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Section 3. Summaries of Infectious Diseases

Influenza

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Influenza classically is characterized by sudden onset of fever, often with chills or rigors, headache, malaise, diffuse myalgia, and nonproductive cough. Subsequently, the respiratory tract signs of sore throat, nasal congestion, rhinitis, and cough become more prominent. Conjunctival injection, abdominal pain, nausea, vomiting, and diarrhea have been reported infrequently. In some children, influenza can appear as an upper respiratory tract infection or as a febrile illness with few respiratory tract signs. In infants, influenza can produce a sepsis-like picture and occasionally can cause croup, bronchiolitis, or pneumonia. Acute myositis characterized by calf tenderness and refusal to walk has been described after several days of influenza illness, particularly with type B influenza infection. Neurologic complications associated with influenza range from febrile seizures to severe encephalopathy and encephalitis with status epilepticus and altered consciousness that can result in neurologic sequelae and death. Reye syndrome has been associated with influenza infection. Myocarditis with fatal outcomes has been reported. Invasive secondary bacterial infection with respiratory tract pathogens, including group A streptococcus, methicillin-resistant Staphylococcus aureus, and Streptococcus pneumoniae, causing severe disease and death, can occur with influenza virus infection.

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ETIOLOGY: Influenza viruses are orthomyxoviruses of 3 genera or types (A, B, and C). Epidemic disease is caused by influenza virus types A and B. Influenza A viruses are subclassified into subtypes by 2 surface antigens, hemagglutinin (HA) and neuraminidase (NA). Recent circulating human influenza A subtypes have included H1N1, H1N2, and H3N2 viruses. Specific antibodies to these various antigens, especially to hemagglutinin, are important determinants of immunity. Minor antigenic variations within the same influenza B type or influenza A subtypes are called antigenic drift. Antigenic drift occurs continuously and results . . . [Go to Full Text]

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Reporting of Adverse Events

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Scheduling Immunizations

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Preterm and Low Birth Weight Infants

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Adolescent and College Populations

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International Travel

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Pregnancy

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Immunocompromised Children

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Children With Chronic Diseases

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Children in Residential Institutions

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Other Infections Spread by the Respiratory Route

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Human Immunodeficiency Virus Infection

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Kawasaki Disease (Mucocutaneous Lymph Node Syndrome)

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Antiviral Drugs

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