Influenza Prevention

Influenza prevention

Introduction

In the last century, communicable diseases were the main cause of death of the population, however, industrialization brought with it an improvement of nutrition, housing, health, drinking water, development of antibiotics and vaccines, allowing the control ofthese illnesses. The latter added to the least infant mortality and health promotion, led to an increase in life expectancy, generating more aging populations in time in the countries that are in the process of. 

However, although the most serious infectious diseases have considerably reduced, the records of the Health Statistics and Information Department (DEIS) show that in Chile the third cause of death is most frequent is associated with infections of theRespiratory system, where influenza, chronic obstructive pulmonary disease (COPD), asthma, pneumonia and others can be found, being below the diseases of the circulatory system in the first place and malignant tumors in second place. Therefore, it is still of real importance to keep the population informed about which are still infection that could potentially cause death, but that can be prevented if different strategies are applied, most of them very simple and without cost.

Developing

Depending on the level of general epidemiology, in addition to the emphasis that has been made to the influenza virus this last year due to the various cases that were presented both in Chile and in the world and added to the imported one that has thePrevention currently, especially in recent years where microorganisms are more aggressive and resistant, it is considered necessary that education be carried out to the population to be able, in the future, to reduce the complications and deaths associated with different respiratory pathologies that are preventable, such asIt is influenza. 

At the country level, making a comparison between 2018 and 2019 of the results published in the Pan American Health Organization, it can be noted that in 2018 the week of July 11 there was UNZA in the cases of influenza compared to previous weeks, predominantly, predominantlyType A influenza (H3N2) and in 2019 at the same date the cases of influenza decreased compared to previous weeks and the types of concurrent influenza were influenza A (H1N1), A (H3N2) and influenza B, however the cases ofSerious acute respiratory infection that had to deal with intensive care unit were associated with influenza A (H1N1).

Next, the influenza virus will be addressed in greater depth as the basis of our project, backed in the prevalence rates of these. Subsequently, the educational project will be discussed together with its purpose, diagnosis, objectives, exposure content, methodology according to available resources, the organization of sessions and evaluation. Factors involved in the process: of the student, of the educator, and of the organization: 

The student in this case is an intercultural population composed of Chileans and Haitians. It is emphasized that the Chilean population attending Cesfam is mostly older adults and in the Haitian population pregnant women and children. The population develops in a vulnerable environment, with a lot of street trade. Generally vulnerable populations are associated with low educational levels.With respect to transport, in the streets you can see a wide variety of buses that pass constantly, precisely outside and in front of the Julio Acuñón Family Health Center there are stops that facilitate the population’s approach to the establishment to the establishment.

The educators, third -year nursing students of the Autonomous University of Chile, aims to expose influenza prevention methods in a simple and dynamic way. Having a large amount of Haitian population the main obstacle when making the presentation is the language, since all the members of the group of educators only handle the Spanish.The entire group of educators have Internet access, which facilitates updated and evidence -based information, also favors in the organization of the team thanks to instant messaging.

With respect to the organization, the group has all the necessary resources to carry out a corporal, both materials and human resources, and also all members handle the information to be delivered. The health establishment has a broad infrastructure, so education can be carried out in various points of CESFAM. It is important to highlight that education cannot carry out a corporal without interruptions, since people travel freely through the enclosure either to confirm or ask for hours, to enter or leave the center.  

The health establishment has a Haitian worker who dominates Spanish and his native language, he works by helping the Haitian population to facilitate communication with health personnel. This worker contributed to the group of educators to translate the information to be delivered.

Regulatory needs: The population of CESFAM Julio Acuña Pinzón has a health need about information on influenza prevention methods in the face of the growing alarm caused by the media with respect to the seriousness of influenza cases. The student team through the realization of an educational presentation seeks. 

Comparative needs: The Chilean population attending Cesfam is mostly older adults and in the Haitian population they are pregnant women and children, these people belong to the risk groups of infection by influenza, therefore, it is very important to intervene in a way in a waypositive in them teaching prevention methods, since they are the groups that can be most affected by possible infection. It is relevant that the entire population knows and understands the different methods of prevention against influenza because the infections would be considerably diminished, however, if a healthy person who does not belong to a risk group is infected, their situation of their situationHealth would not be so serious compared to a person who does belong to a risk group. 

Felt needs: education is carried out in order to cooperate the population of CESFAM with an education, teaching different methods of prevention against influenza because the influenza vaccination campaign has ended and the population has a notorious concern against theNew cases of this virus. You can see people approaching the vaccination room asking about the vaccine stock. Deliver knowledge about different methods of prevention against influenza, in order to achieve the decrease in contagion, as well as deliver knowledge for a better prevention and basic knowledge of this. 

