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Influenza Update

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Overview

This issue provides key information on influenza vaccines and antiviral medications for the 2018-2019 flu season, including precautions, side effects, and use in special populations.

Influenza (commonly referred to as “the flu”) is a contagious viral infection of the respiratory tract (eg, nose, throat, and lungs). Influenza viruses are primarily spread by respiratory transmission – through droplets from coughing or sneezing. The circulation of influenza viruses varies geographically, with transmission occurring between October and May in the Northern Hemisphere of the temperate region (which includes the US), April and September in the Southern Hemisphere of the temperate region, and year-round in tropical/sub-tropical regions. In the US, peak influenza activity often occurs in January and February.

The flu can affect people of all ages, most frequently schoolaged children, usually causing asymptomatic infection or mild to moderate illness. Severe illness and death occur most often in vulnerable populations (eg, infants, elderly, and immunocompromised individuals). Each year, influenza affects 5-20% of the US population and causes 3,000-49,000 deaths from influenza-related complications. In the 2016-2017 season, 31 million Americans were infected, 14.5 million sought medical care, and 600,000 individuals were hospitalized due to influenza.

Influenza vaccination is an important primary prevention strategy. The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination for all persons 6 months and older (unless contraindicated) starting in early fall, as soon as the

vaccine becomes available. The vaccine is available in a variety of formulations; however, the ACIP makes no preferential recommendation and encourages vaccination with any licensed, age-appropriate vaccine during the 2018-2019 season. Despite the ACIP’s universal recommendation for influenza vaccination, only 47% of the target population in the US (individuals 6 months and older) received the vaccine during the 2016-2017 season.

Details

Publication Date: 08/23/2018
Expiration Date: 08/23/2021
CE Credit: 2.0 (0.20 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Richard H. Dang, PharmD, APh, BCACPis an Assistant Professor of Clinical Pharmacy, Director of Student Outreach for Community Health, and Site Coordinator of the PGY-1 Community-Based Pharmacy Residency Program the University of Southern California (USC) School of Pharmacy.

Dr. Dang coordinates courses in introductory and advanced community pharmacy practice, self-care/nonprescription therapies, and travel medicine. He is licensed as an Advanced Practice Pharmacist and is a national trainer for the APhA Pharmacy-Based Immunization Delivery program, the NACDS Community Pharmacy-Based Point-of-Care Testing Certificate program, and the CPhA/NACDS Advanced Practice Pharmacists Certificate Training Program.

Disclosure Statement

Dr. Richard Dang reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Describe the influenza disease course, symptoms, and diagnostic tests. Recognize people at high risk for flu complications.
    2. Describe the determinants for influenza vaccine efficacy. Discuss the rationale for the suboptimal efficacy of the 2017-2018 vaccines, and recommendations for the use of LAIV vaccine in 2018-2019.
    3. State the indications, dosing requirements (children and adults), administration routes, side effects, and contraindications for 2018-2019 influenza vaccinations.
    4. Discuss the use of antiviral drugs for influenza treatment and prevention; be able to apply the current recommendations for their use.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-18-009-H06-P


Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 2.0 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


Tracy Farnen, PharmD

Associate Editors


James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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