Questionnaire/history:

Uncomplicated influenza?

Fever?

Coryza?

Generalised features: headache, malaise, arthralgia, myalgia?

GI symptoms (sometimes)?

Complicated influenza: (always safety net appropriately to include risk of complications)?

Requiring hospital admission

LRTI: bronchitis, secondary bacterial pneumonia (primary influenza pneumonia rare)?

CNS involvement: meningitis, encephalitis, meningoencephalitis?

Exacerbation of underlying medical condition?

Risk factors for complications include:

Neurological, hepatic, renal, pulmonary and chronic cardiac disease?

Diabetes mellitus?

Age over 65 years?

Pregnancy (including up to two weeks post-partum)?

Morbid obesity (BMI >=40)?

Children <6 months of age?

Severely immunocompromised (including those on prednisolone >40mg for 1 week in past 3 months)?

Management:

Advised:

To rest at home and stay off work or school (until 24 hours after resolution of fever helps to reduce spread)

To drink adequate fluids

Paracetamol/ibuprofen with food (if no nausea/vomiting)

Usually lasts for a week but the fatigue and cough may last for a couple of weeks

To seek review if:- Worsening chest symptoms / general deterioration

- Dehydration

- Significantly ill after a week.

Anti-viral medication

Once the DoH issues notice that the pathogen is circulating in the community

Note: Commencing oseltamivir (75 mg twice daily) and zanamivir (10 mg twice daily) for five days more than 48 hours after symptom onset (36 hours for zanamivir use in children) is an off-label use

Resource(s):

UK Health Security Agency (UKHSA): Guidance on use of antiviral agents for the treatment and prophylaxis of seasonal influenza

Information for patient/carer(s):

Patient UK: Influenza and Flu-like Illness

Patient UK: Why wasn’t I prescribed antibiotics?

NHS Health A to Z: Flu