Prevention and Control of Communicable Diseases

Reportable to local or state health department

Influenza (also known as flu) is a very common respiratory disease. Influenza is not what is commonly referred to as “the stomach flu,” which is a term used by some to describe illnesses causing vomiting or diarrhea. Every year, millions of people in the United States get influenza. Influenza often results in more severe illness than other respiratory viruses.

Cause

Influenza virus. The two main types of influenza viruses are type A and type B. Within each type there are many related strains or subtypes, which can change every year. This is the reason a person can get influenza more than once and why a person should get vaccinated every year. Influenza usually occurs in the United States between October and May.

Symptoms

Influenza starts quickly with fever, chills, body aches, headache, cough, runny or stuffy nose, and sore throat. Illness usually lasts 3 to 7 days. Children may develop ear infections, pneumonia, or croup as a result of influenza infection.

Serious complications of influenza occur most often in the elderly, young infants, or people with chronic health problems or weakened immune systems.

Spread

Influenza is spread mainly person to person through droplets created with coughing and sneezing by persons infected with the virus. Infection occurs when a person has contact with droplets in the air or touches contaminated surfaces then touches their eyes, mouth or nose.

Incubation

It takes from 1 to 4 days, usually 2 days, from the time of infection until symptoms begin.

Contagious Period

Most contagious during the 24 hours before the symptoms begin (very young children may be contagious even earlier). After the symptoms start, children can be contagious up to 7 days and adults are generally contagious for 5 days. 

Exclusion

Child Care and School: Those with flu-like illness should stay home for at least 24 hours after they no longer have a fever, or signs of a fever, without the use of fever- reducing medicines. They should stay home even if they are using antiviral drugs.

Decisions about extending the exclusion period could be made at the community level, in conjunction with local and state health officials. More stringent guidelines and longer periods of exclusion – for example, until complete resolution of all symptoms – may be considered for people returning to a setting where high numbers of high-risk people may be exposed, such as a camp for children with asthma or a child care facility for children younger than 5 years old.

Diagnosis

Recommend parents/guardians call their healthcare provider if their child has a high fever and/or persistent cough. Viral cultures may be taken.

Treatment

Antiviral medications (antivirals) can shorten the course of illness if given within 36 to 48 hours after the symptoms begin. Influenza is a viral illness; therefore, antibiotics will not be effective.

Do not give aspirin or salicylate-containing medications to any child or adolescent under 18 years of age.

Acetaminophen (Tylenol) may be used to reduce fever and body aches.

Prevention/Control

• Annual influenza vaccinations are recommended for everyone 6 months of age and older. 

• Those at highest risk for influenza include: 

  • People with certain medical conditions like asthma, diabetes, and chronic lung disease. 

  • Pregnant women. 

  • People 65 years and older.

• In addition, flu vaccine can be given to anyone else who wishes to reduce the likelihood of becoming ill with influenza. The vaccine is usually given in the late fall. People who were not vaccinated in the fall may be vaccinated any time during the influenza season. For current recommendations check the MDHSS website. [NEEDS LINK]

• Cover nose and mouth with a tissue when coughing or sneezing, or cough/sneeze into your sleeve. Dispose of used tissues.
• Regular and thorough handwashing is the best way to prevent the spread of communicable diseases. Wash hands thoroughly with soap and warm running water after contact with secretions from the nose or mouth or handling used tissues.
• Try to avoid close contact with sick people.
• While sick, limit contact with others as much as possible to keep from infecting them.
• Take flu antiviral drugs if your doctor recommends them.
• Clean and disinfect commonly touched surfaces (door knobs, refrigerator handle, water faucets, cupboard handles, and computer keyboards) at least daily. (See Cleaning, Sanitizing, and Disinfection)
• Clean and sanitize mouthed objects and surfaces at least daily and when soiled. (See Cleaning, Sanitizing, and Disinfection)
• DO NOT allow sharing of anything that goes into the mouth such as drinking cups, straws, water bottles, and eating utensils.
• Stay home if you are ill. Encourage parents/guardians to keep ill children at home.

During Pandemic Influenza Additional Recommendations

• A flu (influenza) pandemic is an outbreak caused by a new human flu virus that spreads around the world. Because the pandemic flu virus will be new to people, many people could get very sick or could die. Seasonal flu shots do not protect people from pandemic flu.
• Antiviral medication may be used for the prevention or treatment of influenza. During a pandemic the Department of Health and Senior Services has a limited supply of medication that will be used according to Missouri’s Influenza Plan.
• Child care programs should work closely and directly with their local and state public health officials to make appropriate decisions and implement strategies in a coordinated manner.
• Child care providers should conduct daily health checks on all children. 
• Ill children should stay home and not be taken out of one child care program and put into another child care program even temporarily. 
• Child care programs can help serve as a focus for educational activities aimed at promoting ways to reduce the spread of influenza, including hand hygiene and cough etiquette. See Influenza | Health & Senior Services (mo.gov) [NEEDS LINK]
• The Missouri State Public Health Laboratory performs testing for public health surveillance and for epidemiological purposes. For questions related to testing of clinical specimens or other questions related to pandemic influenza, contact the Department of Health and Senior Services at (800) 392-0272 (24/7) or 573-751-6113 (8-5 Monday thru Friday).

For more information on influenza and pandemic flu planning see the following: 

http://www.pandemicflu.gov/

Order materials from the following:

http://health.mo.gov/emergencies/readyin3/mainreadyform.php [NEEDS LINK]

Your child may have been exposed to:

Influenza (Flu)

Influenza (also known as flu) is a common viral respiratory infection.
Influenza is not “stomach flu”, a term used by some to describe illnesses causing vomiting or diarrhea.

If you think your child has the Flu:

• Tell your child care provider or call the school.
• Need to stay home?
  • Child Care and School:
    Yes, until fever is gone for at least 24 hours (without the use of a fever reducing medicine) and the child is healthy enough for routine activities.

DO NOT give aspirin or salicylate-containing medicines to anyone under 18 years of age.

Symptoms

Your child may have chills, body aches, fever, and headache. Your child may also have a cough, runny or stuffy nose, and sore throat.

Illness may last up to 7 days.

If your child has been infected, it may take 1 to 4 days (usually 2 days) for symptoms to start.

Spread

• By coughing and sneezing.
• By touching contaminated hands, objects or surfaces.

Contagious Period

During the 24 hours before and up to 7 days after the illness begins.

Call your Healthcare Provider

• If anyone in your home has a high fever and/or coughs a lot. Your doctor may give medications.
  
  Antibiotics do not work for illnesses caused by a virus, including influenza.

Prevention

• Cover nose and mouth when sneezing or coughing. Use a tissue or your sleeve. Dispose of used tissues.
• Wash hands after touching anything that could be contaminated with secretions from the nose or mouth. Your child may need help with handwashing.
• DO NOT share anything that goes into the mouth, such as drinking cups, straws, and water bottles.
• Clean and disinfect anything that comes in contact with secretions from the nose or mouth. This includes door knobs, refrigerator handle, water faucets, and cupboard handles. Use a product that kills viruses.
• Annual influenza vaccination is recommended for everyone older than 6 months of age. Ask your health care provider about the flu vaccine.

For more information, call the Missouri Department of Health and Senior Services (MDHSS) Bureau of Communicable Disease Control and Prevention at 573-751-6113 or 800-392-0272 (24/7), or call your local health department.