Fight the Flu 2023

Symptoms can range from mild to severe. Typically, influenza starts with a headache, chills and cough. This is followed by fever, muscle aches, fatigue, loss of appetite, runny nose, sneezing, watery eyes, throat irritation, and in children, sometimes diarrhea and vomiting. Most people recover from influenza within a week to 10 days.

The influenza season usually lasts from October to April, but the exact time can change every year. Typically, the peak time for influenza is end of December to mid-January.

Influenza is a serious contagious viral respiratory infection. In fact, it is one of the top 10 infectious diseases in Ontario. While most healthy adults feel miserable for a few days, for some people, influenza can be serious or life-threatening.

Those most at risk include:

• Adults aged 65 and over
• People who are immunocompromised
• Pregnant women
• Children under the age of five
• People who are obese
• People with chronic medical conditions, including asthma, heart disease, and diabetes
• Residents of long-term care facilities

It is estimated that, in a given year, an average of 12,200 hospitalizations related to influenza and approximately 3,500 deaths attributable to influenza occur in Canada. During the COVID-19 pandemic, there was a reduction in influenza cases related to pandemic restrictions such as social distancing, masking, and lockdowns during peak COVID-19 waves.

Complications include pneumonia, bronchitis, and sinus and ear infections. Influenza and other respiratory virus infections can also worsen chronic conditions, such as asthma.

Influenza and other respiratory viruses are spread by infectious particles (droplets and aerosols) that are released from the respiratory tract of infected people. You can either catch the virus directly from an infected person or by touching surfaces contaminated with the virus.

You are most likely to spread the virus when you have symptoms.

Getting vaccinated against influenza will provide some protection against you getting influenza. Given that the vaccine isn't perfect and that multiple other viruses can cause similar illness, it is important that we don't just rely on the influenza vaccine for protection.

There are several other important infection control measures that can help you avoid getting ill with or spreading a respiratory infection:

• Wash or sanitize your hands frequently
• Cough and sneeze into a tissue or your sleeve, not your hands
• If you are sick with symptoms of the flu or any respiratory virus, you should not be at work, even if you had the flu shot this year. Remember to report respiratory symptoms to Health Services and follow the UHN sick protocol.
• In the rare chance that you have to be at work while ill, you must avoid patient contact where possible. Limit interactions with colleagues. You will have to don increased Personal Protective Equipment (PPE) and your surgical or N95 mask cannot be removed until you are relieved from your work assignment.
• Follow department procedures for notifying your supervisor if you are unable to complete your shift
• If possible, avoid close contact with individuals who have symptoms that are suggestive of influenza-like illness. If you can't avoid close contact with individuals who have such symptoms, wear the appropriate Personal Protective Equipment (PPE) when caring for them.

Limiting the spread of respiratory viruses is everyone's responsibility.

We strongly encourage you to get the influenza vaccine, but at this time the influenza vaccination is not mandatory for healthcare workers at UHN. It's not that we think influenza vaccination isn't important; we think it's incredibly important and would like to see all of our staff vaccinated.

We also acknowledge, however, that the influenza vaccine isn't perfect and this is why we need you to take other measures as well to protect yourself and our patients from respiratory viruses, including influenza.

If you are working on a unit where an influenza outbreak has been declared, it is required that you be vaccinated and/or take prophylactic medication until the outbreak is over.

Staff entering an outbreak area who cannot receive vaccination or prophylaxis due to medical contraindications will continue to work following policies and procedures related to an outbreak, including but not limited to masking at all times, and social distancing at breaks for the duration of the outbreak. Staff who choose not to receive vaccination and/or prophylaxis as indicated for the specific outbreak for unsubstantiated reasons will continue to work following policies and procedures related to an outbreak, including but not limited to masking at all times, and social distancing at breaks for the duration of the outbreak.

