During a period of low regional prevalence of influenza, which of the following patients would NOT warrant testing for influenza?
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.
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?
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.
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
Michael Kim, DO;
Huai Lee Phen, MD
Brad Laymon, PA-C, CPC, CEMC
December 1, 2022
December 1, 2025   CME Information
4 AMA PRA Category 1 Credits™. 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits