espite being considered by many as a minor disease, influenza remains a leading cause of respiratory infection, attributing to many deaths in the UK each year. This article offers an overview of influenza and its prevention, focusing on the use of influenza vaccination in healthcare workers as a public health measure. It highlights potential benefits beyond the protection of individuals against influenza, and considers the impact of health behaviour on improving vaccination uptake in healthcare workers.
Advisory Committee on Immunisation Practices. ( 1999) Prevention and control of influenza: recommendations of the Advisory Committee on Immunisation Practices. National Centre for Infectious Diseases: Atlanta.
2.
Baker CC, Cameron AS (1985) The effects of influenza immunisation on absence. Journal of The Society ofOccupational Medicine35: 134-6.
3.
Baxter D. (2002) How to optimise your uptake of flu vaccine. Pulse 16 September: 38-42.
4.
Beach J., Hobson J. (2002) Influenza vaccination. Occupational Medicine52(5): 237-8.
5.
Brocklehurst N. (2004) Public health and its implications for practice . Nursing Standard18(49): 48-54.
6.
Carman WF, Elder AG, Wallace LA, McAulay K., Walker A., Murray GD, Stott DJ (2000) Effects of influenza vaccination of healthcare workers on mortality of elderly people in long-term care: a randomised control trial. The Lancet355: 93-7.
7.
Centers for Disease Control and Prevention. ( 2000) Prevention and control of influenza: recommendations of the Advisory Committee on Immunisation Practices. MMWR49(RR-3): 1-38.
8.
Centers for Disease Control and Prevention. ( 2004) Prevention and control of influenza: recommendations of the Advisory Committee on Immunisation Practices. MMWR53: 1-40.
9.
Coles FB, Balzano GJ, Morse DL (1992) An outbreak of influenza A (H3N2) in a well immunised nursing home population. Journal of American Geriatric Society40: 58992.
10.
Cox NJ, Subbarao K. (1999) Influenza. The Lancet354: 1277-82.
11.
Cunney RJ, Bialachowski A., Thornley D., Smaill FM, Pennie RA (2000) An outbreak of influenza A in a neonatal intensive care unit. Infection Control andHospital Epidemiology21: 449-54.
12.
Demicheli V., Jefferson T., Rivetti D., Deeks J. (2000) Prevention and early treatment of influenza in healthy adults. Vaccine18: 957-1030.
13.
Demicheli V., Rivetti D., Deeks JJ, Jefferson TO (2004) Vaccines for preventing influenza in healthy adults (Cochrane review). The Cochrane Library: Issue 3. John Wiley and Sons: Chichester.
14.
Dey P., Halder S., Collins S., Benons L., Woodman C. (2001) Promoting uptake of influenza vaccination among healthcare workers: a randomised control trial. Journal of Public Health Medicine23(4): 346-8.
15.
Department of Health. (2000) Influenza vaccine for front-line staff. HMSO: London.
16.
Department of Health. (2002) Getting ahead of the curve: a strategy for combating infectious diseases. HMSO: London.
17.
Department of Health. (2005) Pandemic flu — important information for you and your family. HMSO: London.
18.
Doebbeling BN, Edmond MB, Davis CS, Woodin JR, Zeitler RR (1997) Influenza vaccination of healthcare workers: evaluation of factors that are important in acceptance. Preventive Medicine26: 68-77.
19.
Downie RS, Fyfe C., Tannahill A. (1990) Health promotion models and values. Oxford University Press: Oxford.
20.
Elder AG, O'Donnell B., McCruden B., Symington IS, Carman WF (1996) Incidence and recall of influenza in a cohort of Glasgow healthcare workers during the 1993-4 epidemic: results of serum testing and questionnaire. BMJ313: 1241-2.
21.
Evans ME, Hall KL, Berry SE (1997) Influenza control in acute care hospitals. American Journal of Infection Control25: 357-62.
22.
Ewles L., Simnett I. (2003) Promoting health: a practical guide (fifth edition). Balliere Tindall: London.
23.
Govaert TM, Dinant GJ, Aretz K., Knottnerus JA (1998) The predictive value of influenza symptomology in elderly people. Family Practice15(1): 16-22.
24.
Gross PA, Hermogenes AW, Sacks HS, Lau J., Levandoeski RA (1995) The efficacy of influenza vaccine in elderly persons: a meta-analysis and review of the literature. Annals of Internal Medicine123: 518-27.
25.
Hall CB, Douglas RG (1975) Nosocomial influenza infection as a cause of intercurrent fevers in infants. Pediatrics55: 673-7.
26.
Health Protection Agency. (2005) Influenza pandemic contingency plan. Health Protection Agency, London.
27.
