WHO works to strengthen national, regional and global influenza response capacities including diagnostics, antiviral susceptibility monitoring, disease surveillance and outbreak responses, and to increase vaccine coverage among high risk groups and prepare for the next influenza pandemic. A total of 664 hospital admissions and 85 confirmed deaths have been reported since the beginning of winter 2017. Textbook of Influenza. Safe and effective vaccines are available and have been used for more than 60 years. Sporadic infections occur outside of the influenza season, though the incidence is very low in the European summer when infections may be the result of imported cases from equatorial areas (where transmission is more year round) and the southern hemisphere where most infection takes place between June to October. Furthermore, exacerbations of underlying disease, e.g. Epidemics can result in high levels of worker/school absenteeism and productivity losses. cdc:32653[This corrects the article on p. 1293 in vol. Seasonal epidemics during those years can be more severe than during the years before the pandemic. In addition, the influenza A and B genome consists of eight separate RNA segments. Seasonal and pandemic influenza A represents one of the greatest threats to global health [66–68]. Seasonal influenza is a preventable infectious disease with mostly respiratory symptoms. Moreover, some people become infected, shed virus, yet are subclinical or asymptomatic cases - their role in transmission is not conclusively determined. Firstly there is the severe disease and deaths. influenza meaning: 1. formal for flu 2. formal for flu 3. flu. Type A and B viruses are the predominant virus types causing disease in humans and are the focus of this factsheet. It is usually not prescribed for more than 10 days. 2009 May 7;14(18). The cough can be severe and can last 2 or more weeks. Herpes zoster: seasonal variations and morphological patterns in Pakistan "Overall in the temperate regions of the northern hemisphere (North America and Europe), pandemic and seasonal influenza viruses have been detected only sporadically or at very low levels during the past month," it added. Cowling BJ, Fung ROP, Cheng CKY, Fang VJ, Chan KH, et al. (2008) Preliminary Findings of a Randomized Trial of Non-Pharmaceutical Interventions to Prevent Influenza Transmission in Households. 2013;7 Suppl 2:42-51. chemotherapy). Hospitalization and death occur mainly among high risk groups. It is a contagious disease of the respiratory tract caused by influenza viruses. The burden of influenza-associated critical illness hospitalizations. For A(H1N1)pdm09 oseltamivir resistance has so far only been detected at very low levels in Europe. However, immunity to influenza viruses and vaccines wane over time and a large part of the population is susceptible each season. The early antivirals, adamantane compounds (amantadine and rimantadine), act as M2 inhibitors and are active against influenza A. Administration of the drug should also be considered in patients presenting later in the course of illness. Patients that are not from a high risk group should be managed with symptomatic treatment and are advised, if symptomatic, to stay home in order to minimize the risk of infecting others in the community. Find information on coronavirus disease 2019 (COVID-19). The characteristics of the circulating virus strain and the immunity in the population, contributes to variations in disease burden from year to year, which makes it hard to estimate the annual number of deaths or economic impact. Not all infected present all the symptoms. For at least 40-60 seconds each time, especially after coughing or sneezing. Swelling of the white part … Chichester: John Wiley & Sons Ltd; 2013. Apart from the age-related increased risk, the risk of complications is increased for people of any age with particular chronic medical conditions: Moreover, healthy pregnant women have been found to be at increased risk of becoming hospitalized due to respiratory illness during influenza seasons (Dodds, 2007). Type B infections are less common and usually milder than influenza A(H3N2). Serological testing for detection of antibodies to seasonal influenza viruses is useful for research studies and requires collection of appropriately timed acute and convalescent serum specimens and testing of … Moreover, an EU target was set by the Health Council of all Health Ministers of 75% vaccination coverage by 2014/15 in the older age groups, and if possible extended to people with chronic conditions.