San Francisco Marin Medical Society Blog

Health Update: Influenza and Respiratory Illness 2018 – 19

Actions Requested of San Francisco Clinicians

• Report influenza and other acute respiratory outbreaks, influenza-associated deaths in persons aged 0 – 64 years, and RSV-associated deaths in young children, according to reporting guidance below. • Encourage and administer annual influenza vaccine to everyone aged >6 months. Provide pneumococcal vaccination with Prevnar13® and/or Pneumovax23® as recommended by CDC.

• Prescribe antiviral treatment for patients with suspected or confirmed influenza who are hospitalized for severe illness or who are at higher risk for influenza-related complications. Treat early and empirically, without waiting for lab test results.

• Prescribe antiviral chemoprophylaxis for those at higher risk for influenza-related complications who have been exposed to influenza, especially those in congregate settings.

• Review and implement influenza infection control precautions. In the outpatient setting, those with influenza-like illness (ILI) should be instructed to stay at home until 24 hours after fever resolves, except to access medical evaluation and care. All patients with ILI should wear a (surgical) face mask in all health care settings.


SFDPH Communicable Disease Control phone (415) 554 – 2830; fax (415) 554 – 2848. See

PLEASE REPORT: Outbreaks of influenza or acute respiratory illness occurring in institutions or congregate settings (e.g., long-term care, rehab, assisted living, jail) (report by phone within 24 hours).

• See recommendations checklist and other resources at Fatal laboratory-confirmed influenza-associated cases aged 0 – 64 years (report within 7 days)

• Complete a case history form (

• Note that SFDPH may request that retained specimens from fatal cases be sent to CDPH for viral culture, strain typing and antiviral resistance testing. Goals are to characterize circulating strains, guide antiviral treatment recommendations and look for the emergence of novel strains.

Read full report here.


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