Horcajada JP, Pumarola T., Martinez JA, Tapias G., Bayas JM, de la Prada M., García F., Codina C., Gatell JM, Jiménez de Anta MT (2003) A nosocomial outbreak of influenza during a period without influenza epidemic activity. The European Respiratory Journal21: 303-7.
28.
Jefferson TO, Demicheli V., Deeks JJ, Rivetti D. (2000) Prevention and early treatment of influenza in healthy adults. Vaccine18: 957-1030.
29.
Lester RT, McGeer A., Tomlinson G., Detsky AS (2003) Use of, effectiveness of, and attitudes regarding influenza vaccine among house staff. Infection Control andHospital Epidemiology24(11): 839-44.
30.
Malavaud S., Malavaud B., Sandres K., Durand D., Marty N., Icart J., Rostaing L. (2001) Nosocomial outbreaks of influenza virus A (H3N2) infection in a solid organ transplant department. Transplantation72(3): 535-7.
31.
Manuel DG, Henry B., Hockin J., Naus M. ( 2002) Health behaviour associated with influenza vaccination among healthcare workers in long-term care facilities. Infection Control andHospital Epidemiology23(10): 609-15.
32.
Martinello RA, Jones L., Topal JE (2003) Correlation between healthcare workers' knowledge of influenza vaccine and vaccine receipt. Infection Control andHospital Epidemiology24(11): 799-800.
33.
Munoz FM, Campbell JR, Atmar RL, Garcia-Prats J., Baxter BD, Johnson LE, Englund JA (1999) Influenza A virus outbreak in a neonatal intensive care unit. The Pediatric Infectious Disease Journal18: 811-5.
34.
Naidoo J., Wills J. (2000) Health promotion: foundations for practice (second edition). Balliere Tindall : London.
35.
Nichol KL (2001) Cost-benefit analysis of a strategy to vaccinate healthy working adults against influenza. Archives ofInternal Medicine161: 749-59.
36.
Nichol KL, Hauge M. (1997) Influenza vaccination of healthcare workers. Infection Control andHospital Epidemiology18: 189-94.
37.
Nichol KL, Lind A., Margolis KL, Murdoch M., McFadden R., Hauge M., Magnan S., Drake M. (1995) Effectiveness of vaccination against influenza in healthy working adults. New England Journal of Medicine333: 889-93.
38.
Nichol KL, Mendelman PM, Mallon KP, Jackson LA, Gorse GJ, Belshe RB, Glezen WP, Wittes J. (1999) Effectiveness of live, attenuated intranasal influenza virus vaccine in healthy working adults: a randomised control trial. JAMA282: 137-44.
39.
Nicholson KG, Kent J., Hammersley V., Cancioi E. (1997) Acute viral infection of upper respiratory tract in elderly people living in the community: comparative, prospective, population based study of disease burden. BMJ315: 1060-4.
40.
Ong Aky, Srimanunthiphol J., Frankel RI (2000) Influenza vaccination status of healthcare workers and the extent of their domestic contact with individuals at high risk of influenza-related complications. Infection Control andHospital Epidemiology21(11): 735-8.
41.
O'Reilly FW, Stevens AB (2002) Sickness absence due to influenza. Occupational Medicine52(5): 265-9.
42.
O'Rorke C., Bourke W., Bedford D., Howell F. (2003) Uptake of influenza vaccine by healthcare workers in an acute hospital in Ireland. Irish Medical Journal96(7): 207-9.
43.
Patriarca PA, Weber JA, Parker RA, Orenstein WA, Hall WN, Kendal AP, Schonberger LB (1986) Risk factors for outbreaks of influenza in nursing homes: a case-control study. American Journal of Epidemiology124: 114-9.
44.
Potter J., Stott J., Roberts MA, Elder AG, O'Donnell B., Knight PV, Carman WF (1997) Influenza vaccination of healthcare workers in long term hospitals reduces the mortality of elderly patients. Journal of Infectious Diseases175: 1-6.
45.
Puchucki CT, Pappas Saw, Fuller GF, Krause SL, Lentino JR, Schaaff DM( 1989) Influenza A among hospital personnel and patients — implications for recognition, prevention and control. Archives ofInternal Medicine149: 77-80.
46.
Ritchie KA, Macdonald EB, Gilmour WH, Murray KJ (1999) Analysis of sickness among employees of four NHS trusts. Occupational and Environmental Medicine56: 702-8.
47.
Schepetiuk S., Papanaoum K., Qiao M. ( 1998) Spread of influenza A virus infection in hospitalised patients with cancer. The Australian and New Zealand Journal of Medicine28: 475-6.
48.
Scottish Centre for Infection and Environmental Health. (2004a) Severe Acute Respiratory Syndrome (SARS). Alert, 23 April. See: www.show.scot.nhs.uk/scieh/infectious/respiratory/SARS/SARS.htm (accessed 6 May 2004).
