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CDPH Disease Notification: Act Now Ahead of Influenza Season: Recommendations for Healthcare Providers

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Please see the California Department of Public Health Disease Notification below.



Act Now Ahead of Influenza Season: Recommendations for Healthcare Providers

December 8, 2021

Key Messages

  • Influenza activity in California is expected to increase in the coming months.
  • California Immunization Registry (CAIR2) data show the pace of influenza vaccination decreasing in October and November 2021 despite ample vaccine supplies.
  • As the holiday season begins, providers should:
    • Strongly recommend influenza vaccination
    • Avoid missing opportunities to immunize against influenza
    • Increase efforts to immunize those at increased risk for severe influenza.
    • Offer coadministration of influenza and COVID-19 vaccine when patients present for either vaccine individually. Immunization against influenza will reduce stress on the healthcare system during the pandemic. Other routine vaccines may also be coadministered.
  • Large influenza outbreaks are occurring at post-secondary institutions in the United States.
  • Detection of influenza A(H3N2) viruses by clinical and public health labs nationwide has increased recently, most frequently among young adults. This represents the first significant activity of the 2021-2022 flu season (and the first since March 2020). Influenza A (H3N2) predominant seasons can be severe, especially for older adults and young children.
  • Influenza and SARS-CoV-2 multi-plex testing should be pursued when feasible. Providers caring for persons with respiratory illnesses in inpatient and congregate settings should test them for influenza and SARS-CoV-2. Providers should test outpatients for influenza (as well as SARS-CoV-2) when testing will affect decisions on clinical management or infection control.
  • Provide influenza antiviral treatment as soon as possible for any patient with confirmed or suspected influenza who is: a) hospitalized; b) at higher risk for influenza complications; or c) developing progressive illness.
  • For high-risk persons with influenza-like illness:
    • Test the patient for both influenza and SARS-CoV-2. Two specimens might need to be collected if influenza and SARS-CoV-2 multi-plex testing is not available.
    • Start influenza antiviral treatment immediately. Decisions about starting influenza antiviral treatment should not wait for laboratory confirmation of influenza.
    • If the patient tests negative for influenza, influenza antiviral treatment can be discontinued.
    • If the patient tests positive for SARS-CoV-2, SARS-CoV-2 treatment (either with an anti-SARS-CoV-2 monoclonal antibody or authorized oral antiviral treatment) should be considered in outpatients at high risk for disease progression as outlined in product EUAs.
    • High risk patients co-infected with influenza and SARS-CoV-2 should receive treatment for both viruses. EUAs for anti-SARS-CoV-2 therapy should be reviewed prior to treatment to ensure patients meet criteria.
  • Clinicians should consider mitigation measures, including influenza antiviral post-exposure prophylaxis, during influenza outbreaks in long-term care facilities. Contact your local health department for consultation on suspected outbreaks at college campuses or other facilities.
  • Besides getting immunized, other everyday actions can stop the spread of respiratory viruses:
    • Continue to wear a mask when recommended or required in high-risk settings.
    • Stay away from people who are sick.
    • Stay home when sick for at least 24 hours after symptoms go away. Persons who test positive for SARS-CoV-2 should isolate for 10 days after symptom onset (or date of positive test if no symptoms are present).
    • Cough or sneeze into your elbow, arm, or disposable tissue. If disposable tissue is used, use hand sanitizer or wash hands afterwards.
    • Wash hands frequently and thoroughly with soap and warm water or use an alcohol-based hand sanitizer.
    • Avoid touching your eyes, nose, and mouth.
    • See our Tips for Protecting Yourself and Others This Holiday Season for additional recommendations.

Influenza Resources