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According to Health Canada, influenza and pneumonia are ranked among the top ten leading causes of death in the country. It is estimated that influenza causes approximately 12,200 hospitalizations and 3,500 deaths nation-wide each year. 

This year Canada is seeing an early start of the influenza season. Hospitals across Canada are now overwhelmed by the triple threat of respiratory viruses (COVID-19, RSV, and influenza). 

Getting vaccinated is still the best way to help prevent influenza infection. Wearing masks in indoor settings can also help mitigate the spread of viral infections. 

The Ask a Librarian team is committed to curating evidence-based resources on emerging health topics. Here are some librarian-selected resources from a variety of tools offered with CMA memberships or freely available online.


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Clinical summaries

ClinicalKey – Clinical Overview: Influenza (login required - CMA members only – search “influenza” and the clinical overview is the first result)

CPS – Therapeutic choices: Influenza (login required - CMA members only – search “influenza” and the therapeutics summary is the first result)

DynaMed - Influenza in Adults and Influenza in Children (login required – CMA members only – search “influenza”)

Essential Evidence Plus – Influenza: Essential Evidence (login required – CMA members only – search “influenza”)

Family Practice Notebook – Influenza 

Merck Manual Professional Edition – Influenza 

Guidelines and other information

National

Canadian Clinical Practice Guidelines on Influenza – CPG Infobase

Health Canada - FluWatch surveillance 

Infection Prevention and Control Canada (IPAC Canada) - Influenza Resources

Public Health Agency of Canada - PHAC Webinar: Seasonal Influenza Immunization 2022-2023

International

Centers for Disease Control and Prevention (CDC) - Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022–23 Influenza Season. A summary is also available. 

Infectious Diseases Society of America (IDSA) - Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza

American Academy of Allergy, Asthma, and Immunology (AAAAI) - Administration of influenza vaccines to egg allergic recipients: A practice parameter update 2017

World Health Organization – Influenza 

Book Chapters

ClinicalKey (login required - CMA members only - includes 1,000+ textbooks, 600 full-text journals, images, videos and customizable patient handouts across 30+ medical specialties)

Open access:

Influenza – StatPearls - NCBI Bookshelf (nih.gov) By Sameh W. Boktor; John W. Hafner. 2022 June 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 29083802

Evidence reviews

CADTH Health Technology Review - Concurrent or Sequential Administration of Drugs for COVID-19 and Influenza: Rapid Review

CADTH Reference List - Influenza Vaccination and Risk of Subsequent Non-Influenza Respiratory Viruses: Safety

Articles and article collections:

Does repeated influenza vaccination attenuate effectiveness? A systematic review and meta-analysis
Elenor Jones-Gray, Elizabeth J Robinson, Adam J Kucharski, Annette Fox, Sheena G Sullivan
Lancet Respir Med . 2022 Sep 21;S2213-2600(22)00266-1. doi: 10.1016/S2213-2600(22)00266-1. Online ahead of print
PMID: 36152673 

Misdiagnoses in the Context of Suspected Pandemic Influenza or Coronavirus Disease 2019: A Systematic Review.
Bray L, Meznikova K, James D, Rislan R, Shah R, Mason P, Staniland T, Lillie P, Barlow G, Easom N.
Open Forum Infect Dis. 2022 Oct 5;9(11):ofac515. doi: 10.1093/ofid/ofac515. eCollection 2022 Nov.
PMID: 36340740

Cost-Effectiveness of Intranasal Live-Attenuated Influenza Vaccine for Children: A Systematic Review.
Chan KS, Wong CH, Choi HC.
Vaccines (Basel). 2022 Sep 4;10(9):1466. doi: 10.3390/vaccines10091466.
PMID: 36146544 

The role of respiratory co-infection with influenza or respiratory syncytial virus in the clinical severity of COVID-19 patients: A systematic review and meta-analysis.
Cong B, Deng S, Wang X, Li Y.
J Glob Health. 2022 Sep 17;12:05040. doi: 10.7189/jogh.12.05040.
PMID: 36112521

Comparative effectiveness of adjuvanted versus high-dose seasonal influenza vaccines for older adults: a systematic review and meta-analysis.
Domnich A, de Waure C.
Int J Infect Dis. 2022 Sep;122:855-863. doi: 10.1016/j.ijid.2022.07.048. Epub 2022 Jul 22.
PMID: 35878803

Physical activity and acute exercise benefit influenza vaccination response: A systematic review with individual participant data meta-analysis.
Bohn-Goldbaum E, Owen KB, Lee VYJ, Booy R, Edwards KM.
PLoS One. 2022 Jun 15;17(6):e0268625. doi: 10.1371/journal.pone.0268625. eCollection 2022.
PMID: 35704557

Favipiravir Treatment of Uncomplicated Influenza in Adults: Results of Two Phase 3, Randomized, Double-Blind, Placebo-Controlled Trials.
Hayden FG, Lenk RP, Stonis L, Oldham-Creamer C, Kang LL, Epstein C.
J Infect Dis. 2022 Nov 11;226(10):1790-1799. doi: 10.1093/infdis/jiac135.
PMID: 35639525

Association of Influenza Vaccination With Cardiovascular Risk: A Meta-analysis.
Behrouzi B, Bhatt DL, Cannon CP, Vardeny O, Lee DS, Solomon SD, Udell JA.
JAMA Netw Open. 2022 Apr 1;5(4):e228873. doi: 10.1001/jamanetworkopen.2022.8873.
PMID: 35486404

Patient information

The Canadian Lung Association – Influenza  

CBC Kids - Everything you need to know about the flu shot

Canadian Paediatric Society – Caring for Kids - Influenza in children

Centers for Disease Control and Prevention – Influenza (Flu)

Familydoctor.org – Flu Myths

HealthLink BC – Influenza (Seasonal Flu)

Immunize Canada – The story of influenza

MedlinePlus – Flu 

National Foundation for Infectious Diseases – Flu & Chronic Health Conditions Toolkit

UpToDate – Patient education: Influenza prevention (Beyond the Basics)

Social media, news and other sources

CBC News – Flu season arrives, Public Health Agency of Canada says, November 14, 2022 

The Globe and Mail - Return of seasonal flu, RSV and other viruses could spell disaster for older Canadians, experts say, November 11, 2022

Health Canada - Weekly influenza reports

ScienceUpFirst - Flu season is here

Twitter Search - #flu

Searching for influenza information:

Google search (limit to Canadian websites/.ca domain) - Search for influenza

Google Scholar - Search for influenza

PubMed – US National Library of Medicine – Search for influenza


Need more information on influenza (flu, seasonal flu) or any other clinical topic of interest? Contact the Ask a Librarian team to request a literature search.


This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule.


About the author(s)

CMA Joule’s medical librarians are the professionals behind “Ask a Librarian”, a service for all CMA members looking for clinical search expertise. This experienced team of librarians can support you by searching on your behalf, teaching you effective search strategies or training you to use our clinical resources.

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