49.
Scottish Centre for Infection and Environmental Health. (2004b) Influenza. See: www.show.scot.nhs.uk/scieh/surveillance/influenza.htm (accessed 6 May 2004).
50.
Scottish Executive Health Department. (2000 ) NHS HDL 9 Influenza Immunisation Programme 2000 to 2001. Scottish Executive Health Department: Edinburgh.
51.
Scottish Executive Health Department. (2001 ) Influenza immunisation, SEHD/CMO 13. Scottish Executive Health Department: Edinburgh.
52.
Scottish Executive Health Department. (2003 ) Pneumococcal vaccination for those aged 65 and over 2003 to 2004: Influenza vaccination programme 2003 to 2004, SEHD/CMO 9. Scottish Executive Health Department: Edinburgh.
53.
Scottish Executive Health Department. (2004 ) Influenza immunisation programme for 2004 to 2005, SEHD/CMO 15. Scottish Executive Health Department: Edinburgh.
54.
Smedley J., Palmer C., Baird J., Barker M. (2002) A survey of the delivery and uptake of influenza vaccine among healthcare workers. Occupational Medicine52(5): 271-6.
55.
Smith A. (1989) A review of the effects of colds and influenza on human performance. Journal of the Society of Occupational Medicine39: 65-8.
56.
Smith AP, Thomas M., Brockman P., Kent J., Nicholson KG (1993) Effect of influenza B virus infection on human performance. BMJ306: 760-1.
57.
Smith L. (2003) Influenza 2004: meeting the challenge. National Influenza Immunisation Strategy Group: Auckland .
58.
Steimle D., Aston R., van Damme P. (2002) Immunisation information for parents. Nursing Standard16(29): 40-4.
Valley J., Blue CL ( 2002) Influenza: overview and recommendations for control. Topics in Advanced Practice Nursing eJournal2(1): see: www.medscape.com/viewarticle/421478_print (accessed 3 June 2005).
61.
Wanless D. (2002) Securing our future health. The Stationery Office: London.
62.
Wanless D. (2004) Securing good health for the whole population: final report. The Stationery Office: London.
63.
Weingarten S., Riedinger M., Bolton LB, Miles P., Ault M. ( 1989) Barriers to influenza vaccination acceptance: a survey of physicians and nurses. American Journal of Infection Control17: 202-7.
64.
Weingarten S., Staniloff H., Ault M., Miles P., Bamberger M., Meyer RD (1988) Do hospital employees benefit from the influenza vaccine?Journal of General Internal Medicine3(1): 32-7.
65.
Weinstock DM, Eagan J., Malak SA, Rogers M., Wallace H., Kiehn TE, Sepkowitz KA (2000) Control of influenza A on a bone marrow transplant unit. Infection Control andHospital Epidemiology21: 730-2.
66.
Wilde JA, McMillan JA, Serwint J., Butta J., O'Riordan MA, Steinhoff MC (1999) Effectiveness of influenza vaccine in healthcare professionals: a randomised trial. JAMA281: 908-13.
67.
Wilder-Smith A., Ang B. ( 2003) The role of influenza vaccine in healthcare workers in the era of severe acute respiratory syndrome. AnnalsAcademy of Medicine32(5): 573-5.
68.
Wiselka M. (1994) Influenza: diagnosis, management and prophylaxis . BMJ308: 1341-5.
69.
World Health Organization. (2002) Influenza vaccines: World Health Organization position paper. Weekly Epidemiological Record28(77): 229-40.
70.
World Health Organization. (2003a) Influenza factsheet no 211: revised March 2003. See: www.who.int/mediacentre/factsheets/fs211/en/print.html (accessed 24 May 2005).
71.
World Health Organization. (2003b) Amid SARS concerns, WHO urges influenza vaccination in high risk groups: press release, Sept 2. See: www.who.int/mediacentre/notes/2003/np22/en/ (accessed 24 May 2005).
72.
World Health Organization. (2004) The history of vaccination. See: www.who.int/vaccines-diseases/history/history.shtml (accessed 24 May 2005).
73.
Yassi A., Kettner J., Hammond G., Cheang M., McGill M. (1991) Effectiveness and cost benefit of an influenza vaccination program for healthcare workers. CanadianJournal of Infectious Disease2(3): 101-8.
74.
Yassi A., McGill M., Holton D., Nicolle L. (1993) Morbidity, cost and role of healthcare worker transmission in an influenza outbreak in a tertiary care hospital. CanadianJournal of Infectious Disease4: 5256.
75.
Zambon MC, Stockton JD, Clewley JP, Fleming DM (2001) Contribution of influenza and respiratory syncytial virus to community cases of influenza-like illness: an observational study . The Lancet358: 1410-6.
