Flu Season in LTC: Recognition, Treatment, and Prevention

Throughout the fall, much of the focus has been on vaccination as a key preventive measure.However, it is equally important to recognize flu symptoms and understand current treatmentoptions and guidelines. Early identification and timely treatment can help limit the severityand duration of illness for individuals who test positive for influenza.

The CDC has released updated influenza treatment guidelines that place special emphasison individuals at high risk for serious flu-related complications. While many otherwise healthyindividuals can recover with rest, hydration, and symptom management, high-risk populationsoften require closer monitoring and prompt antiviral treatment.

Individuals considered high risk due to medical conditions include:

  • Asthma
  • Diabetes
  • COPD or cystic fibrosis
  • Heart disease
  • Neurological conditions
  • Blood disorders (such as sickle cell disease)
  • Kidney or liver disorders
  • Severe obesity (BMI greater than 40)
  • Weakened immune systems due to HIV, cancer, chemotherapy, or immunosuppressivemedications

Other high-risk populations include:

  • Adults aged 65 and older
  • Children under the age of 2
  • Pregnant women and those up to two weeks postpartum
  • Individuals residing in nursing homes or other long-term care facilities

If influenza is suspected and at least one symptom is present—or if there has been knownexposure to others who have tested positive—the individual should be tested for flu. This iscritical because antiviral medications are most effective when initiated within 48 hours ofsymptom onset.

Nursing staff play a key role in early detection by closely monitoring symptoms and routinelyasking residents about how they are feeling. This is especially important for residents whomay be confused, disoriented, or unable to clearly communicate symptoms. When flu isstrongly suspected, treatment may be started empirically, even before test results areavailable.

When administered promptly, antiviral medications can reduce symptom severity, shorten theduration of illness, and—most importantly—help prevent serious complications such aspneumonia and hospitalization.

Currently, four antiviral medications are approved and recommended for influenza treatment,available in various dosage forms. Tamiflu is available as a tablet or liquid, Relenza as aninhaled powder, and Rapivab as a single intravenous dose. The most appropriate optiondepends on factors such as patient age, renal function, dosage form, and ability to adhere totreatment.

The table below lists anti-viral options, dosage, routes, and common directions:

Renal Impairment dosing Tamiflu: Mild (60-90ml/min = 75mg twice daily x 5 days); Moderate(30-60ml/min = 30mg twice daily x 5 days); Severe (10-30ml/min = 30mg once daily x 5days); ESRD requires further adjustment dosing with hemodialysis cycle

***Renal Impairment dosing Relenza in Adults: CrCL >50 = 600mg x 1 dose; CrCL 30-49= 200mg x 1 dose; CrCL 10-29 = 100mg x 1 dose***

Having antiviral options, dosing information, and directions readily available can help ensuretimely and accurate pharmacy orders, allowing treatment to begin as quickly as possiblewhen flu is suspected or confirmed.

SpecialtyRx wishes you a warm, safe, and healthy rest of the holiday season—and a healthyflu season, too.

Flu Season in LTC: Recognition, Treatment, and Prevention