Diagnosis

Influenza in the 2019 winter season can affect any person in the population of Cesfam Julio Acuña Pinzón, which consists of individuals of all ages, that is, from infants to older adults, whose educational level varies depending on theAge and opportunities, which cannot be specified due to the large number of people who could assume the role of the student, and whose previous knowledge about the subject of prevention is unknown, an exception of the vaccine that is usually the most identified element,reflecting the need to know those are the other methods to prevent influenza.

The methods that are even more accessible and open to anyone can practice them, in addition to the need to know the signs and symptoms of influenza, so it is considered necessary that the attendees of the enclosure be taught about the different strategies forAvoid contracting the virus and in the event that they contract it, they are able to identify it, all this with the motivation that they can avoid getting sick or suffering complications.

Decrease in immunized population

Risk of infection (vulnerable to an invasion and multiplication of pathogenic organisms that can compromise health) R/C insufficient knowledge to avoid exposure to pathogens, exposure to disease outbreak, inadequate immunization.

General objectives: 

Understand the different methods of prevention against the infection of influenza (cough hygiene, hand washing and hygienization, vaccination).

Specific objectives:

• Know the influenza transmission methods.
• Understand the importance of annual vaccination, its benefits and the risks that are presented by non -vaccinating. 
• Identify the different signs and symptoms, how to differentiate them from a common flu or other disease.
• Know how correct hygiene when coughing and sneezing.

REFERENTIAL FRAMEWORK:

CONTENTS:

• What is influenza?
• Signs and symptoms
• Types of influenza virus
• How to prevent?
• Vaccination

What is influenza?

The influenza virus in a contagious virus that produces an acute respiratory picture very similar to a common cold, however, signs and symptoms are increasing in intensity and severity. While it is true that all people can contract the virus, there is a risk population where there is more likely complications, which can even lead to death.

Its transmission mechanism is through droplets, which are expelled when coughing, sneezing or speaking, although they can also be transmitted by the hands, that is, when touching surfaces or objects with their hands contaminated with these droplets eliminated by a sick subject, the surfaces will be contaminated and if then a healthy person touches that surface and subsequently touches the face or areas close to the mucous membranes, it can be infected.

This virus has an incubation period that can range between 1 to 4 days and those who are infected can transmit the virus 1 to 2 days before the symptoms appear, highlighting that they are in the first 4 days after the appearance of the appearance of thedisease where people with influenza are more contagious.

In our country, according to the Pan American Health Organization, there are epidemic outbreaks every 3 or 4 years and this is how in 2001, epidemic year, a higher mortality is observed compared to the years 2002, 2003 and 2004, whereThe latter doubled the number of cases, and in 2005 lower than the previous year, this associated with that during 2005 a vaccination coverage of influenza greater than 90% in all the age groups of risk of risk was reached.

Signs and symptoms

• Fever: high than 38 degrees with a duration of two to three days and in some cases it can last up to a week, or feel chill. In cases where no antipyretic intake fever is presented, there is an increase in heart rate, pile, cold and humid skin and also signs of poor peripheral perfusion.
• Tos: accompanied by ardor at the trachea level, this can be dry or with expectoration that normally does not affect the saturation of 02, in case of deaturation and/or crépitos it is suspected of pneumonia.
• Fatigue: This symptom can have a longer duration in older adults, being able to reach up to five days.
• Arthralgia: very common in ankles (either in one or both).
• Headache: it manifests itself in the frontal or generalized way.
• Myalgia: In most cases it is presented as a generalized pain, but in case of manifesting in a more local way it is common for it to occur in areas such as the dorsal, lumbar and thigh zone.
• Otitis: It occurs mainly in children.
• Gastrointestinal symptoms: the gastrointestinal level commitment is very rare in adults, this is mostly presented in children and generally consist of nausea, vomiting and/or diarrhea.
• Photosensitivity: It is a characteristic symptom of influenza.
• Odinophage: local symptom that occurs mainly by direct action of the virus to the respiratory epithelium. It should not be confused with dysphagia which corresponds to a difficulty in swallowing that is generally without pain, instead with the odinophagia there is no difficulty in swallowing, but there is a presence of pain.

It should be noted that one of the main signs of influenza such as fever, may not occur in some cases such as older adults or also in immunosuppressed patients.

The existence of factors that determine a possible complication (hospitalization, signs and severe symptoms, death, etc.) From this viral picture are relevant and should be highlighted, such as age, in this case both ends of life (infants and older adults) have a greater risk that their signs and symptoms aggravate. While lethality is greater in the elderly (because their general health is weakened) than in children, the latter have great possibilities of complications because their immune system is much more immature than theof an adult generating that they are more susceptible to infection and that much more intense responses are generated.

