Influenza Information For Healthcare Providers

Symptoms

Influenza illness can include any or all of these symptoms: fever, muscle aches, headache, lack of energy, dry cough, sore throat, and possibly runny nose. The fever and body aches can last 3-5 days and the cough and lack of energy may last for 2 or more weeks. Please note that the Department of Health defines a fever as 100.4ºF/38ºC for people with influenza-like illness.

Influenza can be difficult to diagnose based on clinical symptoms alone, because the initial symptoms of influenza can be similar those caused by other infectious agents. (more)

Most patients with influenza will have mild illness and can be cared for at home, but some patients, such as infants younger than 6 months of age, people with high-risk medical conditions, and anyone with moderate to severe illness, should be seen by a healthcare provider.

Laboratory Tests

A number of tests can help to diagnose influenza, but tests do not need to be done on all patients. For individual patients, tests are most useful when they are likely to give a doctor results that will help with diagnosis and treatment decisions. The Health Laboratory will only test specimens from patients who meet current testing criteria. The recommended specimen for testing is a swab of the nasopharynx. (more)

• Specimen Collection Instructions for H1N1 Influenza Testing
• Algorithm to assist testing and treatment decisions
• Approval Process for Testing at the Health Laboratory for Outpatient Pregnant Women with Influenza Like Illness

Treatment

People with influenza who have high-risk conditions, who have moderate to severe illness, or who live in households with high-risk individuals should take antiviral medications to treat influenza or prevent influenza transmission.

In emergency situations where commercially manufactured Tamiflu for Oral Suspension is not available, pharmacists may compound a suspension (15mg/mL) from Tamiflu (oseltamivir phosphate) Capsules 75mg using either Cherry Syrup (Humco) or Ora-Sweet Sugar-Free. (more)

Infection Control

• Department guidance on mask and respirator use
• Influenza infection control recommendations from the Centers for Disease Control, the Institute of Medicine, and the Healthcare Infection Control Practices Advisory Committee
• Infection control guidance for dental health care settings

Vaccine Information

The Department's Immunization Program has additional immunization information for healthcare providers.

Provider Enrollment

Every facility that will store and administer seasonal influenza vaccine to adults must enroll as a vaccine provider in Rhode Island’s Adult Immunization Program. Providers can enroll online to administer the vaccine to insured adults.

Rhode Island’s Childhood Immunization Program provides seasonal influenza vaccine to providers for children 6 months through 18 years of age. Providers who wish to use state-supplied vaccines for children must complete an annual agreement and enroll in KIDSNET, Rhode Island’s registry for immunization and other preventive services for children.

Reporting

By law, all healthcare facilities in Rhode Island must report the number of their healthcare workers with face-to-face patient contact who received and declined seasonal influenza vaccine this flu season. H1N1 vaccine providers must also report doses of H1N1 vaccine administered weekly.

• Report total seasonal influenza vaccine uptake
• Report total H1N1 influenza vaccine uptake
• Report weekly H1N1 vaccine doses administered

Vaccine Advisories

• Returning H1N1 vaccine to the Wellness Company
• Administration Technique for Nasal-Spray Influenza Vaccine

Reimbursement

Vaccine providers should refer to guidance developed by their individual insurers related to billing for seasonal vaccine administration.