Â. All age groups can be affected but there are groups that are more at risk than others. Congestion is when your nose becomes stuffed up and inflamed. All currently circulating influenza viruses are, children aged between 6 months to 5 years, elderly individuals (aged more than 65 years), individuals with chronic medical conditions, Regular hand washing with proper drying of the hands, Good respiratory hygiene – covering mouth and nose when coughing or sneezing, using tissues and disposing of them correctly, Early self-isolation of those feeling unwell, feverish and having other symptoms of influenza, Avoiding touching one’s eyes, nose or mouth. Apart from assisting in diagnosing the patient, the collected influenza virus specimens also provide material for characterization of viruses and contribute to seasonal vaccine development. Based on this overall picture, the evidence is strong that the recent influenza pandemic patterns are transitioning towards seasonal patterns of influenza. Despite the often short duration of illness, the yearly economic and healthcare burden of influenza is substantial. However, some countries, such as India and New Zealand, are continuing to experience significant levels of influenza H1N1 (2009), and national authorities in … 2012;54(10):1427-36. A single acute serum specimen for seasonal influenza serology is uninterpretable and should not be collected. Type B does not have subtypes but two antigenically distinct lineages: Victoria and Yamagata. Influenza (flu) is a potentially life threatening illness. But did you know that seasonal flu and pandemic flu are not the same? Type B viruses cause somewhat less severe disease and tend to cause fewer complications than some type A viruses. However, at least one observational study of A(H1N1)pdm09 found improved survival in the severely ill when antiviral treatment was provided within five days of symptom onset (Louie, 2012). European influenza seasons have been recorded for several years and are continuously under ECDC surveillance. In uncomplicated adult cases systemic symptoms usually last a few days. Paget WJ, Marquet R, Meijer A, van der Velden J. Influenza activity in Europe during eight seasons (1999-2007): an evaluation of the indicators used to measure activity and an assessment of the timing, length and spread across Europe. What is a pandemic? Influenza Other Respi Viruses. Based on published literature (Dawood, 2010; Hayward, 2014; Ortiz, 2014; Thompson 2003), mainly from the USA and extrapolated to an EU/EEA population of approximately 512 million, the burden of seasonal influenza has been estimated (Figure 1). When hand-washing is not possible, alcohol-based hand sanitisers are an option. The incubation time for seasonal influenza is on average two days, but ranges from one to four days. In some cases the disease becomes more severe due to the influenza virus infection or a secondary, usually bacterial, infection e.g. Zucs P, Buchholz U, Haas W, Uphoff H. Influenza-associated excess mortality in Germany, 1985-2001. The influenza virus causes seasonal epidemics of acute illnesses every winter. Cohort clinical and microbiological study of young patients infected with seasonal influenza subtypes A/H3N2 (Victoria, Pert strains) and B viruses in Ukraine: pathophysiology reaction of large intestinal cavity microbiota Except for virus culture these results can be available within approximately 1-2 days, and can help adjust the treatment. In birds H1-H16 and N1-N9 have been detected. Pain, burning, scratchiness, or itchiness may occur. Vaccination is especially important for people at high risk of influenza complications, and for people who live with or care for the people at high risk. There is also evidence of a fourth type: D (Ducatez, 2015). Face mask use and control of respiratory virus transmission in households. The use of these drugs is very variable between European countries (Kramarz et al., 2009), as are the policies.Â. The deadly outbreak of a novel coronavirus has turned a spotlight on that question and the science of pandemics. by maintaining a distance of at least one meter from someone with symptoms of influenza, and avoiding crowded situations. Since the most recent influenza pandemic in 2009 seasonal influenza consists of variable mixes of influenza A(H3N2), A(H1N1)pdm09 - the latter caused the 2009 pandemic, and the two B virus lineages. The subtypes are determined by two glycoproteins on the virus surface, haemagglutinin (HA) (H1–H18) and neuraminidase (NA) (N1–N11). In many languages people may use the term ‘flu’ not exclusively for influenza virus but also for mild diseases caused by other infectious agents. monographs for inactivated egg- derived and inactivated Nair H, Abdullah Brooks W, Katz M et al. Hospitalizations associated with influenza and respiratory syncytial virus in the United States, 1993-2008. Continuing challenges in influenza include the sporadic human cases of highly pathogenic avian H5N1 influenza, emergence of pandemic H1N1 influenza in 2009 [62,69], and human infections with avian H7N9 influenza … Ducatez MF, Pelletier C, Meyer G. Influenza D virus in cattle, France, 2011-2014. Emerg Infect Dis. Diagnosis of influenza in children is discussed separately. