Influenza in Urgent Care | Postscripts
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Influenza in Urgent Care

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December 2022 Postscript #1

Test Your Knowledge

During a period of low regional prevalence of influenza, which of the following patients would NOT warrant testing for influenza?

  1. A well-appearing 12-year-old boy with a history of moderate asthma, a temperature of 39.4°C (103°F), cough, nasal congestion, clear lungs, and no respiratory distress on examination
  2. A well-appearing, previously healthy 68-year-old man with a temperature of 39.4°C (103°F), cough, myalgia, clear lungs, and no respiratory distress on examination
  3. A well-appearing, previously healthy 12-year-old boy with a temperature of 39.4°C (103°F), cough, sore throat, clear lungs, and no respiratory distress on examination
  4. A well-appearing, previously healthy 18-month-old infant male with a temperature of 39.4°C (103°F), cough, nasal congestion, clear lungs, and no respiratory distress on examination

Answer: C. During periods of low local prevalence of influenza, patients with influenza-like illness who have mild-to-moderate symptoms and no high-risk factors for a more severe disease course do not require testing for influenza and can be treated with supportive therapy alone. A previously healthy 12-year-old boy with without any signs of respiratory distress or compromise is a candidate for supportive therapy. A history of asthma, patient age <2 years, and patient age ≥65 years are risk factors for a more severe disease course in influenza; when there is low local prevalence of influenza, rapid testing should be administered to patients in these groups who present with influenza-like illness so that antiviral therapy can be initiated if the result is positive.

December 2022 Postscript #2

Test Your Knowledge

A 32-year-old woman who is 28 weeks pregnant presents to urgent care with a temperature of 39.2°C (102.5°F), cough, sore throat, and myalgia. She reports that her symptoms started 36 hours earlier. A rapid COVID-19 test is negative and a rapid RT-PCR test for influenza is positive. Local strain-specific epidemiologic data on influenza are not yet available.

Which antiviral medication (if any) should be prescribed for this patient?

  1. Oseltamivir
  2. Baloxavir marboxil
  3. Amantadine
  4. An antiviral is not recommended

Answer: A. Pregnant people are at higher risk for severe course of disease from influenza, so antiviral treatment is indicated for confirmed or suspected influenza in these patients. Oral oseltamivir is the antiviral treatment recommended by the CDC for pregnant people or people who are up to 2 weeks postpartum. Although the evidence is not robust, several studies have found that oral oseltamivir is safe and effective for this patient group.

Publication Information
Editor in Chief & Update Author

Keith Pochick, MD, FACEP
Editor-in-Chief; Attending Physician, Urgent Care
Joshua Russell, MD, MSc, FCUCM, FACEP
Update Author; Supervising Physician, Legacy-GoHealth Urgent Care; Staff Physician, NorthShore University Immediate Care, Vancouver, WA

Urgent Care Peer Reviewer

Michael Kim, DO;
Huai Lee Phen, MD

Charting Commentator

Brad Laymon, PA-C, CPC, CEMC

Publication Date

December 1, 2022

CME Expiration Date

December 1, 2025

CME Credits

4 AMA PRA Category 1 Credits™.
Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits

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CME Information

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