Types of influenza virus

There are four types of influenza: A, B, C and D of which A and B are the main causes of epidemics mainly in the winter season. Type C influenza is generally responsible for minor respiratory diseases and it is unlikely to cause epidemics. Finally, it is believed that type D influenza does not cause human infections since they first damage cattle.

The influenza A virus is divided into two subtypes according to two surface proteins: hemaglutinine H which is divided into another 18 different subtypes and neuraminidase n divided into 11 subtypes. Viruses of this type are subclassified according to the combinations of these two proteins. Those that affect the human being more correspond to A (H3N2) and the A (H1N1) that began to affect humans in 2009 causing the first influenza pandemic in more than 40 years.With regard to influenza B virus, this is classified by lines and strains, B/Yamagata and B/Victoria correspond to those currently circulating.

How to prevent?

Among the main prevention mechanisms is the vaccine, which must be administered annually, which in Chile constitutes a free service in public health services only for risk populations named at the beginning of this theoretical framework, added to professionalsof health.

Other prevention measures that are basic are:

• Frequent hand washing, which must be done with soap and water
• Use of gel alcohol, as long as the hands are not visibly dirty
• When coughing or sneezing use a handkerchief, covering mouth and nose, and then discard.
• In case of not having handkerchiefs, it is recommended to use the forearm to cover mouth and nose.

Vaccination

WHO maintains a constant inspection of influenza that circulates in each place in the world to anticipate the types of viruses that will appear and the maximum action they will have, depending on this entire analysis process, the WHO performs suggestions for the process and creationOf the vaccines, in the case of Chile it was decided to use the “influence” vaccine that meets the recommendations made by WHO and whose composition is:

• Flu virus, hemaglutinine and neuraminidase of the following strains: strain similar to H1N1, strain similar to H3N2 and strain similar to B/Maryland/15/2016.

What are the benefits of influenza vaccination?

• Immunization reduces the risk by 40-60% of consulting a doctor by influenza, so the risk of hospitalization is also reduced.
• It is associated with vaccination with lower indices of cardiac episodes in patients with heart disease.
• Grants protection to women during and after pregnancy reducing at risk of suffering during this process
• Reduces the risk of death, income to ICU and duration of stay in this
• The severity of the disease decreases in vaccinated people, however, it does not prevent them from suffering from it

Types of influenza vaccines

The influenza vaccine was created to cause antibodies destined to combat this disease are formed in the body of the person who is vaccinated, however, these antibodies are completely developed approximately 14 days after the

immunization. While there are many types of influenza, these antibodies only provide protection against the types of viruses included in the vaccine.

It is also important to mention that there is more than one type of influenza vaccine, which in this case are:

• Influvac: Injection Vaccine against influenza currently used in Chile, it contains the inactivated and sub -unit influenza virus. This vaccine comes in a container with a prellenada syringe, it is administered intramuscularly or deep subcutaneous and in the case of doses, in adults and children over 6 months 0.5 ml are administered, but in children 6 to 25 monthsDose of 0.25-0.5 ml and those children who have not presented a previous infection or had not been vaccinated previously require a second dose 4 weeks after the first of the first. Its side effects are generally in relation to puncture, for example;Pain, redness, sensitivity or inflammation in the puncture zone, although it is also possible to find signs and symptoms such as fever, headache and/or myalgia
• Influenza vaccine in high doses
• Vaccine with adjuvant
• Recombinant Vaccine against influenza
• Tetravalent vaccine (against type A viruses and two type b viruses)
• Cell -based vaccine against influenza (intradermal)
• Influenza vaccine through pressure injection
• Influenza vaccine in nasal atomizer: Protects against influenza A (H1N1 and H3N2) and against the two types of influenza B, also presents some contraindications for their use that are:
• Asthma in people over 5 years old.
• Other underlying medical conditions that can make people have high risk of serious complications due to influenza. This includes

conditions such as pulmonary, cardiac diseases (except isolated hypertension), renal (such as diabetes), liver or renal, neurological/neuromuscular or metabolic disorders.

• Moderate or severe disease with or without fever.
• Guillain-Barré syndrome within 6 weeks after a previous dose of influenza vaccine.

It is important to note that the action of managing this vaccine does not cause infection with influenza since these are manufactured with the inactivated virus or without any virus (recombinated vaccine against influenza).

Can seasonal influenza be contracted, although it has been vaccinated this year?

