Influenza-Associated Cystic Fibrosis Pulmonary Exacerbations

Abstract

A n estimated 30,000 people in the United States have cystic fi brosis (CF). 1 CF is an autosomal reces sive disease that affects multiple organ systems; however, respiratory complications account for nearly 85% of CF mortality. 1 Exacerbations of CF pulmonary disease are common and are characterized by cough, increased sputum production, dyspnea, decreased energy level and appetite, weight loss, and decreases in spirometric parameters. 2 Over the last 2 decades, the quality of life and median survival among persons with CF have improved substantially. 1 Nevertheless, increasing age in CF is associated with worsening nutritional status, declining lung function,

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

“…In adults and children with CF, viral infections can trigger pulmonary exacerbations, [269][270][271][272] particularly influenza virus 271,273 and rhinovirus. 269,270 Exacerbations in which a virus is identified are associated with worse clinical severity compared with viral exacerbations.…”

Influenza vaccination among household contacts of children with cystic fibrosis and healthy children

“…Data from randomized controlled studies investigating the effectiveness of influenza vaccination in the CF population have not reported clinically relevant outcomes such as lung function, hospitalization rates or mortality (20). Despite this, there remains sufficient evidence in the literature that influenza leads to excess morbidity in this population (eg, an excess of 2.1% of pulmonary exacerbations occuring during the influenza season [9]). Immunization should, therefore, be encouraged.…”

“…This becomes apparent as progressive lung obstruction and worsening pulmonary function (5)(6)(7)(8). A CF Foundation patient registry study estimated that a 2.1% increase in pulmonary exacerbations occurs during the influenza season (9). Respiratory viruses have also been suggested to be one of the mediators of the onset of chronic Pseudomonas aeruginosa infection in CF patients (10), perhaps via facilitation of colonization of the lung epithelia (11,12).…”

Viral Respiratory Tract Infections in Cystic Fibrosis

“…The emergence of novel influenza virus (H1N1) further heightened the awareness of influenza-like illness. CF Pulmonary exacerbation rates have been shown to be significantly increased during the winter and are highly associated with the influenza season (Ortiz, Neuzil et al 2010). …”