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. oseltamivir) should be prescribed as soon as possible (ideally, within 48 hours following symptom onset) to maximize therapeutic benefits. There are 4 types of seasonal influenza viruses, types A, B, C and D. Influenza A and B viruses circulate and cause seasonal epidemics of disease.. Cough, fatigue, and malaise may last some weeks. chronic bronchitis);Â, cardiovascular disease (e.g. Nogueira PJ, Nunes B, Machado A, Rodrigues E, Gomez V, Sousa L, et al. In industrialized countries most deaths associated with influenza occur among people age 65 or older (1). Laboratory confirmation of influenza virus from throat, nasal and nasopharyngeal secretions or tracheal aspirate or washings is commonly performed using direct antigen detection, virus isolation, or detection of influenza-specific RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). Minor illnesses are the most common causes of nasal congestion. alert_06. Once you are a servant, you may be lucky to be called a master of your craft. The complications can potentially occur in anyone, but hospitalisations are more common in older persons (≥65 years of age, 309/100,000 person-years) (Zhou, 2012) and in the youngest children (<1 year of age, 151/100,000 person-years) (Zhou, 2012). Secondly, but of greater economic impact, are the large numbers of mild to moderate cases which result in time off work, losses to production and pressure and costs on the health and social care services.Â. Thompson WW, Weintraub E, Dhankhar P, Cheng OY, Brammer L, Meltzer MI, et al. The elderly on average have a greater risk of developing severe complications, such as pneumonia. Emerg Themes Epidemiol. (2) Global burden of respiratory infections due to seasonal influenza in young children: a systematic review and meta-analysis. Euro Surveill. Vaccination is the most effective form of influenza prevention. Moreover, only influenza type A viruses are responsible for the occasional pandemics. The level of antiviral resistance is closely followed by public health authorities. • People at higher risk of influenza complications (see “Who is at risk”) are strongly Equally, cross-immunity following infection or vaccination against an influenza strain does not protect completely against subsequent variants of the same type or subtype. by Streptococcus pneumoniae or Staphylococcus aureus. 7. Illnesses range from mild to severe and even death. “The first skill of a great translator is humbleness, to be a servant. However, among the elderly, influenza vaccination may be less effective in preventing illness but reduces severity of disease and incidence of complications and deaths. 2009. In most cases, virus is found in specimens from nose and throat from one day before symptom onset to four to five days after onset. Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. This most commonly manifests itself in pneumonia, and at times even death. By the end of 2008-2009 a majority of seasonal influenza A(H1N1) exhibited oseltamivir resistance. 2007;176(4):463-8. In some cases the pandemic strain replaces one of the previously circulating strains. Influenza activity in Europe during eight seasons (1999-2007): an evaluation of the indicators used to measure activity and an assessment of the timing, length and spread across Europe. But, since 2009 the majority of the circulating influenza A viruses are resistant to the adamantane compounds. It is considered important that patients monitor themselves to detect if their condition deteriorates and they require medical intervention. The genome of influenza viruses is subject to a significant spontaneous mutation rate, known as antigenic drift. Learn more. Influenza season is here; please continue vaccinating through the winter months to prevent flu from spreading further According to CDC, seasonal influenza activity in the United States is high and continues to increase. Health care workers are at high risk acquiring influenza virus infection due to increased exposure to the patients and risk further spread particularly to vulnerable individuals. Lancet 2011; 378: 1917–3 A shift can occur e.g. Microbiology and laboratory reports; External quality assessments, Influenza virus characterisations. There are 4 types of seasonal influenza viruses, types A, B, C and D. Influenza A and B viruses circulate and cause seasonal epidemics of disease. Exercises for Sleep Apnea, Snoring, Sinus Pressure & more. The epidemiology, clinical manifestations, prevention, and treatment of seasonal influenza infection, as well as the diagnosis of avian influenza, are also reviewed elsewhere. In temperate climates, seasonal epidemics occur mainly during winter while in tropical regions, influenza … The affected eye may have increased tears or be "stuck shut" in the morning. In the U.S. alone, annual deaths caused by flu range from 3,300 to 48,600 people, and more than 200,000 are hospitalized each year from flu-related complications. Cowling B, Chan K-H, Fang VJ, Cheun CYK, Fung ROP, Wai W. et al. Facemasks and hand hygiene to prevent influenza transmission in households: a cluster randomized trial Annals of Internal medicine 2009; 151: 437-446. WHO