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In this section : Infectious Diseases

Paediatric Antimicrobial Guidance Treatment of Malaria Gentamicin Prescribing (Paediatrics) Influenza A HIV Testing Guidelines Clostridiodes difficile Infection Blood Culture OPAT SBAR (Complex Infections) Staphylococcus aureus Bacteraemia (SAB) Neutropenic Sepsis Antibiotics and the Kidney Acute Diarrhoea Suspected Meningitis Suspected Sepsis Gentamicin Dosing Urinary Tract Infection Vancomycin Dosing Cellulitis Post Splenectomy Sepsis

Home | Articles | Infectious Diseases | Influenza A

Influenza A

Last updated 9th January 2023

NHSD&G is experiencing an increase in Influenza cases. It appears that some patients are not being considered for influenza NAI therapy as per recent CMO guidelines (see ‘Links’ below)

Risk Factors for Complicated Influenza

These include:

neurological, hepatic, renal, pulmonary and chronic cardiac disease
diabetes mellitus
severe immunosuppression
age over 65 years
pregnancy (including up to 2 weeks post-partum)
children under 6 months of age
morbid obesity (BMI ≥40)
for full details refer to ‘Immunisation against infectious disease’,(known as the Green Book)

Severe Immunosuppression

Degrees of immunosuppression are difficult to quantify and individual variation exists, therefore this list is not comprehensive.
Examples of severe immunosuppression include:

Severe primary immunodeficiency
Current or recent (within 6 months) chemotherapy or radiotherapy for malignancy.
Solid organ transplant recipients on immunosuppressive therapy
Bone marrow transplant recipients currently receiving immunosuppressive treatment, or within 12 months of receiving immunosuppression
Patients with current graft-versus-host disease
patients currently receiving high dose systemic corticosteroids (equivalent to ≥40 mg prednisolone per day for >1 week in an adult, or ≥ 2mg/kg/day for ≥1 week in a child), and for at least 3 months after treatment has stopped.
HIV infected patients with severe immunosuppression (CD4<200/microL or <15% of total lymphocytes in an adult or child over 5; CD4< 500/microL or <15% of total lymphocytes in a child aged 1 to 5; expert clinical opinion in a child aged under 1)
Patients currently or recently (within 6 months) on other types of highly immunosuppressive therapy or where the patient’s specialist regards them as severely immunosuppressed.

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Content by Dr Martin Connor and Dr Ken Donaldson