Chief Health Officer, Victoria, Australia

Influenza Alert for General Practitioners (letter and fact sheet) - August 2007

You will have heard about the death of a young child, possibly associated with influenza infection. This is unsubstantiated as yet, and the Coroner will determine a cause of death.

In Victoria, seasonal activity for influenza has just begun to increase, but is only now into normal seasonal activity. 260 notifications of laboratory confirmed influenza have been received in 2007 up to 8 August, compared to 245 for the same period last year.

Clinical features of influenza

Fever, headache, myalgia, lethargy, coryza, sore throat and cough. Infections in children can be associated with gastrointestinal symptoms such as nausea, vomiting and diarrhoea.

Case management

Symptomatic treatment alone is sufficient for most cases. A neuraminidase inhibitor, if commenced within the first 48 hours of the onset of illness, can decrease the severity and duration of the illness. However, if the patient is significantly unwell refer the patient to an Emergency Department for assessment and management.

Influenza vaccination

Influenza vaccine does not offer post exposure protection. Influenza vaccine is not recommended by the National Health and Medical Research Council (NHMRC) as a universal population based vaccination program for children, however it can be given to any person >6 months of age who wishes to reduce the likelihood of becoming ill with influenza.

Free vaccine is available under the National Immunisation Program for:

• All people aged 65 years and older
• Aboriginal and Torres Strait Islander people aged 50 years and older
• Aboriginal and Torres Strait Islander people aged 15 to 49 years with chronic medical
  conditions

Vaccine is also recommended for people (although not available free under the National Immunisation Program) in the following groups:

• Children (>6 months of age) and adults with chronic illnesses
• Residents and staff of nursing homes and other long term care facilities
• Health care workers

Two doses of vaccine at least one month apart are required for children aged < 9 years receiving influenza vaccine for the first time. Children aged 6 months to < 3 years are recommended to receive 0.25 ml, and those aged 3 – 9 years to receive 0.5 ml. Further vaccine information can be found in the NHMRC Australian Immunisation Handbook. Note that the dose schedule provided here for children comes from the new draft 9th Edition Handbook which can be found on line at www.immunise.health.gov.au.

Remember that laboratory confirmed influenza is a notifiable disease under the Health (Infectious Diseases) Regulations 2001. Doctors and laboratories are required to notify cases within 5 days to DHS. Notifications can be completed by post, by fax to 1300 651 170 or telephoned to 1300 651 160.

Enclosed is a fact sheet to distribute to parents concerned about their children. If you require any further information, please call the Communicable Disease Control Unit on 1300 651 160.

Yours sincerely

Dr John Carnie
Chief Health Officer

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Influenza Alert for General Practitioners (letter and fact sheet) - August 2007 (200kb, pdf)