Pandemic Influenza Information

Avian influenza is caused by avian influenza viruses, which occur naturally among birds.
Pandemic influenza causes a global outbreak, or pandemic, of serious illness that spreads easily from person to person. Currently there is no pandemic influenza.
Seasonal influenza is a contagious respiratory illness caused by influenza viruses.

For more information on pandemic influenza planning tools and Utah's Pandemic Influenza Plan , visit www.pandemicflu.utah.gov/.


Influenza Vaccination Information

Influenza Vaccine

There are two types of influenza vaccine: an injectible “flu shot” and a nasal spray vaccine. Each season three strains of virus are included in the influenza vaccine. The vaccine virus strains for the 2008-2009 season include:

• A/Brisbane/59/2007 (H1N1)-like
• A/Brisbanen/10/2007 (H3N2)-like
• B/Florida/4/2006-like viruses.

The influenza shot (Trivalent Inactivated Influenza Vaccine or TIV) contains killed virus. Influenza shots are approved for use in people older than six months, including healthy people and people with chronic medical conditions.

The nasal spray vaccine (Live Attenuated Influenza Vaccine or LAIV/) contains the same three virus strains but are weakened live viruses. LAIV is approved for use in healthy people 2-49 years of age who are not pregnant.

The following tables describe the recommended number of doses by age for the TIV and LAIV:

TIV (Trivalent Inactivated Influenza Vaccine - injectable)

Who Should Be Vaccinated

Influenza Vaccination Recommendations for the 2008-2009 Flu Season:

• All persons who want to reduce the risk of becoming ill with influenza or of transmitting influenza to others
• All children aged 6 months through 18 years
• All persons aged >50 years
• Children and adolescents (aged 6 months–18 years) receiving long-term aspirin therapy who therefore might be at risk for experiencing Reye syndrome after influenza virus infection
• Women who will be pregnant during the influenza season
• Adults and children who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological or metabolic disorders (including diabetes mellitus)
• Adults and children who have immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus
• Adults and children who have any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration
• Residents of nursing homes and other chronic-care facilities
• Health-care personnel
• Healthy household contacts (including children) and caregivers of children aged <5 years and adults aged >50 years, with particular emphasis on vaccinating contacts of children aged <6 months; and
• Healthy household contacts (including children) and caregivers of persons with medical conditions that put them at higher risk for severe complications from influenza.

Who Should Not Be Vaccinated

Talk with your health care provider before getting the injectable influenza vaccine or TIV if you:

• Have ever had a severe allergic reaction to eggs or to a previous influenza shot or
• Have a history of Guillain-Barré syndrome within six weeks following a previous dose of TIV.

If you are sick with a moderate to severe fever when you go to get your influenza shot, talk to your doctor or nurse about getting your shot at a later date. However, you can get an influenza shot at the same time you have a respiratory illness without fever or if you have another mild illness.

The following groups should not be vaccinated with the nasal spray influenza vaccine:

• People with a history of hypersensitivity, including anaphylaxis, to any of the components of LAIV or to eggs
• People less than two years of age
• People 50 years of age and over
• People with a medical condition that places them at high risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease
• People with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system
• children two to four years old with a history of recurrent wheezing or asthma within the preceeding 12 months
• Children or adolescents receiving aspirin
• People with a history of Guillain-Barré syndrome, a rare disorder of the nervous system
• Pregnant women.

Read the Recommendations of the Advisory Committee on Immunization Practices (ACIP) on the Prevention and Control of Influenza.


Public Influenza Clinic Information Hotline

Influenza vaccine will be available at numerous locations such as; private provider offices and agencies, community health centers, public health departments, aging services, participating pharmacies, and participating grocery stores. For information about times and locations of public influenza clinics, call the Utah Immunization Hotline at: 1-800-275-0659 or visit the Flu Clinic Locator. Private provider information is not available through the hotline number. For private provider information, please call your health care provider directly.


What to Do If You Get the Influenza

Influenza vaccine is the primary measure to avoid illness from the influenza. However, illness can still occur. The following information may be helpful for those who do get influenza.

Be Aware of Common Flu Symptoms

The influenza usually comes on suddenly and may include these symptoms:

• High fever
• Headache
• Tiredness/weakness (can be extreme)
• Dry cough
• Sore throat
• Runny nose
• Body or muscle aches
• Diarrhea and vomiting also can occur, but are more common in children.

