Influenza: incidence, symptoms and treatment

Influenza is a common respiratory condition that has a history of developing into epidemics and pandemics. Individuals at risk of influenza and related complications include older people, young children and individuals with chronic renal, cardiac and respiratory diseases. Influenza can begin suddenly and is accompanied by fever, chills, aches, pains, headaches, fatigue, cough and generalized weakness that can last up to 14 days. Complications of influenza include secondary bacterial pneumonia, post-influenza encephalitis, changes in cardiac electrocardiogram and secondary bacterial infections, such as Staphylococcus aureus-induced myositis. The influenza vaccine is the main form of treatment. Suitably qualified nurse prescribers and nurses who supply and administer the vaccine under patient group directions should be sufficiently knowledgeable about the virus and how its transmission can be prevented in order to educate patients at risk of developing influenza about the role of the vaccine in the prevention of the disease.     

Fitness and absenteeism among hospital workers. Clarifying the connection

A total of 48% of hospital workers rated poor to below average in fitness. Administrative and clericals had the lowest fitness rating, while technical and paraprofessionals were the most fit. Illness absence days ranged from 0 to 39 in a 6 month period, with professionals absent the greatest number of days. Gender, income, and ethnicity explained 50% of the variance in the fitness results. Demographic and social characteristics potentially may confound fitness program outcome, including absenteeism.     

Influenza and its vaccination in HIV1-AIDS patients.

Influenza vaccination of HIV1-seropositive subjects generally protects against specific flu, especially if the patients have not reached a too-advanced stage. Influenza vaccination, as spontaneous influenza, can increase viral load or induce a rebound at a PCR-imperceptible phase of HIV1. Recombinant canarypox vectors encoding HIV1 antigens can stimulate HIV1-specific cytotoxic T lymphocytes.     

Back symptoms in nursing aides in a geriatric hospital. An interview study with special reference to the incidence of low-back symptoms.

The incidence of back symptoms, particularly in the lumbar region, was investigated in 267 female nursing aides in a geriatric hospital. The overall incidence of low-back symptoms was 46.8%. Low-back insufficiency was present in 40%, lumbago in 18.4% and sciatica in 7.6%. Nursing aides with low-back symptoms had a higher incidence of cervical and thoracic spine symptoms than those without low-back symptoms. Recurrence of low-back symptoms had been common, appearing in 82%. Nursing aides with lowback symptoms considered their work more stressful to the spine than those without low-back symptoms. No relationship was found between different kinds of lifting technique and the incidence of low-back symptoms.     

Influenza and atherosclerosis: vaccination for cardiovascular disease prevention

In both animal and human studies, strong prothrombotic and pro-inflammatory effects have been observed after influenza infection. Influenza is an important trigger for acute coronary syndromes, and it has been shown that in the US it may cause up to 90,000 deaths per year simply by triggering fatal myocardial infarctions. Multiple case-control and cohort studies have shown that the influenza vaccine has a marked protective effect against cardiovascular events, decreasing the incidence of these events by 20 - 70% in the settings of primary and secondary prevention. Although influenza vaccination is an extremely cost-effective method of cardiovascular protection and is recommended for all patients with cardiac diseases, it is largely underused in these patients. Therefore, increased efforts should be directed towards educating physicians and patients about the benefits of influenza vaccination in patients with coronary heart disease.     

Influenza and atherosclerosis: vaccination for cardiovascular disease prevention

In both animal and human studies, strong prothrombotic and pro-inflammatory effects have been observed after influenza infection. Influenza is an important trigger for acute coronary syndromes, and it has been shown that in the US it may cause up to 90,000 deaths per year simply by triggering fatal myocardial infarctions. Multiple case-control and cohort studies have shown that the influenza vaccine has a marked protective effect against cardiovascular events, decreasing the incidence of these events by 20 – 70% in the settings of primary and secondary prevention. Although influenza vaccination is an extremely cost-effective method of cardiovascular protection and is recommended for all patients with cardiac diseases, it is largely underused in these patients. Therefore, increased efforts should be directed towards educating physicians and patients about the benefits of influenza vaccination in patients with coronary heart disease.     

Influenza infection and diabetes mellitus. Case for annual vaccination

Herein, epidemiological data on influenza pneumonia and mortality, results of clinical studies, and the outcome of influenza vaccination trials are reviewed. All excess mortality studies that specify for underlying disease list diabetes as one of the major risk factors. During influenza epidemics, death rates among patients with diabetes mellitus may increase by 5-15%. Diabetes mellitus is also mentioned as a risk factor in most clinical studies, making up 3-14% of the patients studied. Even in recent studies, diabetes mellitus is only preceded as a risk factor by cardiovascular disease and chronic pulmonary disorders. To what extent cardiovascular disease and old age contribute to the increased influenza mortality and morbidity in diabetic patients remains unclear. The influence of epidemic influenza on the incidence of diabetic acidosis in combination with an impaired immune response to both Staphylococcus aureus and the influenza virus suggests that diabetes mellitus itself is the main risk factor. It is concluded that all patients with diabetes mellitus should receive annual vaccinations and that, in official recommendations, patients with diabetes mellitus should be mentioned as a separate risk group. Whole-virus vaccines are preferred over subunit vaccines.     

Influenza vaccination and chemotherapy: a shot in the dark?

Influenza infection is a potential cause of excess morbidity in patients who are immunosuppressed because of haemato-oncological malignancy or its treatment. Therefore vaccination against influenza is recommended in these patient groups. This systematic review of the literature and vaccine manafacturers' data assesses the current levels of knowledge concerning influenza vaccination in this patient group. There is a paucity of data, and the patient groups in the studies are heterogeneous. Serological responses are generally lower than expected in healthy controls and may be critically dependent on the timing of vaccination relative to chemotherapy. Antibody levels considered protective in healthy individuals may not prevent clinical infection in those with malignant disease. There are no data on protection from clinical infection. The vaccine appears to be well tolerated in this patient group. It is reasonable to offer vaccination to patients receiving treatment for haemato-oncological disorders. However, the degree of clinical protection afforded may be inferior to that experienced by healthy individuals. Further trials are warranted to assess the magnitude of benefit and optimal schedules of vaccination.     

Factors associated with work-related injury among hospital employees: a case-control study.

The Central Arkansas Veterans Healthcare System (CAVHS) spends $1 million annually on occupational illnesses and injuries. To address the problem of injuries among hospital employees, a retrospective case-control study was conducted to examine select risk factors for work-related injuries (WRI) among CAVHS employees. Study methods included a review of employee health charts and computer and manual databases from 1997 to 2002 (N = 2,050). The researchers found that WRI increased with age; WRI occurred more often in women than in men; WRI was greater among maintenance and custodial staff compared to direct caregivers, and less among clerical staff; WRI occurred less often in part-time than full-time staff; and WRI increased with increasing body mass index. Developing standards, guidelines, and policies for preplacement screening, preventive measures, training, and education may help to minimize WRI and associated costs.