Preventing and treating influenza

WHO estimates that seasonal influenza epidemics result in three to five million cases of severe illness and 250 000 to 500 000 deaths each year in the industrialised world alone. Although vaccination remains the most important measure for reducing this sizeable public health burden, the influenza virus neuraminidase inhibitors, zanamivir and oseltamivir, have been welcomed as long awaited additional tools for treatment and prevention. However, in terms of meeting public health objectives, which include clinical effectiveness in high risk groups and preparedness for the next influenza pandemic, they have important limitations. As documented in the paper by Cooper et al p 1235) in this issue, neuraminidase inhibitors are clinically effective for the treatment of influenza in otherwise healthy adults and children as well as for prevention of the disease.1 When used as a treatment, they can reduce the duration of uncomplicated disease by about one day, and the likelihood of complications requiring antimicrobial treatment. Taken prophylactically they can decrease the likelihood of developing influenza by 70-90% depending on the …