Guidelines
Influenza-like Illness

Influenza-like Illness

Droplet & Contact Precautions

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

ILI is characterized by:

  • Fever and cough
  • Fever and gastrointestinal symptoms (nausea, vomiting, diarrhea)
  • Contact with anyone with flu-like symptoms in the last 7 days PLUS any of the following:
    • Muscle aches
    • Joint pains
    • Sore throat
    • Extreme fatigue or weakness

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.