Chair, Charles Vega, MD, FAAFP, prepared useful Practice Aids pertaining to influenza for this CME/MOC/NCPD activity titled “Examining Novel Approaches to Improve the Management of Influenza: An Animated Exploration.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD information, and to apply for credit, please visit us at https://bit.ly/31FYp8J. CME/MOC/NCPD credit will be available until July 20, 2022.

1. Antiviral Therapies for the Treatment of Influenza:
Recommendations and Available Options
Full abbreviations, accreditation, and disclosure information available at PeerView.com/BNC40
1. www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm. 2. Uyeki TM et al. Clin Infect Dis. 2019;68:895-902. 3. Baker J et al. Pediatr Infect Dis. 2020;39:700-705. 4. Tamiflu (oseltamivir phosphate) Prescribing Information. https://www.accessdata.fda.gov/
drugsatfda_docs/label/2011/021087s057lbl.pdf. 5. Rapivab (peramivir) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/206426lbl.pdf. 6. Relenza (zanamivir) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/
label/2010/021036s025lbl.pdf. 7. Xofluza (baloxavir marboxil) Prescribing Information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210854s000lbl.pdf.
Antiviral Therapy Recommendations1,2
High-Risk Patients
Any patient with confirmed or suspected influenza
(regardless of vaccination status) who
• Is hospitalized
• Has a severe, complicated, or progressive illness
• Is at higher risk for influenza complications
Who?
When?
• As early as possible
• Do not await confirmatory lab results
• Ideally, within 48 h of symptom onset; but antiviral
treatment might benefit patients with a severe,
complicated, or progressive illness and hospitalized
patients when started after 48 h of illness onset
When?
Within 48 h of symptom onset
Otherwise Healthy Patients
Any previously healthy, symptomatic outpatient not at high
risk with confirmed or suspected influenza, on the basis of
clinical judgment
Who?
Overview of Antiviral Therapies to Treat Influenza1,3-7
• One dose
• High-risk or otherwise healthypatients ≥12 y
• Under investigation for pediatric patients <12 y
Baloxavir
Tablet
Polymerase Complex Inhibitor
• 2 doses/d for 5 d
• Otherwise healthy patients ≥7 y
• Not recommended for patients with chronic airway diseases
• Pregnancy category C
Zanamivir
Inhaled powder
Neuraminidase Inhibitors
• 2 doses/d for 5 d
• Any age
Oseltamivir
Capsule or liquid
• 15-30 min administered by
healthcare provider
• Otherwise healthy patients ≥2 y
Peramivir
IV infusion

2. Influenza vs COVID: Know the Difference and the Disease Course
Full abbreviations, accreditation, and disclosure information available at PeerView.com/BNC40
a
Information is rapidly evolving and subject to change. b
Increases to 104˚ F within 12 h, then decreases 0.5-1.0˚/d. c
Elderly and immunosuppressed patients may not manifest fever.
1. Solomon DA et al. JAMA. 2020;324:1342-1343. 2. www.cdc.gov/flu/about/burden/index.html. 3. Verity R et al. Lancet Infect Dis. 2020;20:669-677. 4. www.cdc.gov/flu/professionals/acip/clinical.htm. 5. www.cdc.gov/flu/symptoms/flu-vs-covid19.htm.
Influenza vs COVID-191-3
Characteristics Influenza
Coinfection is possible!
COVID-19a
Transmission
Overall infectivity
When is it most infectious?
Incubation period
Hospitalization rate
Case fatality rate
Droplet
Droplet
(airborne, fomite, fecal-oral possible)
More contagious
48 hours before symptom onset
Less contagious
After symptom onset
1-4 d
(median: 2 d)
2-14 d
(median: 5 d)
1.1% (age 20-29 y) to 18.4% (age ≥80 y)
2%
~0.1% ~0.25%-3.0%
Infectivity: 1 d before to
3-4 d after symptom onset
Uncomplicated
symptoms typically
resolve
Cough may persist
Fever,b,c
chills, fatigue,
myalgia, dry cough, sore
throat, headache, rhinitis
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Influenza Clinical Course1,4,5
Day