This is indeed possible since it can happen that before vaccinating the user was exposed to the virus or also during the period that the antibodies take to develop (effective protection occurs 15 days after vaccination) thus suffering the infection, another case does notLess common is to be exposed to influenza virus that are not included in the vaccine

since because of this the organism does not acquire a defense against these viruses. In addition, it is important to mention that there are many other viruses that do not correspond to those of influenza but that cause similar diseases to those that this virus causes since they also appear frequently in the same season where influenza viruses are scattered.

Another very important situation is that despite acquiring immunization, the possibilities of contracting the virus if they exist, but the signs and symptoms occur in less intensity and the possibilities of suffering complications are reduced, thus reducing the possibilities hospitalization and/or of death.

Treatment

In the case of patients who manage to recover spontaneously and do not present greater complications, the main treatment is based on the high consumption of liquids, antipyretics administration for fever control, bed rest and general measures to mainly control signs and signs andsymptoms caused by this picture.

The main treatment in more severe cases corresponds to the antiviral drugs which must be prescribed by the treating doctor since they are not free sale.

These drugs are of great benefit to achieve a reduction in this viral table since its severity and duration decreases, in addition to preventing possible complications.

The centers for disease control and prevention (CDC) recommend that seriously ill people, who have symptoms of the disease and have a greater possibility of suffering complications should be submitted early to this treatment. This with special emphasis on those who have a high risk factor, because receiving the treatment quickly makes the difference between suffering a mild or more serious picture reaching hospitalization even.

The recommended time to start treatment is within the first 48 hours after having contracted the virus, however, starting treatment is also useful.

Methodology:

In this education the methodology to be used will be of the theoretical-expository type and the theme of influenza will be addressed, both its etiology, symptomatology, and forms of prevention, emphasizing the way of preventing this disease (vaccination and other methods), putthat the period in which the educational presentation will be held is at the time of the most critical year and with the greatest number of incidence of respiratory complications in the population.

This seeks to inform and generate a responsible and conscious attitude in the target population (Cesfam Julio Acuña Pinzón) regarding the care of their health and their community.

Organization

Quantity sessions

Dates

Weather

6

07/04/2019 and 11/07/2019

20 – 25 minutes

Objectives

Deliver relevant information regarding influenza and its main method of prevention so that the population generates self-care behavior.

CONTENTS

Definition of influenza, its cause, the mechanisms of transmission, signs and symptoms, the prevention methods and their benefits.

Educational Methodology/Technique

Education through exhibitors (3rd year nursing students) and visual support (cards with information about the topics to be discussed and images relevant to the subject) in inclusive language (Spanish and Creole) according to the population assisting to CESFAM. Printed posters will also be used that will be fixed on the walls of the health center, so that people as they read them can learn about influenza prevention methods.

Human Resources

Material resources

Financial resources

– Informed exhibitors of the topic.

(Role assumed by 3rd year nursing students of the Autonomous University of Chile, Providencia headquarters)

– Cardboard

– Eva rubber

– Markers

– Printing machine

– White sheets

– Glue

– Scissors

Third year nursing students from the Autonomous University of Chile: Gilean Correa, Genesis Cortés, Claudia Díaz, Paulina Díaz, María José Ferruz and María Sara García.

Evaluation:

Education was presented with an unstable audience, that is, the people who were listening to the presentation could abandon the exhibition at any time since they could be called to be treated, they could also join as the presentation advanced, among other situations. Given this, the opportunity is given to the individuals to consult their doubts at the end of the presentation in order that the activity has been clear for the entire audience, in this way it is possible to evaluate the level of understanding that was achieved in education.

Conclusion:

Nursing professionals meet different roles, these can be carried out in the health, administrative, educational and research area. All roles are of real importance, since they are all to benefit people directly or indirectly.

One of the most relevant nursing roles is educational because education is an important factor when preventing diseases or promoting health, thus reducing infections and promoting self-care.

With the increase in acute respiratory diseases in the winter, the completion of the influenza vaccination campaign and the imminent collective panic of people in the new cases of the viruses mentioned in the communication media is very important to interaction of health personnelwith the people. One of the most important nursing tasks is to ensure the well -being of people, so the problem and health need that the population has and positively intervenes in them is prioritized to achieve tranquility and awareness. To achieve this, people’s education are used.

Through the educational exhibition presented at the CESFAM Julio Acuña Pinzón it was observed that people intended to learn on the subject, although at the beginning of the sessions there were little audience, this grew potentially as the presentation progressed. Individuals at the end of education had the opportunity to carry out all doubts relevant to the subject, having full confidence in the exhibitor group.

It is important to highlight the confidence of people in health personnel, so it is very important that professionals maintain their knowledge as possible since these are transmitted to individuals. People go to their homes with the information that is given to them, being able to positively affect their lifestyles.

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