High Risk For Influenza-related Complications Research Articles

Annual Universal Influenza Vaccination: Ready or Not?

Influenza causes annual worldwide epidemics of respiratory disease. Currently, the United States and many other countries recommend influenza vaccination for persons who are at high risk for influenza-related complications. This commentary explores the potential benefits of a policy advocating universal annual influenza vaccination and outlines obstacles that need to be overcome to make such a recommendation feasible. The 5-year experience of a free influenza vaccination program for everyone > or =6 months of age in the Canadian province of Ontario is reviewed.

Pediatric influenza prevention and control.

Global evaluation of influenza vaccination in children indicates that current recommendations are not followed. Most children at high risk for influenza-related complications do not receive the vaccine, and increased efforts are needed to protect them. Furthermore, immunizing healthy infants 6–23 months of age and their close contacts should be strongly encouraged. Vaccinations are recommended for children with recurrent acute otitis media or recurrent respiratory tract infections and possibly for healthy daycare and school-age children because of the potential socioeconomic implications of influenza. Issues that need to be addressed include educating physicians and parents concerning influenza-related illness and complications, cost-effectiveness and safety of licensed vaccines, adequate vaccine supply, and availability of intranasal products.

Zanamivir: a review of its use in influenza.

Zanamivir is a novel inhibitor of the enzyme neuraminidase, a surface glycoprotein essential for the replication of type A and B influenza viruses. Statistically significant reductions in median time to alleviation of major symptoms of influenza were reported in phase II and III studies of zanamivir. Benefit was seen with early treatment (within 30 or 36 hours of onset of illness) in phase II trials. Median times to alleviation of major (or 'clinically significant') symptoms were reduced by 1 to 2.5 days after treatment with zanamivir 10 mg twice daily by oral inhalation for 5 days in 3 phase III studies. Benefit of zanamivir treatment in terms of time to return to normal activities and reductions in consumption of paracetamol (acetaminophen), and reductions in the level of interference of influenza with sleep, work, leisure and recreational activities, were reported. Reductions relative to placebo of 2.5 to 3.25 days were observed in median time to alleviation of major symptoms in high-risk patients. Available data also indicate potential of zanamivir in the prophylaxis of influenza. A statistically significant reduction in the incidence of influenza A was reported with zanamivir 10 mg by oral inhalation once daily for 4 weeks in a double-blind study in 1107 persons in 2 university communities. Prophylactic benefit of zanamivir in influenza A and B outbreaks has also been suggested by data from a nursing home community. Adverse event profiles in patients receiving zanamivir therapeutically or prophylactically appear similar to those in patients receiving placebo. The most commonly reported adverse events in therapeutic trials have been nasal signs and symptoms, diarrhoea, nausea, headache, bronchitis and cough. Prompt treatment with zanamivir in patients with naturally acquired influenza is associated with significant reductions in duration of symptomatic illness, accelerated return to normal levels of activity and reduced consumption of antibiotics for influenza-related complications. While vaccination in selected populations remains the seasonal intervention of choice for prophylaxis, the efficacy, good tolerability and lack of resistance seen with zanamivir are likely to make the drug a valuable treatment option, particularly in individuals not covered or inadequately protected by vaccination, and in those at high risk of influenza-related complications. Confirmation of the prophylactic efficacy of zanamivir would indicate a major potential role for the drug in this setting, especially in persons for whom vaccination is not suitable or fully effective, in closed communities (e.g. nursing homes) and in individuals at high risk.

Practical Use of Vaccines to Prevent Infection with Influenza Virus and Streptococcus pneumoniae

Effective vaccines for the prevention of influenza and pneumococcal disease are available. Inactivated influenza vaccines should be administered yearly to those at high risk for influenza-related complications, including the elderly and those with chronic cardiac, pulmonary, and selected other conditions. Pneumococcal capsular polysaccharide vaccines should be administered once to individuals at high risk for pneumococcal disease or complications, including the elderly, individuals with pulmonary or cardiac conditions, and immunocompromised individuals, particularly those with splenic dysfunction. More effective vaccines for both pathogens are currently being developed, and show promise for further reducing the impact of these public health problems.

Prevention and Control of Influenza

Diagnosis and Treatment1 October 1987Prevention and Control of InfluenzaRecommendations of the Immunization Practices Advisory CommitteeAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-107-4-521 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail AbstractAbstractUnless vigorous measures are used to control influenza in the 1987 to 1988 season, mortality due to this disease may increase because the proportion of elderly persons in the United States is rising, and age and its associated chronic diseases are risk factors for severe influenza illness. Also, the younger populations at high risk for influenza-related complications are increasing for various reasons, including the success of neonatal intensive-care units, better management of diseases such as cystic fibrosis, and better survival rates for organ-transplant recipients. To help control influenza in the upcoming season, information on the influenza strains in the trivalent vaccine is provided, recommendations for vaccination of persons in households with a high-risk person are made, and precautions for the use of amantadine hydrochloride are described. This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: ▹From the Immunization Practices Advisory Committee, Centers for Disease Control; Atlanta, Georgia. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byChronic obstructive pulmonary diseaseStrategies in Preserving Lung Health and Preventing COPD and Associated DiseasesAcute psychosis after amantadine overdoseAge-Related Decline in Interleukin 2 Production in Response to Influenza VaccineChronic obstructive pulmonary diseasePrevention de l'infection chez le sujet agéImmunization in Adults 1 October 1987Volume 107, Issue 4Page: 521-525KeywordsCystic fibrosisElderlyMedical risk factorsMortalityPopulation statisticsVaccines ePublished: 1 December 2008 Issue Published: 1 October 1987 PDF downloadLoading ...