INFLUENZA

Answer

Influenza among the elderly persons.

Influenza, commonly known as flu, is an infection caused by RNA viruses which affects both animal and human respiratory tracts. The virus causes fever, headache, coughs and feeling of weakness, while others develop nausea, diarrhea, sore throats and vomiting, fever, running nose, headache, sore throat, muscle pains, coughing, exhaustion and in few cases nausea and vomiting (Jefferson, 2014). These symptoms often persist for two or more weeks before recovery (Charu, 2017). In comparison to other viral respiratory related infections, influenza causes more adverse effects with low death rate of about 0.1 percent of patients infected the virus. It is an infectious respiratory illness caused by the influenza virus. People with Influenza are at high risks of developing complications such as pneumonia, dehydration, sinus problems, ear infections, myocarditis (inflammation of the heart) encephalitis (inflammation of the brain), inflammation of muscle tissues and multi-organ failure.

 The influenza virus is spread through the air when an infected individual coughs or sneezes. When an infected individual coughs or sneezes, he or she releases more than half a million virus particles which are then spread to people nearby (CDC, 2013). Causal organisms can also aid in transmission through impetigo, diarrheal infections, antibiotic resistant organisms and scabies. Uninfected individuals pick the virus by inhalation or touching surfaces contaminated by the virus and then touching their mouths or eyes. It can also occur through direct transmission of causal organisms between an infected patient, in this case Mr. Azikiwe, and a highly susceptible health worker. This can occur through intact skin or touching of contaminated doorknob describing indirect contact transmission route (Cowling, 2014).

 Although being a low life-threatening infection, influenza records an annual average of 36000 deaths and 114,000 hospitalizations in the United States of America. It is also recorded that 90% of deaths due to influenza occurs among adults of 65 years and older. Influenza was the leading cause of death of elderly persons in 1998. Mr Azikiwe being 88 years old is at risk of losing his life since he already has contracted complications related to influenza such as his productive cough.

Most nursing homes such as Sunset Nursing Home are at risk having more influenza infection spread if necessary steps are not taken. This is due to the clustered population of the hospitalized individuals and those taking care of them. Relatives and friends who come visit hospitalized individuals are also at risk of infection. Mr. Azikiwe may spread his illness to his daughter and grandchildren who visit him. In the United States nursing homes report 60% attack rates and among those infected: 52% can develop pneumonia, 29% can be hospitalized and 10% can die of complications related to influenza. Its adverse effects leads to higher healthcare costs more deaths than any other viral illness.

It is important to observe certain prevention and control measures in elderly homes for influenza. These measures include proper use of Personal Preventive Equipment like gloves and masks, and disinfecting any shared equipment by patients is a crucial precaution which must be employed in nursing homes. It should be aimed at maintaining an infection free herd in the homes such as vaccinating against the virus (Fiore, 2008). However, infection may still occur in a few individuals who due to background factors may not be protected from the virus even after vaccination. It is possible that the staff in Sunset Nursing Home may have vaccinated everyone there but Mr. Azikiwe’s body was not protected possibly since he is an immigrant. Other measures may then be applied such as isolation, effective treatment and strict surveillance in the nursing homes.

The World Health Organization (WHO) recommends vaccination as an effective method of preventing influenza infection. Hospitalized persons as well as nurses taking care of them should get vaccinated every once a year. The Centers for Disease Control and Prevention (CDC) recommends the vaccination of all staff and residents of nursing homes to maintain a minimum of 80% vaccinated individuals. This according to them will ensure a population in a home that is immune to influenza.

Staff in Sunset Nursing Home should run vaccination campaigns before the onset of influenza season (Jimenez-Jorge,2015). They should seek the consent of individuals to receive vaccination once every year for as long as they are living in the home. In the case where patients don’t agree to consent, the home should make it a rule to vaccinate all patients and make them aware (Grohskopf,2014) The home should also ensure the medical practitioners administering vaccination are accredited and qualified so as to ensure effective vaccination.

However reports by the World Health Organization (WHO) show that influenza vaccine can only be between 50 to 60% effective in preventing influenza and other influenza associated complications. This is because of several factors such as people ignoring the call to go vaccinate. The WHO set a goal of 75% influenza vaccination among the elderly by 2010 however not achieved as only 38% took the vaccination. Another reason for this shortcoming may be such as for Mr. Azikiwe’s case who has a different background.

