Influenza (Flu); clinical features, management and prevention

Introduction

Influenza is a specific, acute viral infection of the respiratory tract in humans. It is caused by a group of myxoviruses i.e. influenza virus type A, B and C.

Incubation period: 1 to 3 days.

  • Transmission is by close contact or by droplets from respiratory tract of an infected person.
  • Can also spread through fomites.

Diagnosis

  • Tissue culture of nasal and pharyngeal secretions.
  • Clinical features.
  • Sputum culture.

Over the last five years, there has been a global pandemic among poultry and birds of an avian influenza caused by influenza type A (H5N1). This had been associated to small number of infection in humans, usually associated with closed exposure to infected poultry. Recently, there have been reported cases of pandemic influenza (HIN 1) in Ghana.

Pathophysiology

The virus is air borne and multiplies in the upper respiratory tract. They attack the nasal, tracheal and bronchial mucosal cells. The virus damages the ciliated epithelium of the tracheobronchial tree, rendering the patients vulnerable to the development of secondary bacterial infections.

Clinical features

  1. Sudden onset of fever, sore throat, cough, headache, rhinorrhoea and photophobia.
  2. G.I. symptoms include nausea, vomiting abdominal pain and diarrhea.
  3. The soft and hard palate may be reddened.
  4. Weakness, swelling and fatigue may persist for several days.
  5. Dyspnoea, cyanosis, haemoptysis and pulmonary oedema and death may proceed as soon as 48 hours after onset of the influenza.

Treatment

There is no specific treatment.

  1. Give symptomatic treatment such as Antipyretics and Analgesics.
  2. Maintain fluid electrolyte balance when there is profuse sweating, fever and vomiting.
  3. Oxygen therapy for cyanosis and shock.
  4. Amantadine (anti-viral agent used against influenza).
  5. Early report to any health facility.

Nursing management

  • Proper application of infectious control measures.
  • Rest and sleep;
    • Ensure bed rest during initial stages.
    • Room should be well ventilated.
    • Nurse in a room with deem light
    • Maintain quit environment.
  • Elimination;
    • Patient should be encouraged to pass urine and move his bowels.
    • Properly dispose off patient’s excreta.
  • Nutrition:
    • Give nourishing fluids e.g. fruit juices, light soup and beverages.
    • Serve balanced diet.
  • Observation:
    • Monitor vital signs every 4 hourly.
    • Observe for signs of shock and intervene if present.
    • If pyrexia is present, the temperature should be checked regularly and tepid sponging done to reduce the temperature.
    • Keep intake and output chart.
  • Administer medications as ordered.
  • Patient education about personal hygiene and prevention of the disease.

Prevention

  • Proper hand washing.
  • Wearing of protective clothing.
  • Proper disposal of soiled linen and secretions.
  • Vaccination against influenza.
  • Health education.

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