Table 1 Key points: care of patients with severe influenza

• There are an estimated 291,000–646,000 seasonal influenza-associated respiratory deaths every year worldwide.

• Annual influenza vaccination is the primary method of preventing influenza and influenza-related complications, especially in high-risk persons.

• Influenza molecular diagnostic testing is recommended for all patients requiring hospitalization with suspected influenza.

• Influenza antiviral treatment should be started as soon as possible in hospitalized patients with suspected influenza, including critically ill patients, and should not be delayed while awaiting results of influenza diagnostic tests.

• Enterically administered oseltamivir is recommended for influenza patients except for those with contraindications (e.g., gastric stasis, ileus, malabsorption).

• Repeat virologic testing in lower respiratory tract specimens may be required to determine therapeutic endpoints in ventilated patients with influenza

• Corticosteroids are not recommended for the routine treatment of influenza except when indicated for treatment of underlying medical conditions (e.g., COPD or asthma exacerbation) or septic shock.