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Influenza Virus

Diagnosis of Influenza

Accurate Diagnosis of Influenza is Challenging…

• It can be difficult to distinguish among the many types of "common cold" viruses, bacteria and influenza viruses, because many of these pathogens can cause non-specific respiratory and somatic symptoms⁵
• Serious bacterial infections may begin with influenza–like symptoms or may coexist with or occur as complications during the course of influenza

…Especially for Children

• Influenza is responsible for substantial morbidity in children and increases the need for health care, including hospitalization ⁶
• A prospective, population-based study showed that:
  • 83% of children were misdiagnosed in the outpatient setting ⁷
  • 72% of children were misdiagnosed in the inpatient setting ⁷

Early and Accurate Diagnosis is Critical

• Vaccine effectiveness varies. Therefore, influenza should not be ruled out in the differential diagnosis.
  • 17-59 years of age*: 70% to 90% effective
  • 50-64 years of age*: 52% effective
  • 58-104 years of age^†: 17% to 53% effective
  * Vaccine efficacy based on measurement of immune response.
  † Vaccine efficacy based on measurement of antibody response.
• Rapid diagnostic tests are available that can detect influenza viruses in 30 minutes.
• Early diagnosis of influenza can reduce the inappropriate use of antibiotics and provide the option of using antiviral therapy such as TAMIFLU ³
• To be effective at treating and reducing duration of influenza symptoms, TAMIFLU must be administered within 12 to 48 hours of symptoms onset ¹

Improve Your Influenza Diagnoses

The identification of influenza is improved when clinicians are aware that influenza virus is present in their area. ⁵ Use the Flu Tracker to find out where the flu is circulating nationwide.

Know Influenza Signs and Symptoms vs. Common Cold ⁵

	Signs & Symptoms	Influenza	Common Cold
	Onset	Sudden	Gradual
	Fever*	Common: lasting 3-4 days	Rare
	Cough	Dry; can become severe	Hacking; mild
	Headache	Prominent	Rare
	Muscle/joint aches, pain	Unusual; often severe	Slight
	Fatigue and weakness	Can last up to 2 weeks	Very mild
	Extreme exhaustion	Early and prominent	Never
	Chest discomfort	Common	Mild/moderate
	Stuffy nose	Sometimes	Common
	Sneezing	Sometimes	Usually
	Sore throat	Sometimes	Common

* For many people aged ≥ 65 years or who have chronic illnesses, the risk and severity of influenza infection is magnified; however, flu-induced fever in these individuals may be minimal or even absent.

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Important Safety Information

Indications

TAMIFLU is indicated for the treatment of uncomplicated influenza caused by viruses types A and B in patients 1 year and older who have been symptomatic for no more than 2 days.

TAMIFLU is also indicated for the prophylaxis of influenza in patients 1 year and older.

TAMIFLU is not a substitute for early and annual vaccination as recommended by the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP).

Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use TAMIFLU.

Safety Information

There is no evidence for efficacy against any illness caused by agents other than influenza types A and B.

Treatment efficacy in subjects with chronic cardiac and/or respiratory disease has not been established. No difference in the incidence of complications was observed between the treatment and placebo groups in this population.

No information is available regarding treatment of influenza in patients at imminent risk of requiring hospitalization.

Efficacy of TAMIFLU has not been established in immunocompromised patients.

Safety and efficacy of repeated treatment or prophylaxis courses have not been studied.

Influenza can be associated with a variety of neurologic and behavioral symptoms, which can include events such as hallucinations, delirium and abnormal behavior, in some cases resulting in fatal outcomes. These events may occur in the setting of encephalitis or encephalopathy but can occur without obvious severe disease. There have been postmarketing reports (mostly from Japan) of delirium and abnormal behavior leading to injury, and in some cases resulting in fatal outcomes, in patients with influenza who were receiving TAMIFLU. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made but they appear to be uncommon based on TAMIFLU usage data. These events were reported primarily among pediatric patients and often had an abrupt onset and rapid resolution. The contribution of TAMIFLU to these events has not been established. Patients with influenza should be closely monitored for signs of abnormal behavior. If neuropsychiatric symptoms occur, the risks and benefits of continuing treatment should be evaluated for each patient.

In postmarketing experience, rare cases of anaphylaxis and serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme, have been reported with TAMIFLU.

The most common adverse events reported >1% of patients treated with TAMIFLU and more commonly than in patients treated with placebo are:

• Treatment of adult and pediatric patients - nausea, vomiting.
• Prophylaxis of adult and pediatric patients - nausea, vomiting, abdominal pain.

Vaccination is considered the first line of defense against influenza.

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