also recommends vaccination of healthcare workers. Seasonal influenza is characterized by a sudden onset of fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and a runny nose. Estimates of US influenza-associated deaths made using four different methods. Seasonal influenza is a respiratory infection caused by the influenza virus. Kramarz P (2009), Monnet D, Nicoll A, Yilmaz C, Ciancio B. Use of oseltamivir in 12 European countries between 2002 and 2007 – lack of association with the appearance of oseltamivir-resistant influenza A(H1N1) viruses. Most simple seasonal influenza cases are managed symptomatically and are advised bedrest at home to minimize the risk for infecting others in the community. Type A viruses are responsible for the highest burden of disease during seasonal epidemics, although both influenza A and B types are able to cause epidemics, significant disease and deaths. ECDC continues to emphasise that all Europeans who are recommended to have the influenza vaccine should get vaccinated. (1) Estimates of US influenza-associated deaths made using four different methods. Influenza is one of the world's greatest infectious disease challenges. Read more in Influenza-related deaths - available methods for estimating numbers and detecting patterns for seasonal and pandemic influenza in Europe (Nicoll et al., 2012). 2015;21(2):368-71. Influenza is caused by viruses in the family Orthomyxoviridae. Burden of seasonal influenza hospitalization in children, United States, 2003 to 2008. J Pediatr. 2010;157(5):808-14. Thompson WW, Weintraub E, Dhankhar P, Cheng OY, Brammer L, Meltzer MI, et al. That is then a pandemic strain (see Edwin D. Kilbourne, 2006; Influenza Pandemics of the 20th and 21st Century). It may e.g. Due to the high resistance (>99%) adamantanes are no longer recommended. 2009;3:37-49. The time from infection to illness, known as the incubation period, is about 2 days, but ranges from one to four days. rhinovirus, respiratory syncytial virus, parainfluenza and adenovirus can also present as Influenza-like Illness (ILI) which makes the clinical differentiation of influenza from other pathogens difficult. Emerg Infect Dis. However, in 2009-2010, when the most recent influenza pandemic took place,, A(H1N1)pdm09 replaced A(H1N1). Each year, influenza causes serious infection and death around the globe, usually in the winter months (seasonal influenza). But influenza can cause severe illness or death especially in people at high risk (see below). Jefferson T, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review. inadvertently changed the meaning. Treatment is recommended for a minimum of 5 days, but can be extended until there is satisfactory clinical improvement. The diagnosis of seasonal influenza in adults will be reviewed here. 2013 Jul;7(4):584-603. doi: 10.1111/irv.12000. Although vaccination is the preferred option for preventing influenza, antivirals can be useful when the vaccine fails or is unavailable, for example, due to: antigenic mismatch with circulating virus, waning immunity in elderly, patient being immunocompromised, the vaccine not yet available, or during an outbreak of an emerging influenza strain or pandemic. • Seasonal influenza vaccination is available for anyone aged 6 months and over to protect against influenza, provided they do not have a medical reason that precludes them from receiving influenza vaccines. Summary information on antiviral resistance from influenza viruses in Europe is published in the weekly influenza update Flu News Europe. Regular hand washing with proper drying of the hands. In 2011, a live attenuated influenza vaccine was also approved in the EU for children and adolescents.Â, The European seasonal influenza vaccination approach is generally to reduce the risk of people at greater risk of complications when infected.Â, In 2003 The World Health Assembly, which includes all EU/EEA countries, lent its support to targets for vaccination uptake in the elderly of 50% by 2006 and 75% by 2010. Hayward AC, Fragaszy EB, Bermingham A, et al. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respir Med. Overall, it is hard to control seasonal influenza. However, the level of virus shedding before symptoms start is lower than for a few days after. The diagnosis can be confirmed by taking specimens for laboratory analysis. Neuraminidase inhibitors (i.e. Sore throat and runny nose may last longer. Seasonal influenza is an acute respiratory infection caused by influenza viruses which circulate in all parts of the world. Seasonal influenza vaccines are produced either in embryonated hens’ eggs or on a cell culture substrate. Herd immunity (also called herd effect, community immunity, population immunity, or social immunity) is a form of indirect protection from infectious disease that occurs when a sufficient percentage of a population has become immune to an infection, whether through vaccination or previous infections, thereby reducing the … Influenza risk groups are people who are more likely than others develop complications should they be infected. monograph for Vaccines for human use. Estimating influenza-related excess mortality and reproduction numbers for seasonal influenza in Norway, 1975–2004. 