Mid-season update: Influenza

Sports Medicine Rounds

January 27, 2005

Paul W. Baumert, Jr. M.D., FAAFP

Assistant Clinical Professor of Orthopedics and Rehabilitation

Influenza (“the flu”)

•      Contagious, respiratory illness

•      Typically lasts days

•      Incubation period is 1-4 days

•      Infectious from the day before symptoms begin through about 5 days after illness onset

Symptoms of Influenza

•      Fever (usually high)

•       Headache

•       Malaise (can be extreme)

•      Body aches

•       (Diarrhea/vomiting can occur, but more common in kids)

•      Cough (nonproductive)

•       Sore throat

•       Runny or stuffy nose

Possible complications in athletes

•      Bacterial pneumonia

•      Dehydration

•      Worsening of other chronic medical problems

•    Asthma

•    Diabetes

•      Sinus/ear infections

Morbidity/mortality

•      Risks higher for:

•    Young children, esp. <1 year

•    Persons > 65 years of age

•    Underlying medical conditions

•      114,000 hospitalizations per year

•      36,000 deaths annually

Deaths from flu epidemic in early 20th century would fill Kinnick to capacity over 300 times!

Diagnosis of influenza

•      Clinical

•      Tests

•    Rapid testing

•   Affects treatment

•    Culture

•    Serology

•    Chest xray

Medication for influenza

•      Antiviral medications for type A influenza only:

•    Amantadine (Symmetrel)

•    Rimantadine (Flumadine)

•      Antiviral medications for both type A and B:

•    Oseltamivir (Tamiflu)

•    Zanamivir (Relenza)

Medication for influenza

•      If given for treatment:

•    Most helpful if given within the first 48 hours of symptoms

•    5 day regimen

•      If given for prophylaxis:

•    7 day regimen

If you get influenza:

•      Rest

•      Fluids

•      Avoid alcohol/tobacco

•      Habits for good health

•    Cover your nose/mouth

•    Don’t touch eyes/nose/mouth

•    Wash hands

•    Stay away from others

Prevention of influenza

•      Inactivated vaccine

•      Live, attenuated vaccine (FluMist)

Important warning signs

•      Difficulty breathing or shortness of breath

•      Pain or pressure in the chest or abdomen

•      Sudden dizziness

•      Confusion

•      Severe or persistent vomiting

2004-2005 Flu season at UI

•      10/4/04:  First training room flu shot clinic ( Jacobsen Athletic Building )

•      10/5/04:  Chiron announces it will not provide 40 million doses of flu vaccine to U.S. as expected

•      10/6/04:  UIHC requests all available vaccine be returned.  Other planned training room flu shot clinics cancelled.

2004-2005 Flu season at UI

•      12/10/04:  First reported case of influenza in the state of Iowa

•      12/17/04:  End of semester.  Vectors for possible transmission disperse.

2004-2005 Flu season at UI

•      1/1/05:  Iowa 30, LSU 25.  Regional outbreak of gastrointestinal illness reported in/around Baton Rouge , LA.   No reported illnesses in the state of Iowa of any kind.

2004-2005 Flu season at UI

•      1/18/05:  Spring semester begins.  Vectors for possible transmission return.

2004-2005 Flu season at UI

•      1/26/05:  UHL reports 64 confirmed cases of influenza to date.  Reports of some class/school outbreaks within the state this week.  Unofficial reports of Solon schools being significantly affected.

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Influenza Web Resources

CDC web site:

www.cdc.gov/flu/

Iowa Dept. of Public Health site:

www.idph.state.ia.us/adper/flu.asp