These symptoms are usually referred to as “flu-like symptoms." A lot of different illnesses, including the common cold, can have similar symptoms.

Cold versus the Flu

The influenza and the common cold are both respiratory illnesses caused by different viruses. Because these two types of illnesses have similar symptoms, it can be difficult to tell the difference between them. In general, the influenza is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the influenza. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.

General Steps to Take If You Get Sick

If you develop flu-like symptoms, and you are not at high risk for complications from the influenza:

• Get plenty of rest
• Drink a lot of liquids
• Avoid using alcohol and tobacco
• Consider taking over the counter medications to relieve the symptoms of influenza (but never give aspirin to children or teenagers who have flu-like symptoms)
• Stay home and avoid contact with other people to protect them from catching your illness
• Cover your nose and mouth with a tissue when you cough or sneeze to protect others from your germs.

Most healthy people recover from the influenza without complications.

Look Out for Emergency Warning Signs

There are some emergency warning signs that require urgent medical attention. In children, some emergency warning signs that need urgent medical attention include:

• High or prolonged fever
• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Changes in mental status, such as not waking up or not interacting; being so irritable that the child does not want to be held or seizures
• Flu-like symptoms improve but then return with fever and worse cough; and
• Worsening of underlying chronic medical conditions (for example, heart or lung disease, diabetes).

In adults, some emergency warning signs that need urgent medical attention include:

• High or prolonged fever
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest
• Near fainting or fainting
• Confusion; and
• Severe or persistent vomiting.

Seek medical care immediately, either by calling your doctor or going to an emergency room, if you or someone you know is experiencing any of the signs described above or other unusually severe symptoms. When you arrive, tell the receptionist or nurse about your symptoms. You may be asked to wear a mask and/or sit in a separate area to protect others from getting sick.

Special Concerns for People at High Risk for Complications from the Influenza

Some people are at increased risk to develop complications of influenza. This group includes:

• People 65 years of age and older
• Children 6-59 months of age
• People of any age with chronic medical conditions (for example, heart or lung disease, asthma, diabetes, or HIV infection); and
• Pregnant women.

If you are in a group that is considered to be at high risk for complications from the influenza and you get flu-like symptoms, consult your health care provider when your symptoms begin.

Some of the complications caused by influenza include bacterial pneumonia, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. Children also may get sinus and ear infections.

Staph Infection and the Influenza

Persons infected with influenza are sometimes at higher risk for developing secondary infections, such as pneumonia. During the 2007-2008 U.S. influenza season, several cases of Methicillin Resistant Staphylococcus aureus (MRSA) infections, including pneumonias, occurred in association with influenza infection.

Click here for more information on Preventing the Flu.

Influenza Vaccine Supply

Four companies are currently licensed to produce influenza vaccine in the U.S. market: Sanofi Pasteur, Inc., MedImmune Vaccines, Inc., Novartis Vaccine, and GlaxoSmithKline, Inc.

Influenza vaccine manufacturers are projecting that as many as 146 million doses of influenza vaccine will be available from currently licensed manufacturers in the U.S. for use during the 2009-2009 influenza season. This amount depends upon production yields, FDA release, and demand for product.

 Additional information is available on the Centers for Disease Control and Prevention Influenza page http://www.cdc.gov/flu/.

Influenza Vaccine Suppliers

ASD Healthcare Cash Link
866-281-4FLU

Bessie Medical
1-800-543-2111

CNS (Community Nursing Services)
1-801-207-8749 (ask for Mavis McAffee)

FFF Enterprises
1-800-843-7477

General Injectables & Vaccines, Inc (GIV)
1-800-521-7468

Henry Schein Medical
1-800-772-4346

Sanofi Pasteur, Inc.
1-800-822-2463

Click here for a more extensive list of influenza vaccine distributors.

Purchasing Influenza Vaccine

Providers can find influenza vaccine for purchase through the Influenza Vaccine Availability Tracking System (IVATS). IVATS provides a downloadabel spreadsheet with the following information:

• Names of wholesale distributors or manufacturers with vaccine in stock for sale and/or on order
• How to order vaccine (phone, email, web or fax)
• Brands and formulations in stock for sale and/or on order
• If on order, projected availability date(s).

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