2010; 138(11):1559-68. 21, PMID: 26197993. Among healthy adults, influenza vaccine provides protection, even when circulating viruses do not exactly match the vaccine viruses. There are a number of other estimates of excess deaths from European countries (Gran et al., 2010; Nogueira et al., 2009; Zucs et al., 2005). Â. Killingley B, Nguyen-Van-Tam J. Routes of influenza transmission. Influenza Other Respir Viruses. Partners and networks working with influenza prevention and control. In Europe, and the rest of the northern hemisphere, seasonal influenza generally occurs in regular annual epidemics in winter, between November and April. Some of the main underlying reasons for this are: imperfect vaccine effectiveness, influenza cases do not always seek healthcare, and  delayed and rare use of antiviral treatment. Available from http://www.cdc.gov/EID/content/15/2/233.htm. MacIntyre CR, Epid MA, Cauchemez S, Dwyer DE, Seale H, Cheung P, et al. Meijer A, Lackenby A, Hungnes O, Lina B, van der Werf S, Schweiger B, et al. Oseltamivir-resistant influenza A (H1N1) virus, Europe, 2007–08 season. Although vaccination is the preferred option for preventing influenza, antivirals can be useful when the vaccine fails. Influenza Other Respir Viruses. Influenza vaccine is not licensed for children less than 6 months old. 2014;42(11):2325-32. Prescription of prophylaxis depends on several factors e.g. conditions and treatments that suppress the immune function (e.g. They frequently have underlying diseases which reduce their resistance to infection, and their immune response may also be less effective. The effects of seasonal influenza epidemics in developing countries are not fully known, but research estimates that 99% of deaths in children under 5 years of age with influenza related lower respiratory tract infections are found in developing countries (2). Nicoll A, Ciancio BC, Lopez Chavarrias V, Mølbak K, Pebody R, Pedzinski B, et al. To prevent transmission, people should cover their mouth and nose with a tissue when coughing, and wash their hands regularly. Overall, estimates of influenza morbidity and mortality should be interpreted with caution. Heiman et al.) Seasonal influenza affects about 5–20% of the population each year. Patients should monitor themselves to detect if their condition deteriorates and seek medical attention Patients that are known to be in a group at high risk for developing severe or complicated illness, (see above) should be treated with antivirals in addition to symptomatic treatment as soon as possible. Sampling can e.g. Corticosteroids should not be used routinely, unless indicated for other reasons (eg: asthma and other specific conditions); as it has been associated with prolonged viral clearance, immunosuppression leading to bacterial or fungal superinfection. Learn more about the classification of influenza viruses, influenza outbreaks, and influenza symptoms and treatment. At any one time there is a mix of influenza viruses circulating in the human population. In the northern hemisphere, including Europe, seasonal influenza generally occurs in epidemics between November and April each year, and in the southern hemisphere between June and October. Seasonal influenza is a vaccine-preventable disease that each year infects approximately 10 to 30 % of Europe's population, and causes hundreds of thousands of hospitalisations across Europe. Antibodies against these glycoproteins are associated with immunity against influenza. There is some evidence supporting that surgical masks worn by ill people may reduce infections among close contacts when influenza is circulating. On average an infectious person will infect less than two non-immune people. Impact of influenza exposure on rates of hospital admissions and physician visits because of respiratory illness among pregnant women. The information contained in this factsheet is intended for the purpose of general information and should not be used as a substitute for the individual expertise and judgement of healthcare professionals when it comes to patient care. Resistance to neuraminidase inhibitors was rare in seasonal influenza until the emergence of resistant seasonal A(H1N1) viruses in 2007-2008 (Moscona, 2005; Meijer, 2009). chronic lung conditions (e.g. A number of other viruses and bacteria cause similar symptoms so that much of influenza-like illness (ILI) is not actually caused by influenza. During the influenza surveillance season ECDC and WHO Europe jointly publish weekly updates on influenza in Europe, based on information provided by experts, virologists and medical doctors throughout the wider European region.Â, A global overview is also available from WHO.