.0 57.1 Jefferies S et al Randomized controlled trial of the effect of regular paracetamol on influenza infection. Respirology. Dec 6, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26638130 <Internet> http://onlinelibrary.wiley.com/doi/10.1111/resp.12685/full
- ↑ Shenoy ES, Lai PS, Shepard JA, Kradin RL Case 39-2015 - A 22-Year-Old Man with Hypoxemia and Shock. N Engl J Med 2015; 373:2456-2466. December 17, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26672848 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcpc1507212
- ↑ CDC Health Advisory. Feb 1, 2016 Flu Season Begins: Severe Influenza Illness Reported. http://emergency.cdc.gov/han/han00387.asp
- ↑ Kidd M. Influenza viruses: update on epidemiology, clinical features, treatment and vaccination. Curr Opin Pulm Med. 2014 May;20(3):242-6. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24637227
- ↑ 61.0 61.1 61.2 Davlin SL, Blanton L, Kniss K, et al. Influenza Activity - United States, 2015-16 Season and Composition of the 2016-17 Influenza Vaccine. MMWR Morb Mortal Wkly Rep 2016;65:567-575 http://www.cdc.gov/mmwr/volumes/65/wr/mm6522a3.htm
- ↑ 62.0 62.1 Centers for Disease Control and Prevention (CDC) ACIP votes down use of LAIV for 2016-2017 flu season. http://www.cdc.gov/media/releases/2016/s0622-laiv-flu.html
American Academy of Pediatrics AAP Supports ACIP Recommendation for Use of Inactivated Flu Vaccine. https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Supports-ACIP-Recommendation-for-Use-of-Inactivated-Flu-Vaccine.aspx - ↑ 63.0 63.1 De Serres G, Skowronski DM, Ward BJ et al Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement. PLOS One. Published: January 27, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28129360 Free Article <Internet> http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163586
- ↑ Qualls N, Levitt A, Kanade N, et al. Community Mitigation Guidelines to Prevent Pandemic Influenza - United States, 2017. MMWR Recomm Rep 2017;66(No. RR-1):1-34 https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm
- ↑ 65.0 65.1 Hung IFN, To KKW, Chan JFW et al. Efficacy of clarithromycin-naproxen-oseltamivir combination in the treatment of patients hospitalized for influenza A(H3N2) infection: An open-label randomized, controlled, phase IIb/III trial. Chest 2017 May; 151:1069 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27884765
- ↑ 66.0 66.1 66.2 66.3 66.4 Merckx J, Wali R, Schiller I et al Diagnostic Accuracy of Novel and Traditional Rapid Tests for Influenza Infection Compared With Reverse Transcriptase Polymerase Chain Reaction: A Systematic Review and Meta- analysis. Ann Intern Med. Sept 5, 2017. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28869986 <Internet> http://annals.org/aim/article/2652566/diagnostic-accuracy-novel-traditional-rapid-tests-influenza-infection-compared-reverse
Ison MG Contemporary Influenza Diagnostics: Renewed Focus on Testing Patients. Ann Intern Med. Sept 5, 2017. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28869977 <Internet> http://annals.org/aim/article/2652872/contemporary-influenza-diagnostics-renewed-focus-testing-patients - ↑ 67.0 67.1 Beigel JH, Bao Y, Beeler J et al Oseltamivir, amantadine, and ribavirin combination antiviral therapy versus oseltamivir monotherapy for the treatment of influenza: a multicentre, double-blind, randomised phase 2 trial. Lancet Infectious Diseases. Sept 22, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28958678 <Internet> http://thelancet.com/journals/laninf/article/PIIS1473-3099(17)30476-0/fulltext
Ison MG Finding the right combination antiviral therapy for influenza. Lancet Infectious Diseases. Sept 22, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28958679 <Internet> http://thelancet.com/journals/laninf/article/PIIS1473-3099(17)30537-6/fulltext - ↑ 68.0 68.1 68.2 Centers for Disease Control and Prevention (CDC) Seasonal Influenza (Flu): FluView http://www.cdc.gov/flu/weekly/
- ↑ Paules CI, Sullivan SG, Subbarao K, Fauci AS Chasing Seasonal Influenza - The Need for a Universal Influenza Vaccine. N Engl J Med. Nov 29, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29185857 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMp1714916
- ↑ 70.0 70.1 Dugan VG, Blanton L, Elal AI, et al. Update: Influenza Activity - United States, October 1- November 25, 2017. MMWR Morb Mortal Wkly Rep 2017;66:1318-1326 https://www.cdc.gov/mmwr/volumes/66/wr/mm6648a2.htm
