The most recent influenza surveillance data indicate that influenza-like illness (ILI) has increased in the community in the past week. The influenza-like illness (ILI) rate during week 49 (week ending December 8th 2019) was 37.5 per 100,000 population which is now above the Irish baseline ILI threshold of 18.1 per 100,000 for the first time this season. The baseline threshold is used to assess influenza activity in the community. In addition, during week 49, 143 confirmed influenza cases were reported as hospitalised with 12 confirmed influenza cases admitted to critical care units to date this season. Three influenza-associated deaths and eleven outbreaks of confirmed influenza have been reported to HPSC so far this season. Influenza A (H3N2) is the dominant virus circulating in the community with influenza A (H1N1)pdm 09 and B also circulating to a lesser degree. The latest flu report published each Thursday is available here on the HPSC website.
In light of the increase in influenza activity it is likely that people presenting with influenza-like illness are infected with an influenza virus. In this context, it is recommended that antivirals be used for the treatment and prophylaxis of influenza in clinical at-risk groups (see below) as well as any who are at risk of severe illness and/or complications from influenza if not treated.
Antiviral Guidance-Ireland
Due to the levels of influenza activity reported last week (week ending December 8th 2019) in Ireland, antiviral drugs for the treatment and prophylaxis of influenza in at-risk patients are recommended in line with the Guidance on the use of antiviral agents for the treatment and prophylaxis of influenza, 2019-2020 which is available on the HPSC website. Those in clinical at-risk groups presenting with symptoms of influenza and those with clinical complications from influenza or progressive influenza illness including any hospitalised cases should be considered for treatment with antivirals.
The defined risk groups for the treatment of influenza with antivirals are:
Influenza Vaccine
This increase in influenza activity also highlights the need to ensure maximum protection through vaccination for those most at risk. It is important that persons aged 65 years and older, those aged less than 65 years who are in risk groups (i.e. have chronic medical conditions, are immunosuppressed and all cancer patients) and pregnant women are protected by vaccination against the complications from flu. It is also important that healthcare workers and carers of those in risk groups are vaccinated.
It is not too late for the above persons to receive the flu vaccine if they have not already done so. In addition, unvaccinated patients in the high risk groups who are treated for suspected or confirmed Influenza should still be offered the (Quadrivalent) vaccine when recovered to protect them against other circulating influenza types.
Details on influenza vaccination are available:
Other influenza guidance
See algorithms for the management of influenza when it is circulating in the community:
Pregnancy
Guidelines on the use of antivirals in pregnancy for patients with influenza are available on the HPSC website
Residential Care Facilities
Guidelines and a checklist for the prevention, detection and control of influenza-like illness and influenza outbreaks in residential care facilities are available on the HPSC website
Infection Prevention and Control Advice
All frontline workers should observe appropriate infection control measures. Information on this is available on the HPSC website.
Details of Influenza Activity in Ireland are available on the HPSC website
See also: https://www.hpsc.ie/A-Z/Respiratory/Influenza/SeasonalInfluenza/
Details of Influenza Information for Health Professionals on the HPSC website at:
https://www.hpsc.ie/A-Z/Respiratory/Influenza/SeasonalInfluenza/Guidance/
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