Novel Influenza

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An influenza A virus subtype that is different from the current circulating human influenza A subtypes (H1 and H3). Some animals (avian and swine populations) are considered higher risk for transmitting a novel/variant influenza strain to humans. Some examples include H5N1, H7N9, and H3N2v. Variant influenza viruses refer to influenza viruses that usually circulate in swine, but on occasion may cause an influenza infection in humans.

The transmission route of novel/variant influenza viruses is likely to be similar to seasonal influenza which is primarily transmitted by droplet spread. Transmission may also occur by direct or indirect contact with oral secretions or fecal material from infected animals.

People infected with swine influenza A viruses will exhibit symptoms similar to seasonal influenza. Seasonal influenza symptoms may include fever, chills, general discomfort, headache, muscle aches, headache, sore throat, and cough. Among children, otitis media, nausea, vomiting, and diarrhea are common. People infected with avian influenza A viruses may have a wide range of illness including mild respiratory symptoms and conjunctivitis to lower respiratory tract disease, acute respiratory distress syndrome (ARDS), and death.

There are no vaccines for novel/variant influenza A viruses with the exception of influenza A H5N1. The United States federal government maintains a stockpile of H5N1 vaccine. The stockpiled vaccine could be used if a H5N1 virus begins transmitting easily from person to person.

General Precautions
Currently, the best way to prevent infection is to stay away from sick animals such as poultry or swine. Other activities that may be performed to prevent getting influenza include:

  • Hand washing and using alcohol-based hand sanitizers,
  • Covering your coughs and sneezes with a disposable tissue or your arm or sleeve,
  • Avoiding touching your eyes, nose, or mouth,
  • Avoiding close contact with persons who are ill,
  • Staying home when you are ill, and
  • Taking antiviral medications if prescribed by your doctor.
  • In certain situations (e.g., influenza outbreaks in settings like nursing homes), antiviral medications may be prescribed to high-risk individuals to prevent them from developing influenza illness after exposure to infected individuals.

Healthcare Settings
For additional and specific guidelines view the CDC’s Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease.

Key Points

  • Healthcare providers (HCPs), including Public Health and staff at healthcare facilities (HCFs), should use standard, contact, and airborne precautions when dealing with a suspected or confirmed case of infection with avian influenza, including a person under investigation (PUI) for avian/novel influenza.
  • Personal protective equipment (PPE) that should be used by HCPs/HCFs includes gown, gloves, goggles, face shield, and N95 respirator or higher.
    • HCP must be fit tested for N95 masks.
  • When the patient arrives at the HCF, the patient should be placed in airborne isolation (i.e., a negative pressure room or airborne isolation infection room [AIIR]).
    • When outside of the AIIR, patients should wear a facemask to contain secretions.
  • Public health and the patient’s provider should notify the accepting HCF before the person under investigation (PUI) for avian/novel influenza arrives at the facility.

Recent Texas Trends
Texas has had no cases of novel/variant influenza since 2009 when a new influenza A (H1N1) virus began circulating among the human population. This new influenza virus caused the first pandemic of the 21st century. Texas DSHS 2009 Pandemic Data.