Influenza: Prevention (Pediatric Nursing)

00:01 Influenza prevention is key.

00:04 It's much harder to treat influenza than it is to prevent it.

00:08 How do we prevent influenza? Well, first is get vaccinated.

00:13 Stay home if you have influenza.

00:15 Patients should not be going to school.

00:16 They should not be going to work when they have influenza.

00:19 They can exercise.

00:20 Studies have shown that mild to moderate exercise can boost your immune system.

00:26 Patient should eat healthy for the same reasons, and should keep their hands clean because this is how they're going to transmit the influenza virus to other people and to themselves.

00:36 Cover your mouth and nose when coughing and sneezing.

00:39 Don't touch your face because this is how the virus will get into your body.

00:44 Smile more.

00:44 Studies have shown that smiling can actually increase your immune system function.

00:49 And maybe starting antivirals as prophylaxis in high-risk group populations.

00:55 Now, this means if you have a patient with influenza sitting in front of you who might not be a candidate for antiviral treatment, they may have an immunocompromised family member who is at a really high risk for influenza complications.

01:06 There is a prophylactic dose of antivirals that can be started in this population to prevent them from getting the flu virus.

01:12 And these antivirals, while they're not that good at helping the influenza virus when you are already sick, they are pretty good at preventing it in other members of the community.

01:22 Management.

01:22 Prevention.

01:23 Get the vaccine.

01:25 You are at least 60% less likely to become infected with the influenza virus.

01:31 Flu viruses used in flu shots are inactivated, so they cannot cause infection.

01:36 And this is a common conversation I have with my patients.

01:38 They will say, "I don't want to get the flu shot because the last time I got the flu shot, I got the flu." And then I have a conversation with them that that is impossible to happen from the flu shot.

01:47 It turns out they got the flu because it was flu season, and they could have gotten their flu shot 2 weeks sooner to actually give them some antibodies that might be protective.

01:55 But the flu shot cannot cause influenza.

01:58 Get the flu vaccine as soon as possible because, as mentioned, it takes 2 weeks for those protective antibodies to actually develop.

02:05 The nasal spray is not effective.

02:07 You should get the flu shot to be properly vaccinated.

02:10 The flu shot is designed yearly to protect against the highest risk and actively circulating strains of influenza.

02:18 Herd immunity is the idea that when most people get the flu vaccine, it helps protect the population as a whole.

02:25 Children need to receive 2 flu shots per the recommended schedule, 4 weeks apart if they have not previously received the double vaccine.

02:33 Children 6 months through 8 years getting vaccinated for the first time and those who have only previously gotten 1 dose of the vaccine should get 2 vaccines during the next flu season.

02:43 All children who have previously gotten 2 doses of the vaccine at any time only need 1 dose.

02:49 The first dose should be given as soon as the vaccine becomes available.

02:54 In management in deciding how many vaccines your pediatric patient will need, you need to see, are they between 6 months and 8 years of age? If so, the next step is have they received 2 or more total doses of any trivalent flu vaccine prior to July 1st of 2016? If "yes," they can just get 1 dose.

03:14 The second dose should be given at least 28 days after the first dose.

03:18 And this first dose is going to prime the immune system.

03:21 The second dose is what's actually providing the immune protection.

03:25 Children who only get 1 dose, but actually needed 2, will have reduced or no protection from a single dose of the flu vaccine.

03:32 So it's like they never got their flu shot to begin with.

03:35 If the child needs 2 doses, start the process early since it will take 2 weeks after the second dose for the protection to actually begin.

03:43 And this will ensure that the child is protected before influenza starts circulating in their community.

03:49 The flu virus is smart and sneaky, and it poses a huge challenge.

03:54 It's always changing.

03:55 Both antigenic drift and antigenic shift are terms used to describe ways in which the flu virus changes over time.

04:03 A drift is a minor change, and a shift is a major one.

04:07 While influenza viruses are changing by antigenic drift all the time, antigenic shift only happens occasionally.

04:14 Antigenic drift is a minor change in the H and N proteins.

04:19 When the virus replicates, these little point mutations occur, but overall, the subtype remains the same.

04:25 When these minor changes or mutations happen, the virus looks a little bit different to our immune system and the antibodies created previously to the flu virus or the flu vaccine will no longer recognize the new virus.

04:39 This is continually happening.

04:42 The antibodies made to protect you from another infection are very specific to the 1 strain only, and provide very limited protection in the event you get sick with another strain.

04:52 This is why we need flu vaccines every year.

04:55 The new vaccine is going to have the new changes from the new antigenic drifts.

05:02 This is in contrast to antigenic shift, which is a major change in the influenza virus.

05:07 This shift occurs, typically, when the human flu virus crosses with a flu virus that usually affects animals, such as birds or pigs, and involves major changes in the H and N proteins.

05:19 When these viruses mutate, they shift to create new subtypes, and that's a different form that's ever been seen in humans before.

05:26 This can happen in 3 ways.

05:28 The first, a human flu virus is going to infect an animal, such as a pig.

05:32 The same pig also gets infected by a flu virus from another animal, such as the duck.

05:38 The 2 flu viruses can mix and mutate, creating a completely new flu, which can then spread back to humans.

05:45 The second way is a strain of bird flu can pass directly to humans without undergoing any type of mutation.

05:52 And the third way is a strain of bird flu that's going to pass to another animal first, and then be passed on to humans without undergoing any type of mutation.