Strict Surveillance

Staff in elderly homes like nurses, doctors, pharmacists, dieticians, occupational therapists and social workers should check for infections of the flu or any symptoms among the individuals they are looking after. For instance in Sunset Nursing Home the staff should do checkups on its residents. This was effective in noting that Mr. Azikiwe was having flu like symptoms. (Kallewaard, 2016) They should also keep clear health records of Mr. Azikiwe and follow up on his well-being. If influenza symptoms are detected in the home, they should make sure affected individuals are tested and treatment is commenced immediately.

It is also important to communicate with public health workers for regular updates on influenza outbreaks in the area where Sunset Home is located. Apart from looking out for influenza among hospitalized individuals, the staff too should also look after themselves. Staff members should also get tested if influenza like symptoms are detected among them and everyone is made aware of its presence (WHO, 2009). These measures are important in detecting influenza early enough before it spreads among the population.

If an influenza infection is very in a home the infected individuals should be isolated from the population in confined rooms until there are cured. Mr. Azikiwe should be isolated from the population in Sunset Nursing Home to avoid further infections to other residents. The staff may also consider isolating the whole residence from other contacts such as visitors. This is effective in ensuring the virus is not spread to outsiders and also ensuring outsiders do not infect the residents. Mr. Azikiwe may have contracted the influenza from his daughter and granddaughters during their visits. He should be separated from his family even with their habitual fondness to come visit him.

The staff should observe high level standards of hygiene during an outbreak such as washing their hand regularly and wearing masks while dealing with their patients. Staff working with infected persons should keep away from those uninfected (Reed, 2014). They should remind people to avoid physical contact to prevent droplet transmission of the virus. The staff should also ensure that the facility is cleaned by wiping surfaces with detergent to eliminate the survival if influenza virus on surfaces. These measures will ensure there is no spreading of the virus among the population.

Even with these above measures taken there is still need to cure Mr. Azikiwe off his illness so that the virus is eliminated from the residence. Antiviral medicine is effective in this case since influenza is caused by a virus (Avian influenza, 2013). These medicines prove useful if the disease is detected early enough. Lucky for Mr. Azikiwe who has being suffering for a few days now. Mr. Azikiwe should take plenty of rest, drink a lot of water and avoid smoking and alcohol. Antibacterial may be prescribed if a patient is suffering from bacterial pneumonia.

Effective medication may be administered to a patient but some strains of influenza can be resistant to the standard antiviral drugs administered. There are two classes of antiviral drugs used against influenza: Neuraminidase inhibitors (oseltamivir and zanamivir) and M2 protein inhibitors (adamantane derivatives).

Neuraminidase inhibitors do not prove to be very effective since its benefits are not greater than its risks when administered to a healthy person. And there no any benefit when administered to one with other health problems. When administered to patients having influenza it slightly decreases the length of time symptoms appear. The influenza virus showed increased resistance to it over time forcing researchers to look for an alternative.

They came up with M2 inhibitors that was effective against influenza A viruses if given early in the infection. However it was ineffective against Influenza B viruses. Overtime influenza became resistant to this drug with 91% resistance in America in 2005. The CDC advised against using M2 inhibitors during the 2005–06 influenza season due to high levels of drug resistance. There is still studies on the use of oscillococcinum which is made from wild duck heart and liver. This treatment however has not been tested for clinical use.

Mr. Azikiwe should be administered with effective treatment to ensure full recovery. The facility should also allow for the use of alternative drugs to cure him. They should give room and resources for research since this will help other newly infected patients (Virus, 2009). Researchers in the field of medicine play a big role here in the fight against influenza. Granting them resources will be effective in achieving better treatment for the virus

Loosing Mr. Azikiwe’s life will have a huge impact on the society since his daughter and three grandchildren will be affected. According to the World Health Organization: "Every winter, tens of millions of people get the flu. Most are only ill and out of work for a week, yet the elderly are at a higher risk of death from the illness. We know the worldwide death toll exceeds a few hundred thousand people a year, but even in developed countries the numbers are uncertain, because medical authorities don't usually verify who actually died of influenza and who died of a flu-like illness."