Managing influenza in primary care - A practical guide to clinical diagnosis

Influenza remains a significant cause of worldwide morbidity and mortality. With the availability of new effective antivirals for the treatment of influenza, early diagnosis of the disease will become increasingly important for effective disease management. Although investigators are generally in broad agreement about the symptoms of influenza, there are currently no agreed guidelines for the clinical diagnosis of influenza during annual outbreaks. This paper outlines the recommendations of a Working Party (comprising virologists and family practitioners) who met to construct criteria that could be used by primary healthcare professionals to aid early clinical diagnosis of influenza, i.e, before the development of any complications. A virologically confirmable diagnosis of influenza is likely when an otherwise healthy adult presents, during a known local influenza outbreak, with rapid onset of the symptom complex of fever, feverishness or chills plus myalgia, cough or malaise. Guidelines for the diagnosis of influenza in children, in patients with chronic diseases and in the elderly require further refinement.