The ACP recommends sigmoidoscopy, colonoscopy, or air-contrast barium enema every 10 years from the ages of 50 to 70 years. No upper age limit. Influenza vaccination in the elderly has been shown to reduce hospitalization rates, to be cost effective, and to reduce influenza-associated mortality. There is agreement between the different organizations that annual immunization with 0.5 cc of the current trivalent influenza vaccine is recommended for adults over 65 years and those who live in a chronic care facility. Caretakers for high-risk patients should also be immunized, including physicians and nurses.
Influenza vaccination is contraindicated in persons with allergy to egg.
Some authorities recommend not giving the vaccine during febrile illness. Rimantidine or amantadine prophylaxis is recommended as an adjunct to vaccination during outbreaks of influenza A in nursing homes and hospitals. Dose is 100 mg bid for adults less than 65 years and healthy adults over 65 years. A 100 mg per day dose should be considered in frail older adults and those with liver or renal disease. The prophylaxis should be continued for 2 weeks.