Pregnant women, infants, and other groups at high risk for flu complications according to new guidelines

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New US guidelines from the Infectious Diseases Society of America (IDSA) are advising that those at high risk for influenza complications, in particular pregnant women and the extremely obese, should seek treatment quickly if they develop the flu this season. 

The seasonal flu guidelines, which are published in Clinical Infectious Diseases, identify pregnant women and those who have recently given birth, people who are extremely obese with a body mass index (BMI) of 40 or more, young children, especially those under 2, and nursing home residents as all being at high risk of complications or even death.

In addition, individuals who already have health complications or are receiving medication, such as people younger than 19 who are receiving long-term aspirin therapy, those with chronic medical conditions including asthma, cerebral palsy, epilepsy, stroke, heart or lung disease, kidney, liver or metabolic disorders, and those with a weakened immune system due to disease or medication, such as people with HIV or AIDS, cancer, or on chronic steroids, also have a higher risk of complications, as do American Indians and native Alaskans.

The guidelines recommend that high-risk individuals with flu or suspected should begin antiviral treatment as soon as possible, without waiting for results of testing. 

Although antiviral treatment is recommended within two days after the start of flu symptoms in people who aren't at high risk for complications, the guidelines advise they prescribing the treatment to those at high risk even if they have been sick for more than two days.

If people at high risk become seriously ill with influenza, then healthcare providers should turn to infectious diseases (ID) doctors for further advice.

"Influenza can be serious, especially for the sizable group of people at high risk," said Timothy M. Uyeki, MD, MPH, MPP, co-chair of the guidelines committee.

"Annual influenza vaccination is the best way to prevent influenza, but it is not 100 percent effective. Those at high risk need to be encouraged to seek medical care right away if they develop influenza symptoms during influenza season."

Typical flu symptoms to look out for include fever, cough, muscle aches, chills, runny nose, sore throat. Some will also experience headache and chest pain.

"High-risk individuals who are hospitalized with flu complications are at an increased risk for serious bacterial infections and infectious diseases physicians' expertise is critical to ensuring they receive the best care," said Andrew T. Pavia, MD, and co-chair of the guidelines committee. "ID doctors also can provide guidance when a patient who has the flu is not responding to antiviral treatment or is getting worse."

Last season the flu was responsible for around 49 million illnesses in the United States, including 960,000 hospitalizations and 79,000 deaths.