When it comes to communicable diseases, influenza is at or near the top of the list. It commonly strikes in the summertime, but can infect people any time of year. It's also passed on easily and can make people very sick. Some cases of the flu even result in death, often from complications related to other illnesses but not always. This paper considers not only the causes and symptoms of the flu, but also how nurses can play a role in prevention and treatment.
Communicable Disease: Influenza
Description of the Disease
Influenza or "the flu" is a common illness in the winter months, all throughout the United States and many other countries. Both birds and all mammals can contract influenza (Brankston, et al., 2007). In recent years there have been scares regarding "bird flu" and "swine flu," both of which are simply different strains of influenza. The cause of the flu is an RNA virus in the family Orthomyxoviridae (Eccles, 2005). Once people contract the flu, they present with common symptoms such as chills, fever, a runny nose, muscle pains, a sore throat, and a headache. The headache is quite often severe, and flu sufferers may also have weakness, fatigue, severe bouts of coughing, and a general feeling of overall discomfort. People with the flu can also become nauseated and vomit, although that is more typical in children and not nearly as common in adults (Eccles, 2005). Many people also confuse influenza with the common cold, as many of the symptoms are similar. However, the flu is much more severe.
The flu is transmitted person to person, and can also be transmitted to people from animals (Eccles, 2005). When a person who has the flu coughs or sneezes, the flu virus is transmitted through the air in the aerosol droplets that are produced. However, there are other ways to contract the flu. If a person touches nasal secretions from an infected person or droppings from an infected bird, he or she can catch influenza (Eccles, 2005). Additionally, viruses can live on various types of surfaces, sometimes for a long time. If a person touches a contaminated surface and then touches his or her nose, eyes, or mouth, the virus can be passed that way. That is why hand washing is discussed so much during flu season. Treatment of the flu is usually in the form of liquids and bed rest, as well as over the counter medications. Tamiflu is a popular option, but can be in short supply during widespread flu outbreaks.
Demographics of Interest
In most people, the flu is a troublesome and annoying illness that makes them feel bad for a few days to a week or longer. However, in very young children, the elderly, the immunocompromised, and people who have other medical conditions, the flu can be debilitating or even deadly. Seasonal epidemics are when the flu is most commonly seen, which translates to between three and five million cases of severe illness every year. Out of those severe illnesses, there are between 250,000 and 500,000 people who die either from the flu itself or from complications surrounding it (Ballinger & Standiford, 2010). In pandemic years, millions of people can die from influenza (Eccles, 2005). Three pandemics occurred in the 20th Century, and these generally occurred when a new strain appeared or the virus mutated in such a way that the current treatments and vaccines for it were not as effective (Harper, et al., 2005). There can be other reasons for pandemics to occur, but those are the most common causes.
People who have preexisting conditions have both higher morbidity and higher mortality rates when it comes to the flu (Eccles, 2005). That is also true of the very young and the very old. The reason babies and the elderly have more trouble with influenza is due to the fact that they do not have the immunity levels seen in older children through middle-aged and senior adults. The same can be said of the people who have immune system issues. That can include people who have HIV or other immune suppressing diseases, but can also include people who have diseases that are not as serious (Brankston, et al., 2007). At times perfectly healthy people die from influenza, as well, and that can include people from any age group. While it is not as common to see this happen as it is to see people who are already sick pass away, there are times when the influenza virus hits someone particularly hard. In those cases, the flu often develops into viral and/or bacterial pneumonia, which can make breathing difficult (Eccles, 2005).
Determinants of Health
Determining a person's health is very important when it comes to judging how they may handle influenza. Of course, that does not mean health is the only factor. Stress, lack of sleep, lifestyle, proper eating habits, and other issues in a person's life can affect whether a person gets the flu and how he or she reacts to the illness (Eccles, 2005). For some people the flu is a minor annoyance for a few days, and for others it causes serious illness or death. Although age and preexisting conditions are both big factors for influenza problems, young people who are otherwise healthy can still experience complications that are completely unexpected. The flu can also be particularly hard on pregnant women and their developing fetuses, so they should always talk to their doctors about getting a flu shot and what other steps they can take in order to avoid contracting the flu (Ballinger & Standiford, 2010). Even people who do everything "right" can still get sick, but careful avoidance of those who are sick and proper hand washing can go a long way toward helping a person avoid the flu.
Epidemiologic Triangle
People who have weak immune systems and/or work extensively with the public are at the greatest risk for contracting the flu (Eccles, 2005). Both of those factors contribute to the development of the disease. The epidemiological triangle showcases this, as it is made up of the agent, the host, and the environment (Harper, et al., 2005). The agent is the virus itself, the host is the person or animal who harbors the virus, and the environment is the external factors that cause and/or allow for the transmission of the virus from one organism to another. The agent factors include the presence or absence of the virus, and the host factors include the person or animal that has the virus. The environmental factors are the most important, as they can be many and varied. It is the environmental factors that control how the virus spreads (Eccles, 2005).
Role of the Community Health Nurse
The community health nurse has an important role to play. He or she must focus on finding the cases of the flu in the area in order to accurately report them. The nurse must collect data from the patients, as well, and analyze that data in order to determine the severity of the level of flu being seen (Brankston, et al., 2007). If there are pandemic proportions, it is very important that be noted as soon as possible, so that people in the community can understand the seriousness of the issue. Additionally, it is vital that there are good follow-ups done in order to determine if the flu is peaking or if the number of cases is still building. By following up to see how ill people are getting and whether there are more or fewer deaths than would typically be seen, it is also possible to make a determination about the severity of the flu for that particular season (Harper, et al., 2005). This is highly valuable when it comes to making recommendations for people in the community and providing advice.
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