- ↑ 71.0 71.1 71.2 Iuliano AD, Roguski KM, Chang HH et al Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. The Lancet. Dec 13, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29248255 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33293-2/fulltext
Sullivan S. Challenges in reducing influenza-associated mortality. The Lancet. Dec 13, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29248256 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33292-0/fulltext - ↑ 72.0 72.1 Brooks M. US Influenza Activity Widespread and Intense, May Be Peaking Medscape - Jan 12, 2018. https://www.medscape.com/viewarticle/891265
- ↑ 73.0 73.1 Yan J, Grantham M, Pantlelic J et al Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community. Proceedings of the National Academy of Sciences. Jan 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29348203 Free full text <Internet> http://m.pnas.org/content/early/2018/01/17/1716561115.full
- ↑ 74.0 74.1 Kwong JC, Schwartz KL, Campitelli MA et al Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med 2018; 378:345-353. Jan 25, 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29365305 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1702090
- ↑ 75.0 75.1 Centers for Disease Control & Prevention (CDC) Situation Update: Summary of Weekly FluView Report. Jan 26, 2018 https://www.cdc.gov/flu/weekly/summary.htm
- ↑ 76.0 76.1 76.2 Brooks M Flu Season as Intense as 2009 Pandemic. Medscape - Feb 09, 2018. https://www.medscape.com/viewarticle/892503
- ↑ 77.0 77.1 77.2 Flannery B, Chung JR, Belongia EA, et al. Interim Estimates of 2017-2018 Seasonal Influenza Vaccine Effectiveness - United States, February 2018. MMWR Morb Mortal Wkly Rep 2018;67:180-185 https://www.cdc.gov/mmwr/volumes/67/wr/mm6706a2.htm
- ↑ FDA News Release. March 2, 2018 FDA warns of fraudulent and unapproved flu products. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm599223.htm
- ↑ 79.0 79.1 Schauwvlieghe A, Rijnders B, Philips N et al Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: a retrospective cohort study, Lancet Respir Med July 31, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30076119 https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(18)30274-1/fulltext
- ↑ 80.0 80.1 Hayden FG, Sugaya N, Hirotsu N Baloxavir Marboxil for Uncomplicated Influenza in Adults and Adolescents. N Engl J Med 2018; 379:913-923. Sept 6, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30184455 https://www.nejm.org/doi/full/10.1056/NEJMoa1716197
- ↑ Rolfes MA, Millman AJ, Talley P et al. Influenza-associated parotitis during the 2014-2015 influenza season in the United States. Clin Infect Dis 2018 Aug 15; 67:485 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29617957 https://academic.oup.com/cid/article/67/4/485/4957003
Elbadawi LI, Talley P, Rolfes MA et al. Non-mumps viral parotitis during the 2014-2015 influenza season in the United States. Clin Infect Dis 2018 Aug 15; 67:493. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29617951 https://academic.oup.com/cid/article/67/4/493/4957004
Pavia AT. Is parotitis one more complication of influenza? The ongoing challenge of determining causal associations. Clin Infect Dis 2018 Aug 15; 67:502 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29617960 https://academic.oup.com/cid/article-abstract/67/4/502/4957005 - ↑ 82.0 82.1 82.2 82.3 82.4 82.5 82.6 Uyeki TM, Bernstein HH, Bradley JS et al. Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. Clin Infect Dis 2018 Dec 19 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30566567 https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935
- ↑ 83.0 83.1 Uyeki TM. Influenza. Ann Intern Med. 2017 Sep 5;167(5):ITC33-ITC48. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28869984
- ↑ 84.0 84.1 Blanton L, Dugan VG, Abd Elal AI, et al. Update: Influenza Activity - United States, September 30, 2018- February 2, 2019. MMWR Morb Mortal Wkly Rep 2019;68:125-134
- ↑ 85.0 85.1 85.2 Dugas AF, Hsieh YH, Lovecchio F et al. Derivation and validation of a clinical decision guideline for influenza testing in 4 US emergency departments. Clin Infect Dis 2019 May 21 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30843056 https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciz171/5370566
- ↑ 86.0 86.1 Lewis R Two Drugs Better Than One for Severe Influenza. Medscape - Dec 16, 2019. https://www.medscape.com/viewarticle/922729
