Influenza in Children and Adolescents: Epidemiology, Management, and Prevention

Abstract

EDUCATION GAP: Influenza is among the most common infectious causes of pediatric emergency department visits and hospitalizations. Clinicians should use evidence-based guidelines to learn how to identify, manage, prevent, and treat influenza cases. Disease caused by influenza virus can be mitigated with appropriate treatment and prevention efforts.

OBJECTIVES : 1. Describe the virology and epidemiology of influenza.

2. List the clinical features and complications of influenza infections.

3. List the benefits and limitations of testing modalities for the diagnosis of influenza.

4. Appropriately apply American Academy of Pediatrics, Infectious Diseases Society of America, and Centers for Disease Control and Prevention (CDC) treatment guidelines for influenza or suspected influenza.

5. Describe the importance of influenza vaccination.

Figure 1.

Signs, symptoms, and complications of influenza. Adapted from Ghebrehewet S, MacPherson P, Ho A. Influenza. BMJ. 2016;355:i6258. (41)

Figure 2.

Clinical flow diagram for influenza testing. Adapted from the Centers for Disease Control and Prevention. Guide for considering influenza testing when influenza viruses are circulating in the community. Available at: https://www.cdc.gov/flu/professionals/diagnosis/consider-influenza-testing.htm. (65) ^aAn influenza-like illness is defined as a fever plus cough or sore throat. ^bVaccination status should not influence testing algorithms. ^cTesting for influenza should be interpreted based on the clinical picture and type of test used with corresponding sensitivity/specificity. ^dManagement changes may include antiviral treatment, antibiotic treatment, further diagnostic tests, and decisions about infection prevention and control practices. ^eDuring periods of high influenza activity, a clinical diagnosis of influenza can be made.

Figure 3.

Clinical flow diagram for influenza antiviral treatment. (22)(46)(47)

Figure 4.

Clinical flow diagram for influenza chemoprophylaxis. (22)(46)(47) ^aThe Infectious Diseases Society of America defines exposure as living with/caring for a person with influenza or being in a setting with a high chance of contact with respiratory droplets from an infected person.