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Frequently Asked Questions on Seasonal Influenza

Frequently Asked Questions on Seasonal Influenza
2020-04-27
  1. What is Seasonal Influenza?
  2. What are the symptoms if I have got seasonal influenza?
  3. What should I do if I develop respiratory symptoms?
  4. How is seasonal influenza transmitted?
  5. How can I prevent getting seasonal influenza?
  6. When should I wash my hands?
  7. When shall I wear a surgical mask?
  8. Who should receive seasonal influenza vaccination?
  9. Which vaccine should members of the public get vaccinated, trivalent or quadrivalent vaccine?
  10. Is it necessary to get vaccinated against seasonal influenza every year?
  11. What are the possible side effects of the inactivated influenza vaccine?
  12. What are the possible side effects of the live attenuated influenza vaccine?

1.  What is Seasonal Influenza?

Seasonal influenza is an acute illness of the respiratory tract caused by influenza viruses. It is usually more common in periods from January to March/April and from July to August in Hong Kong.

2.  What are the symptoms if I have got seasonal influenza?

For healthy individuals, seasonal influenza is usually self-limiting with recovery in 2 – 7 days. Symptoms may include fever, cough, sore throat, runny nose, muscle pain, fatigue and headache; some may also have vomiting and diarrhoea. Cough is often severe and prolonged but fever and other symptoms generally resolve in 5 – 7 days. However, influenza can be a serious illness to the weak and frail or elderly people, and may be complicated by bronchitis, chest infection or even death.

3.  What should I do if I develop respiratory symptoms?

You should put on a surgical mask if you develop respiratory symptoms such as fever, cough, sore throat, runny nose, muscle pain, fatigue and headache; and should have adequate rest, drink plenty of water, refrain from work or attending class at school. You should seek medical advice if symptoms persist or deteriorate so that a diagnosis could be made early. Antibiotics, which target bacterial infection but not viral infection, will not cure influenza or make recovery faster. In addition, antiviral agents may reduce severity and duration of illness but must be used under doctor's prescription.

4.  How is seasonal influenza transmitted?

Influenza viruses mainly spread through droplets when infected people cough, sneeze or talk. The infection may also spread by direct contact with the secretions of infected persons.

5.  How can I prevent getting seasonal influenza?

  • Receive seasonal influenza vaccination for personal protection
  • Perform hand hygiene frequently, especially before and after touching the mouth, nose or eyes; after touching public installations such as handrails or door knobs; or when hands are contaminated by respiratory secretion after coughing or sneezing. Wash hands with liquid soap and water, and rub for at least 20 seconds. Then rinse with water and dry with either a clean cotton towel or a paper towel
  • If hand washing facilities are not available, or when hands are not visibly soiled, hand hygiene with 70 to 80% alcohol-based handrub is an effective alternative
  • Cover your mouth and nose with tissue paper when coughing or sneezing. Dispose of soiled tissues into a lidded rubbish bin, then wash hands thoroughly
  • When having respiratory symptoms, wear a surgical mask, refrain from work or attending class at school, avoid going to crowded places and seek medical advice promptly
  • Build up good body immunity by having a balanced diet, regular exercise, adequate rest, reducing stress, do not smoke and avoid alcohol consumption
  • Regularly clean and disinfect frequently touched surfaces such as furniture, toys and commonly shared items with 1:99 diluted household bleach (mixing 1 part of 5.25% bleach with 99 parts of water), leave for 15-30 minutes, and then rinse with water and keep dry. For metallic surface, disinfect with 70% alcohol
  • Use absorbent disposable towels to wipe away obvious contaminants such as respiratory secretions, and then disinfect the surface and neighbouring areas with 1:49 diluted household bleach (mixing 1 part of 5.25% bleach with 49 parts of water), leave for 15-30 minutes and then rinse with water and keep dry. For metallic surface, disinfect with 70% alcohol and
  • Maintain good indoor ventilation. Avoid going to crowded or poorly ventilated public places; high-risk individuals may consider putting on surgical masks while in such places

6.  When should I wash my hands?

Remember to wash your hands under the following situations:

  • Before and after touching the eyes, nose and mouth
  • Before eating or preparing food
  • After using the toilet
  • When hands are contaminated by respiratory secretions, e.g. after coughing or sneezing
  • After touching public installations or equipment, such as escalator handrails, elevator control panels or door knobs
  • After changing diapers or handling soiled items from children or the sick
  • Before and after visiting hospitals, residential care homes or caring for the sick; and
  • After touching animals, poultry or their droppings

In general, members of the public should wash hands with liquid soap and water when hands are visibly dirty or visible soiled with blood and body fluid, after using the toilet or changing the diapers. If hand washing facilities are not available, or when hands are not visibly soiled, hand hygiene with 70 to 80% alcohol-based handrub is an effective alternative.

7.  When shall I wear a surgical mask?

Members of public should wear a surgical mask when respiratory symptoms develop, e.g. fever, runny nose, coughing or sneezing; or care for patients with respiratory symptoms and visit clinics or hospital. Avoid going to crowded or poorly ventilated public places; high-risk individuals may consider putting on surgical masks while in such places.

8.  Who should receive seasonal influenza vaccination?

Influenza can cause serious illnesses in high-risk individuals and even healthy persons. Given that seasonal influenza vaccines are safe and effective, all members of the public aged 6 months or above except those with known contraindications are recommended to receive influenza vaccine for personal protection.

9.  Which vaccine should members of the public get vaccinated, trivalent or quadrivalent vaccine?

Both trivalent (IIV3) and quadrivalent (IIV4) inactivated influenza vaccines are recommended for use in Hong Kong. Trivalent influenza vaccine may potentially prevent the majority of influenza burden in Hong Kong based on past laboratory data, while quadrivalent influenza vaccine may potentially offer additional protection against influenza B. Members of the public should consult their family doctors for details.

10.  Is it necessary to get vaccinated against seasonal influenza every year?

Yes. The circulating seasonal influenza strains may change from time to time. In accordance with the circulating strains, the seasonal influenza vaccine composition is updated every year to enhance protection. The immunity built up in a vaccinated person in the prior season will decrease over time and may become too low to provide protection in next season.

11.  What are the possible side effects of the inactivated influenza vaccine?

Inactivated influenza vaccine is very safe and usually well tolerated apart from occasional soreness, redness or swelling at the injection site. Some recipients may experience fever, muscle pain, and tiredness beginning 6 – 12 hours after vaccination and lasting up to 2 days. If fever or discomforts persist, please consult a doctor. Immediate severe allergic reactions like hives, swelling of the lips or tongue, and difficulties in breathing are rare and require emergency consultation.

Influenza vaccination may be rarely followed by serious adverse events such as Guillain-Barré syndrome (about 1 to 2 cases per million vaccinees) and severe allergic reaction (anaphylaxis) (9 in 10 million doses distributed). However, influenza vaccination may not necessarily have causal relations with these adverse events. Studies have shown that the risk of Guillain-Barré syndrome after influenza infection (17.20 per million) is much higher than after influenza vaccination (1.03 per million).

(The Lancet Infectious Diseases. 2013 Sep; 13(9): 769-76)

12.  What are the possible side effects of the live attenuated influenza vaccine?

The most common adverse reactions following live attenuated influenza vaccine administration are nasal congestion or runny nose (in all ages), fever (in children) and sore throat (in adults).  The safety in pregnant women has not been established.  Children aged below five years with recurrent wheezing/ persons of any age with asthma may be at increased risk of wheezing following administration.