It's best to get the vaccine every year to keep yourself healthy. Different influenza viruses circulate every year and immunity from the influenza vaccine decreases over time. Even if there is no significant change in the virus, your body's immunity level declines over several months.

The effectiveness of the seasonal influenza vaccine varies from year to year. Some years the vaccine is more effective than others because it's a closer match to what's circulating in the community.

Overall, decades of experience suggest that the influenza vaccine is, on average, 40-60 per cent effective in preventing infection in healthy adults. Evidence also shows that even if a person gets influenza after being vaccinated, their illness will be less severe. Although the vaccine is not perfect, getting immunized is one of the best ways available to prevent influenza infection.

Remember that the influenza vaccine can only prevent influenza, not influenza-like respiratory illness that may be caused by other viruses, such as COVID-19.

No, you can't get influenza from the vaccine because the viruses contained in the vaccines we currently provide are inactivated (killed) and cannot cause influenza.

You can still catch the other respiratory viruses that are circulating at the same time as influenza. Also, if you have been exposed to influenza right before vaccination (i.e., before your body has built immunity to the virus from vaccination), you may get sick from that infection and mistakenly attribute it to the vaccine.

UHN has not implemented a mandatory influenza vaccination policy. Instead, we continue our policy of supporting vaccination and most importantly, imploring our staff not to come to work when ill with influenza-like illness.

If you work at other hospitals you need to find out what their policies are around influenza prevention this year and follow them while you work there. They may ask you to submit proof of your flu vaccination.

Yes, most people with an egg allergy can get the influenza vaccine. If you are able to eat baked goods with eggs then you are able to get the vaccine. If you have a severe egg allergy (anaphylaxis), you need to speak to your doctor. You may be able to get the vaccine in a medical clinic or in your allergist's office.

In most cases, not only is it safe, it is recommended that pregnant women get vaccinated. Some studies suggest that pregnant women are at greater risk of developing complications from influenza.

Pregnant women who get vaccinated also pass on their immunity to their baby, protecting them from influenza for the first six months of their life.

The symptoms do overlap and it may be difficult to tell which virus you have without testing. If you develop respiratory or GI symptoms, you are required to follow Health Services policies for reporting symptoms. If you choose to obtain a COVID-19 PCR and it results negative, then you may have the flu or one of the other commonly circulating cold viruses. You will not be tested for them unless you have severe symptoms requiring a visit to a hospital. You would be required to stay home until you have had no fever for 24 hours and your respiratory symptoms have significantly improved for the past 24 hours. If you were experiencing GI (gastrointestinal) symptoms like diarrhea or vomiting, they need to be fully resolved for 48 hours to return to work.

Essentially, you can use the same practices we have been using for COVID-19. Wash your hands often, wear your mask indoors and maintain physical distancing as much as possible. Most importantly, stay home if you're feeling unwell.

Great question – a lot of people are asking this one! You can get the flu shot and the COVID-19 vaccine at the same time. NACI recommends that COVID-19 vaccines can be co-administered with other vaccines, including flu, for individuals over five years old. You may get both vaccinations at the same time, but if you felt post-vaccination symptoms after receiving the COVID-19 or flu vaccination, you may choose to space them out. Find out if you are eligible for a COVID-19 booster.

Unfortunately, you are not. The COVID-19 vaccine is specific to the SARS CoV-2 virus and the influenza virus requires its own vaccine to build antibodies specific to it. Many people may be tired of talking about vaccines, but getting this vaccine is very important – for you and for our community.

Stay home, rest, drink plenty of fluids, inform Health Services and follow UHN's attendance policy.

Flu vaccines are available in a variety of community pharmacies, your family doctor's office, and during UHN's flu campaign. UHN's 2023-2024 flu campaign includes walk-in flu shots at the main entrances of UHN hospital sites. If you obtain your vaccine outside of the UHN campaign, it is important to advise Health Services when you obtain the vaccine to ensure your records are updated should there be an outbreak.