Wang Y, Fan G, Salam A et al Comparative effectiveness of combined favipiravir and oseltamivir therapy versus oseltamivir monotherapy in critically ill patients with influenza virus infection. Journal of Infectious Diseases. Dec 11, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31822885 https://academic.oup.com/jid/advance-article-abstract - ↑ CDC Health Alert Network, March 28, 2019 https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a1.htm
- ↑ Centers for Disease Control & Prevention (CDC) Preliminary In-Season U.S. Influenza Burden Estimates. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm
Weekly U.S. Influenza Surveillance Report https://www.cdc.gov/flu/weekly/index.htm
Weekly U.S. Influenza Surveillance Report Key Updates for Week 48, ending November 30, 2019 https://www.cdc.gov/flu/weekly/index.htm - ↑ 89.0 89.1 CDC Health Alert Network. January 10, 2020, Elevated Influenza Activity: Influenza B/Victoria and A(H1N1)pdm09 Viruses are the Predominant Viruses. https://emergency.cdc.gov/han/HAN00425.asp
Owusu D, Hand J, Tenforde MW, et al. Early Season Pediatric Influenza B/Victoria Virus Infections Associated with a Recently Emerged Virus Subclade - Louisiana, 2019. MMWR Morb Mortal Wkly Rep. ePub: 10 January 2020 https://www.cdc.gov/mmwr/volumes/69/wr/mm6902e1.htm? - ↑ 90.0 90.1 Butler CC, van der Velden AW, Bongard E et al. Oseltamivir plus usual care versus usual care for influenza-like illness in primary care: An open-label, pragmatic, randomised controlled trial. Lancet 2020 Jan 4; 395:42 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31839279
- ↑ 91.0 91.1 91.2 Chow EJ, Rolfes MA, O'Halloran A Acute Cardiovascular Events Associated With Influenza in Hospitalized Adults. A Cross-sectional Study. Ann Intern Med. August 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32833488 https://www.acpjournals.org/doi/full/10.7326/M20-1509
MacIntyre CR Influenza Vaccine: Routine Secondary Prevention for Patients With Cardiovascular Disease? Ann Intern Med. August 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32833491 https://www.acpjournals.org/doi/10.7326/M20-5810 - ↑ 92.0 92.1 Liu JW, Lin SH, Wang LC et al Comparison of Antiviral Agents for Seasonal Influenza Outcomes in Healthy Adults and Children. A Systematic Review and Network Meta-analysis. JAMA Netw Open. 2021;4(8):e2119151. August 13. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34387680 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2782995
- ↑ 93.0 93.1 93.2 93.3 93.4 93.5 Bronze MS Fast Five Quiz: Influenza Practice Essentials Medscape. November 3, 2021 https://reference.medscape.com/viewarticle/962197
Nguyen HH, Bronze MS Influenza Treatment & Management Medscape. November 5, 2021 https://emedicine.medscape.com/article/219557-treatment - ↑ Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza. Clin Infect Dis. 2019;68(6):e1-e47 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30566567 PMCID: PMC6653685 Free PMC article https://academic.oup.com/cid/article/68/6/e1/5251935
- ↑ 95.0 95.1 AMA Morning Rounds. Oct 31, 2022 American Medical Association
- ↑ 96.0 96.1 96.2 96.3 Bronze MS Fast Five Quiz: Influenza During the COVID-19 Pandemic. Medscape. Nov 15, 2022 https://reference.medscape.com/viewarticle/983770
- ↑ 97.0 97.1 Larkin H Combined COVID-19 and Flu Test Authorized for Point-of-Care Use. JAMA. 2023;329(1):14-15. doi:10.1001/jama.2022.23890. Jan 3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36594962 https://jamanetwork.com/journals/jama/fullarticle/2800045
- ↑ 98.0 98.1 Febbo J, Revels J, Ketai L. Viral Pneumonias. Radiol Clin North Am. 2022 May;60(3):383-397. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35534126 Review.
- ↑ 99.0 99.1 Morris DE, Cleary DW, Clarke SC. Secondary Bacterial Infections Associated with Influenza Pandemics Front Microbiol. 2017 Jun 23;8:1041. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28690590 PMCID: PMC5481322 Free PMC article
- ↑ 100.0 100.1 Hanula R et al. Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: A systematic review and meta-analysis. JAMA Intern Med 2023 Jun 12; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/37306992 PMCID: PMC10262060 Free PMC article https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2805976
- ↑ Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. Clin Infect Dis. 2019;68:895-902. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30834445
- ↑ National Institute of Allergy and Infectious Diseases (NIAID) Influenza https://www.niaid.nih.gov/diseases-conditions/influenza
Centers for Disease Control & Prevention (CDC) Diagnosing Flu https://www.cdc.gov/flu/symptoms/testing.htm