Seasonal influenza: Controversies, conumdrums and consensus

Abstract

Even during non-pandemic years, influenza infects 18% of unvaccinated people. Most recover after a few days’ rest. However, deaths from complications caused by seasonal flu range from about 600 to around 13 000 during an epidemic. Patients are usually infectious for about 6 or 7 days, beginning a day or so before symptoms emerge. School nurses should suggest that otherwise healthy children and members of staff should rest at home until they are non-longer infectious and feel better. During this time, they should keep warm and drink plenty of water. Children or adults with comorbidities should see their doctor, who might suggest antivirals. Ironically, routinely suggesting antipyretics might encourage flu's spread. School nurses could educate children and staff about good hygiene and establish policies that limit transmission. Currently, many people who would benefit from vaccination are not immunised. So, school nurses can stress the importance of vaccination to appropriate adults (including teachers and other staff) and children. However, it is too early to ascertain the uptake and effectiveness of the childhood vaccine programme. While controversy surrounds some elements of management—especially neuraminidase inhibitors—vaccination and good hygiene remain the foundations of management for this perennial problem.