Q: WHAT IS INFLUENZA (FLU) AND HOW IS IT CAUSED? Influenza is a highly contagious disease caused by a virus. Influenza A and B are the major types of influenza viruses that cause human disease and can affect people of all ages. When someone who has influenza sneezes, coughs, or even talks, the influenza virus is expelled into the air and may be inhaled by anyone close by. The Influenza viruses change slightly each year. For this reason the vaccine for each flu season is different from the last. For healthy children and adults, influenza is typically a moderately severe illness. Most people are back on their feet within a week. Anyone can get influenza, especially when it is widespread in the community. Q: WHAT ARE THE SYMPTOMS OF INFLUENZA? The symptoms tend to begin suddenly and are more severe than those of a common cold. Although flu infections differ from person to person, most cause the following symptoms:
Fever for 4-5 days (38 degrees C or higher)
Chill Chills, rigors (feeling cold and shaking while having a high temperature
Mild nausea, vomiting, diarrhoea (more common in children)
Extr Extreme exhaustion, headache, muscle aches
Although the fever and body aches usually last for 3-5 days, a cough and fatigue may persist for 2 weeks or more. Cold symptoms come on more gradually than flu, and they do not usually include fever, headache, extreme exhaustion or severe muscle aches. Colds are typified by sneezing, stuffy or runny nose, and sore throat. Q: HOW LONG IS A PERSON WITH INFLUENZA CONTAGIOUS? The period between infection and onset of symptoms for influenza (incubation period) is 1-4 days. A person with influenza may be contagious 1 day before symptoms appear and for 3-7 days after the onset of symptoms. Children may be contagious for longer than 7 days. Q: HOW CAN INFLUENZA AND ITS COMPLICATIONS BE PREVENTED? The best way to avoid the flu and complications such as pneumonia is to have an annual vaccination, maintain optimal health and practice good personal hygiene. Frequent hand washing has been shown to be an important aspect of infection control. Q: WHO SHOULD HAVE THE INFLUENZA VACCINE? If you wish to decrease your risk of contracting the currently circulating influenza virus strains you should be vaccinated annually. For anyone in a high risk category, influenza is a very serious and potentially fatal illness, and the National Health and Medical Research Council advise annual vaccination. People who are not healthy or well to begin with are particularly susceptible to the complications that can accompany the flu. Bacterial pneumonia is the most common complication of influenza in those high risk individuals. You may be at high risk if you are over 65 years of age or have:
Chronic disorders of the pulmonary system including severe
Chronic cardiac and circulatory conditions
Sources: World Health Organization, the Australian Influenza Specialist Group, the National Health & Medical Research Council (NHMRC) Guidelines, NSW Health and Influvac product information.
If you have contact with people in the above categories you should also be vaccinated to prevent the spread of influenza to those at greater risk. Q: WHO SHOULD NOT HAVE THE INFLUENZA VACCINATION? Individuals who are severely allergic (anaphylactic) to chicken products such as eggs and feathers, should not have the vaccine because the process of making the vaccine includes the use of chicken eggs and traces of egg protein may remain in the vaccine. Persons who have had an anaphylactic reaction to any of the components of the vaccine (see consent form), or who have had an anaphylactic reaction to the influenza vaccine should not be vaccinated. Individuals with an acute febrile illness (fever greater than 38.5 degrees C) should wait until they are recovered to have the vaccination. Individuals with a history of Guillain-Barre Syndrome (GBS) should discuss vaccination with their local doctor. Q: IS THE INFLUENZA VACCINE SAFE FOR PREGNANT WOMEN? The influenza vaccine is recommended for pregnant woman who will be in the second or third trimester during the influenza season. In particular, pregnant women who fall into one of the above risk categories should be vaccinated. The vaccine is a Category B2. Q: WHAT ARE THE SIDE EFFECTS OF THE INFLUENZA VACCINE? Up to 10% of people immunized develop a headache or some swelling, redness or discomfort at the injection site, which usually settles in a day or two. Less than 1% of individuals develop a mild fever, some with muscular