Seasonal Influenza Instructions 2020-2021 and the Influenza Vaccination is provided through a circular by the Ministry of Health.
A. DESCRIPTION - EPIDEMIOLOGICAL DATA - CHARACTERISTICS
Influenza is a contagious disease of the respiratory system caused by the flu virus. It can cause mild to severe illness and sometimes even death.
The elderly, Young children and people with certain chronic diseases are at greater risk of serious complications from the flu.
Long-term follow-up of the disease in Greece shows that seasonal influenza activity usually begins to increase in January, while it peaks during the months of February - March.
Specifically during the period 2019-2020, in our country the epidemic wave of influenza started last week 1/20 (30 December 2019 to 5 January 2020 peaked the week 6/20 (03-09 February 2020), while gradually declining influenza activity continued at low levels in the following weeks until the end of the surveillance period.
The type of influenza virus that prevailed in our country during the period 2019-2020 was the type A virus in percentage 77,9%, while the type B virus was detected in 22,1% of cases with laboratory confirmation.
Regarding the subtypes of influenza A virus, subtype A was released more(H3N2) (66,9%), prevailing over subtype A.(H1N1) pdm09 (33,1%).
The time of onset of the seasonal flu epidemic cannot be accurately predicted, but often with its onset there is a disorganization of professional and social life, excessive increase in drug consumption and not infrequently, increase in mortality.
Important measures to reduce the spread of influenza are the systematic implementation of personal hygiene measures (e.g. Frequent hand washing), the isolation of sufferers and the avoidance of confinement indoors. However, These measures are partially effective and -although significant- they are not enough.
The most effective way to prevent it is to get the flu shot, which, when administered correctly and in a timely manner, protects against the transmission of influenza virus, helps protect against the serious complications of the flu and consequently reduces absenteeism, school and any other social event.
As every year and because the flu virus mutates into different subtypes, so for the period 2020-2021 the composition of the influenza vaccine contains the approved strains of the virus, according to the recommendations of the World Health Organization (WHERE).
Any flu vaccine can be prescribed for this year according to the National Vaccination Program (licensed), whose composition contains the approved strains by the Hellenic Medicines Agency (ΕΟΦ).
It is pointed out that, No serious systemic side effects of the influenza vaccine have been reported through pharmacovigilance systems.
It is noted that it is expected that during the next flu season 2020-2021, The flu virus will be released in parallel with the SARS-CoV-2 virus, causing coronavirus disease-2019 (COVID-19). This particular situation requires the most complete implementation of influenza vaccination in the coming period, with priority given to the vaccination of persons belonging to high-risk groups..
The goal is to reduce the chances of simultaneous infection with both viruses, which may aggravate the condition of patients, as well as the reduction of the burden of health services and in particular of the Intensive Care Units, so that they can better meet a potentially increased demand.
B. VACCINATION RECOMMENDATIONS
According to the National Vaccination Program of our country, Influenza vaccination should be given systematically and as a matter of priority to individuals (adults and children) belonging to the following high risk groups:
1. People of age 60 years and older
2. Children (6 months and over) and adults with one or more of the following aggravating factors or chronic diseases:
• Chronic respiratory diseases, such as asthma , chronic obstructive pulmonary disease.
• Heart disease with severe hemodynamic disorder
• Immunosuppression (hereditary or acquired)
• Organ transplantation and bone marrow transplantation
Sickle cell anemia (and other hemoglobinopathies)
• Diabetes mellitus or other chronic metabolic disease
• Chronic kidney disease
• Chronic liver disease
• Neurological-neuromuscular diseases
3. Pregnant women regardless of gestational age, lactating and lactating.
4. People with morbid obesity (Body Mass Index >40Kg/m2) and children with BMI >95ηΕΘ.
5. Children taking aspirin for a long time (e.g. for Kawasaki disease, rheumatoid arthritis and others).
6. People who are in close contact with children under 6 months or care for or live with people with an underlying disease, which increases the risk of influenza complications.
7. Closed populations, such as staff and in-house students (schools, military and police schools, special schools etc.), recruits, institutions for the chronically ill and nursing homes, booking stores.
8. Employees in health care facilities (medical staff, other employees, students of health professions in clinical practice) and in refugee-immigrant accommodation centers.
10. Veterinarians, poultry farmers, pig farmers, breeders, butchers and people in general who come into regular contact with birds or pigs.