Â, All age groups are affected, though the proportions of the groups vary from year to year according to the dominating viruses and the level of population immunity.Â, The burden from seasonal influenza has two aspects. Influenza is an acute viral infection that primarily attacks the nose, throat and lungs. The usual experience following a pandemic is that the pandemic strain dominates the annual epidemics for some years. And, you need the humbleness to understand your original, to be part of it—then also the practical humbleness to get someone who knows more […] It is a significant cause of morbidity and mortality, especially in individuals who are at the extremes of age, pregnant, immunocompromised, or have chronic underlying disease. The severity of seasonal influenza depends on the virus, host factors, and other factors, e.g. individual factors, type of exposure, and risk associated with the exposure. Quadrivalent vaccines include a 2nd influenza B virus in addition to the viruses in trivalent vaccines, and are expected to provide wider protection against influenza B virus infections. Seasonal influenza is an acute respiratory infection caused by influenza viruses which circulate in all parts of the world. For the best clinical benefit, treatment with antivirals should be given early in the infection, within 48 hours, (the earlier the better). Influenza A. Epub 2012 Sep 13. These usually affect most of the countries for one to two months and last in Europe for about four months overall (Paget et al., 2007). These should target uptake of seasonal influenza vaccination and also perceptions of risk and beliefs about the efficacy and safety of pandemic influenza vaccinations. Severe disease may also include myocarditis or encephalitis, which may be fatal. The term twindemic blends twin, here meaning “twofold” or “double,” and pandemic, a global outbreak of a disease, such as COVID-19.In other words, a twindemic represents “twin pandemics” of flu and COVID-19 at the same time.Twindemic may also be informed by a word closely related to pandemic, epidemic—a term for a … Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289(2):179-86.Webster RG, Monto AS, Braciale TJ, Lamb RA (editors). Emerg Infect Dis. Post-exposure prophylaxis with influenza antivirals, for example for an at-risk unvaccinated person, is dependent on timely prescription given that the incubation period is 1-4 days. These data contribute to the bi-annual WHO expert meetings where the recommendations of the influenza vaccine composition for the next season are formulated. Live attenuated influenza vaccine is available as a nasal spray. 2014;2(6):445-54. However, quite often the initial influenza infection is not recognised and the death is not classified as being due to influenza. Influenza, acute viral infection of the upper or lower respiratory tract, marked by fever, chills, and a generalized feeling of malaise. Proper collection, storage and transport of respiratory specimens is the essential first step for laboratory detection of influenza virus infections. If the infected person doesn’t cover his or her mouth and nose people within a range of two meters can be infected. Influenza D virus in cattle, France, 2011-2014. 2012; 17(18):pii: 20162. Neuraminidase inhibitors, oral oseltamivir and inhaled zanamivir, are useful for treatment and prophylactic use. Seasonal influenza vaccines shall be compliant with the Ph. At irregular intervals there are influenza pandemics. cardiovascular disease, may also occur. Dawood FS1, Fiore A, Kamimoto L, et al. Only type A viruses are able to cause pandemics as they have a reservoir in animals. The virus can also be spread by hands contaminated with influenza viruses. Skip directly to site content Skip directly to page options Skip directly to A-Z link. http://www.cdc.gov/EID/content/15/2/233.htm, Oseltamivir-resistant influenza A (H1N1) virus, Europe, 2007–08 season, Oseltamivir resistance – disabling our influenza defences. Alcohol-based hand sanitisers reduce the amount of influenza virus on contaminated hands. This virological surveillance in the EU is of the utmost importance and contributes to the WHO Global Influenza Surveillance and Response System (GISRS) that monitors the evolution of influenza viruses. There is also some evidence that infectious aerosols may play a role in influenza transmission. Pre-exposure prophylaxis with influenza antivirals can be prescribed for longer or shorter time periods when an exposure is expected, for example in healthcare settings.  Vaccination is especially important for people at higher risk of serious influenza complications: Individuals with specific chronic medical conditions, pregnant women, and children aged 6-59 months, the elderly and healthcare workers. Uncomplicated seasonal influenza disease presents as rapid onset of the following combination of systemic and respiratory symptoms: Children may also present with gastrointestinal symptoms such as vomiting or diarrhea, apart from fever and respiratory symptoms. 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