or joint aches and a slight feeling of being unwell. This may last one or two days. Severe reactions are rare. There have been rare (1in 1million) reports of neurological reactions including a transient paralysis; however they have not been confirmed as being definitely related to the vaccine. It is possible to have an allergic response to the vaccine. Q: HOW EFFECTIVE IS INFLUENZA VACCINE? In years in which there is a good match between the vaccine virus and the virus strain causing illness, influenza vaccine is generally considered to be 70%-90% effective in preventing influenza illness for 6-12 months in healthy adults. It is important to know that it takes about 2-3 weeks after influenza vaccination for a person to develop protection against influenza infection. Also, influenza vaccine does not protect against respiratory illness caused by other viruses. Q: CAN YOU GET INFLUENZA FROM A VACCINATION? No, it is impossible to get influenza from the vaccine. The viruses in the vaccine are inactivated (killed) and incapable of causing influenza. The urban myth about getting the flu after receiving the vaccine is explained by the fact that a person may be unknowingly exposed to the flu just prior to having the vaccine or in the 14 days after having the vaccine while they develop immunity. A bad cold is often described as being ‘the flu’. Remember, if you can still get out of bed and function relatively normally you probably do not have influenza. Q: WHICH STRAINS ARE INCLUDED IN THE VACCINE FOR AUSTRALIA & NEW ZEALAND? The Southern Hemisphere vaccine for the Winter of year 2014* contains: A/California/7/2009 (H1N1)-like strain (A/California/7/2009 NYMC X-181) 15µg haemagglutinin/dose A/Texas/50/2012 (H3N2)-like strain (A/Texas/50/2012 NYMC X-223A)15 µg haemagglutinin/dose B/Massachusetts/2/2012-like strain (B/Massachusetts/2/2012 NYMC BX-51B)15 µg haemagglutinin/dose
*As approved by the Australian Influenza Vaccination Committee and the New Zealand Ministry of Health. Q. WHO WILL ADMINISTER THE INFLUENZA VACCINATION?
Sources: World Health Organization, the Australian Influenza Specialist Group, the National Health & Medical Research Council (NHMRC) Guidelines, NSW Health and Influvac product information.
The vaccination will be given by a qualified Doctor or a Registered Nurse who is accredited in Vaccination Medicine and has current emergency procedure training, according to state/territory regulations.
Q. WHAT PRECAUTIONS SHOULD I TAKE AFTER RECEIVING THE INFLUENZA VACCINATION?
You need to wait in the vicinity of the vaccination staff for 15 minutes after you have received your vaccination.
In some people, having an injection can make them feel light headed or dizzy. Do not drive or operate machinery unless you feel well.
If you experience any of the more common side effects listed on the consent form for more than a few days, please notify your local doctor. If you experience any of the more serious side effects listed on the consent form immediately seek medical help.
Q. DOES THE VACCINE INTERACT WITH ANY MEDICATIONS?
Yes, Influenza vaccine can impair the metabolism of warfarin, theophylline, phenytoin, phenobarbitone and carbamazepine by the hepatic P450 system. Results from studies have been variable in degree of interaction and time after vaccination for the interaction to take effect. The interaction may be idiosyncratic. Patients taking warfarin, theophylline, phenytoin, phenobarbitone, or carbamazepine should be advised of the possibility of an interaction and told to look out for signs of elevated levels of medication.
Sources: World Health Organization, the Australian Influenza Specialist Group, the National Health & Medical Research Council (NHMRC) Guidelines, NSW Health and Influvac product information.
Scope of Practice for Naturopathic Physicians: Standards, Limits and Conditions for Prescribing, Dispensing and Compounding Drugs May 27, 2010 (Edited 23.09.10) ___________________________________________________________________________________ Standards, Limits and Conditions Draft Framework ACKNOWLEDGEMENTS: The College of Naturopathic Physicians of British Col
TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS CONDITION Ist line treatment 2nd line treatment Comments SYPHILIS Penicillin allergy Penicillin allergy Penicillin allergy 3 days or Benzylpenicillin 18 – 24MU daily IV (3 –4MU 4 hrly) 17 days Plus prednisolone as above Penicillin allergy treatment of neonate at birth with penicillin Or Azithromycin 500mg daily