C. VACCINATION INSTRUCTIONS
The flu vaccine should be given early and before the onset of the usual flu-like outbreak., as they are required approximately 2 weeks to achieve an immune response. Preferably the vaccination should be completed at least 4-6 weeks before the start of the annual flu epidemic in Greece (that is, in mid-to the end of November). In addition, vaccination is continued throughout the seasonal flu for people for whom vaccination is indicated and who have not been vaccinated in time..
Influenza vaccination generally includes 1 only dose of vaccine per year.
• Infants and older children <9 years vaccinated for the first time, or those <9 years they had previously only received 1 flu vaccine dose needed 2 doses of influenza vaccine at least at intervals 28 days.
• In aged infants >= 6 months is granted 0,5 ml (the whole dose), in accordance with instructions from official European or other medicines (FDA, EMA et al.).
D. MEDICAL AND NURSING STAFF AND OTHER WORKING IN HEALTH SERVICE AREAS
Health care providers are at increased risk of contracting infections at work and passing them on to colleagues, patients and his family. Immunization against influenza of health care personnel protects not only vaccinated, but also acts as a barrier against the transmission of influenza and even in people with contraindications to vaccination (e.g. infants under 6 months, allergic people etc.) or with a low immune response and helps to maintain the provision of health care during the peak of the seasonal flu.
Especially the staff of the Intensive Care Units, including Neonatal Intensive Care Units, of Intensive Care Units, as well as the staff of the Special Infection Units, of the special Units of Immunosuppressed, of Transplant Units, of Hematology and Oncology Clinics and Emergency Departments (ICT) must be fully vaccinated.
It is reminded that according to the relevant.3 Ministerial Decision, the annual vaccination coverage rate of the health services staff in each hospital (public, private or military), Primary health care center and local health unit is one of the indicators for monitoring the compliance of health service personnel in the implementation of germ control control measures.,with which the efficiency and effectiveness of the Administrations of the health service units and the quality of the provided health services are evaluated.
The Committee for Nosocomial Infections of any Hospital or other health institution included in the scope of the relevant. 3 Ministerial Decision owes :
1. To promote and facilitate the uninterrupted influenza vaccination of the medical and other personnel.
2. To send to EODY data of vaccination coverage for the seasonal flu of the employees of its organization, overall and per high risk segment (as above).
E. GENERAL INSTRUCTIONS
• EOF to ensure the adequacy of the vaccine in the Greek market throughout the period of transmission of influenza virus.
• The Commanders of RFA, the General Managers of Public Health & Social Welfare of the Regions, the Directors of Public Health & Social Welfare of the Regional Units, as well as the Mayors of the Kallikratiki Municipalities of the country are invited to participate within the framework of their responsibilities and in cooperation with EODY in the joint organization of actions of informing the public and special populations both for the flu, and the importance of influenza vaccination through the distribution of printed material, speeches, social messages in the media. etc..
• The seasonal flu is monitored by the Directorate of Epidemiological Surveillance and Intervention for Infectious Diseases of EODY through:
1. Primary health care morbidity monitoring system (Sentinel).
2. Mandatory declaration system for laboratory-confirmed influenza (declared with the flu declaration form (ΥΔ 7)).
3. Monitoring system for severe cases of laboratory-confirmed influenza that require hospitalization in ICU. or intubated patients outside the ICU.
The epidemiological surveillance of influenza, both in Europe and in our country, for this year's flu season will start the week 40/2020 (28 September 2020 – 04 October 2020) and will be completed the week 20/2021 (17 – 23 May 2021).
• Laboratory diagnosis of influenza should be made in severe cases of influenza hospitalized in ICU (or is in mechanical respiratory support in a clinic waiting for a bed in an ICU). EODY undertakes the coverage of the cost of the laboratory test of clinical samples for the diagnosis of influenza in the following laboratories:
1. National Laboratory for Influenza and Other Respiratory Viruses of Southern Greece, Hellenic Pasteur Institute in Athens.
2. National Flu Reference Laboratory of Northern Greece, B 'Laboratory of Microbiology, AUTh Medical Department, in Thessaloniki.
It is pointed out that, Laboratory diagnosis of influenza is not required for antiviral therapy.
• People in high-risk groups are advised to arrive at health facilities early in the onset of symptoms for medical diagnosis and treatment..
• This circular is posted on the website of the Ministry of Health (www.moh.gov.gr) in the axis "Health" and in the section "Public Health" - "Vaccinations", for information of institutions and citizens.
• The Press and Public Relations Office of the Ministry of Health is invited to issue a Press Release in order to inform all the printed and electronic media..