Influenza-like Illness

Until influenza test results are negative and symptoms which require isolation are resolved

Note

Flu season: December to April

  • From May to November, Influenza testing is not routinely run and requires approval from medical microbiology

  • If influenza is suspected, please page the medical microbiologist on call at 2161 to order appropriate testing

  • Pregnant women and women up to 4 weeks postpartum are considered at high risk for influenza related complications

  • Increased hospitalization rates, stillbirths, premature deliveries and increased infant and maternal mortality have been observed particularly in women who have influenza in their third trimester

Treatment

Additional Information

  • Encourage breastfeeding

    • Prior to each feed, mothers should wash hands thoroughly, and wear a surgical mask during feeding
  • If mother and newborn are separated, encourage hand expression and/or pumping of breast milk Q3h

Call Physician, Anesthesiologist, and/or Respiratory Therapy when respiratory rate >30 breaths/min or oxygen saturation <95%

  • Blood pressure, heart rate, respiratory rate, oxygen saturation, temperature Q4h for 24h

  • Urine output Q4h for 24h

Also consider:

  • Antepartum fetal heart rate via intermittent auscultation Q4h for 24h

  • Intrapartum fetal heart rate monitoring as per protocol

  • Nasopharyngeal FLOQ Swab using the Copan UTM kit for Influenza Rapid NAT

Also consider:

  • Complete blood cell count with automated white blood cell differential (CBC)

  • Sodium

  • Potassium

  • Chloride

  • Carbon dioxide, total (bicarbonate plus dissolved carbon dioxide)

  • Urea

  • Creatinine

  • Lactate

  • C-reactive protein (CRP)

  • International normalized ratio (INR)

  • Partial thromboplastin time (PTT), activated

  • Alanine aminotransferase (ALT)

  • Aspartate aminotransferase (AST)

  • Lactate dehydrogenase (LDH)

  • Bilirubin, total

  • Blood culture x2 if temperature >38ºC

  • Sputum culture

Consider chest X-ray

  1. Aoki FY, Allen UD, Stiver HG, Evans GA. The Association of Medical Microbiology and Infectious Disease Canada. The use of antiviral drugs for influenza: a foundation document for practitioners. Can J Infect Dis Med Microbiol 2013; 24(Supp C): 1C-15C.
  2. Fiore AE, Fry A, Shay D, Gubareva L, Bresee JS, Uyeki TM. Centers for Disease Control and Prevention (CDC). Antiviral agents for the treatment and chemoprophylaxis of influenza - recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity & Mortality Weekly Report. Recommendations & Reports 2011;60(1):1-24.
  3. Harper SA et al. Seasonal influenza in adults and children – diagnosis, treatment, chemoprophylaxis and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. CID 2009; 48: 1003 – 32.
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