Managed Care - October 2008 - (Page IS7) hundreds of thousands of deaths around the world. Fortunately, contemporary molecular biology and advanced genetic techniques allow for a better understanding of viral biology and the origins of influenza pandemics that may enable improved diagnosis and disease control. The influenza vaccine has reduced the disease burden of flu, but has not significantly lowered the death rate. This is a result of the combined factors of underutilization of the vaccine and a revised understanding of disease spread. It is imperative that vaccination rates improve, particularly among the high-risk elderly population and health care workers. It also is clear that targeting children for universal vaccination can help to control spread of the virus and reduce morbidity and mortality in all age groups. References Arden NH, Patriarca PA, Kendal AP. Experiences in the use and efficacy of inactivated influenza vaccine in nursing homes. In: Kendal AP, Patriarca PA, eds. Options for the control of influenza. New York: Alan R. Liss Inc. 1986:155–168. Belshe RB. The origins of pandemic influenza: lessons from the 1918 virus. N Engl J Med. 2005;353:2209–2211. Belshe RB, Edwards KM, Vesikari T, et al. Live attenuated versus inactivated influenza vaccine in infants and young children. N Engl J Med. 2007;356:685–696. Belshe RB, Gruber WC. Prevention of otitis media in children with live attenuated influenza vaccine given intranasally. Ped Infect Dis J. 2000;19:S66–S71. Belshe RB, Hay AJ. Drug resistance and mechanisms of action on influenza A viruses. J Resp Dis. 1989;10:S52–S61. Blumberg EA, Albano C, Pruett T, et al. Immunogenicity of influenza virus vaccine in solid organ transplant recipients. Clin Infect Dis. 1996;22:295–302. CDC (Centers for Disease Control and Prevention). Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008a;57(early release):1–60. CDC. Influenza (flu) fact sheet. 2008b. «http://www.cdc.gov/ flu/keyfacts.htm». Accessed Sept. 25, 2008. CDC. Fluview: a weekly influenza surveillance report prepared by the influenza division. 2008c. «http://www.cdc.gov/ flu/weekly.» Accessed Sept. 25, 2008. CDC. Rapid diagnostic testing for influenza: information for clinical laboratory directors. December 2006. «http://www. cdc.gov/flu/professionals/diagnosis/rapidlab.htm». Accessed Sept. 25, 2008. Cooper NJ, Sutton AJ, Abrams KR, et al. Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: systematic review and meta-analyses of randomised controlled trials. Br Med J. 2003;326: 1275–1281. Couch RB. Influenza: prospects for control. Ann Intern Med. 2000;133:992–998. Couch RB. Respiratory virus infections. In: Galasso GJ, Whitley RJ, Merigan TC, eds. Antiviral Agents and Human Viral Disease, 4th ed. Philadelphia: Lippincott-Raven.1997:369–413. Couch RB, Kasel JA, Glezen WP, et al. Influenza: its control in persons and populations. J Infect Dis. 1986;153:431–440. Dorrell L, Hassan I, Marshall S, et al. Clinical and serological responses to an inactivated influenza vaccine in adults with HIV infection, diabetes, obstructive airways disease, elderly adults and healthy volunteers. Int J STD AIDS.1997;8: 776–779. Elveback LR, Fox JP, Ackerman E, et al. An influenza simulation model for immunization studies. Am J Epidemiol. 1976;103: 152–165. Glezen WP, Taber LH, Frank AL, et al. Influenza virus infections in infants. Pediatr Infect Dis J. 1997;16:1065–1068. Hayden FG, Belshe R, Vilanueva C, et al. Management of influenza in households: a prospective randomized comparison of oseltamivir treatment with or without postexposure prophylaxis. J Infect Dis. 2004;189:440–449. IIV (Influenza virus vaccine live, intranasal [FluMist]) [prescribing information]. Gaithersburg, Md: MedImmune; June 2008. Jin XW, Mossad SB. Avian influenza: an emerging pandemic threat. Cleve Clin J Med. 2005;72:1129–1134. Kilbourne ED. Influenza. New York: Plenum Medical Book Co. 1987. Moser MR, Bender JR, Margolis HS, et al. An outbreak of influenza abroad a commercial airliner. Am J Epidemiol. 1979;1101:1–6. Mumford JA. Vaccines and viral antigenic diversity. Rev Sci Tech. 2007;26:69–90. Neuzil K, Mellen BG, Wright PF. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med. 2000;342:225–231. Nichol KL, Wuorenma J, Von Sternberg T. Benefits of influenza vaccination for low-, intermediate-, and high-risk senior citizens. Arch Intern Med. 1998;158:1769–1776. Oseltamivir phosphate (Tamiflu) [prescribing information]. Nutley, N.J.: Hoffman La-Roche. February 2008. Palache AM. Influenza vaccines: a reappraisal of their use. Drugs. 1997;54:841–856. Patriarca PA, Weber JA, Parker RA, et al. Efficacy of influenza vaccine in nursing homes: reduction in illness and complications during an influenza A (H3N2) epidemic. JAMA. 1985;253:1136–1139. Simonsen L, Clarke MJ, Williamson GD, et al. The impact of influenza epidemics on mortality: introducing a severity index. Am J Public Health.1997;87:1944–1950. Sullivan KM, Monto AS, Longini IM Jr. Estimate of the US health impact of influenza. Am J Public Health. 1993;83: 1712–1716. Taubenberger JK, Reid AH, Lourens RM, et al. Characterization of the 1918 influenza virus polymerase genes. Nature. 2005;437:889–893. U.S. Census Bureau. U.S. and world population clocks. «http://www.census.gov/main/www/popclock.html». Accessed July 30, 2008. WHO (World Health Organization). Cumulative number of confirmed human cases of avian influenza A (H5N1) reported to WHO, April 8, 2008. «http://www.who.int/csr/ disease/avian_influenza/country/cases_table_2008_04_08/ en/index.html». Accessed Aug. 8, 2008. Disclosure: Robert Belshe, MD, has received grant/research support from Merck, has served as a consultant for MedImmune and Merck, and has served on the speaker’s bureau for sanofi-aventis, Merck, and MedImmune. He reports having been compensated for work related to the influenza virus vaccine live, intranasal (FluMist), the influenza virus vaccine suspension for intramuscular injection (Fluzone), and an investigational product from Merck. IMMUNIZATION STRATEGIES / MANAGED CARE 7 http://www.cdc.gov/flu/keyfacts.htm http://www.cdc.gov/flu/keyfacts.htm http://www.cdc.gov/flu/weekly http://www.cdc.gov/flu/weekly http://www.census.gov/main/www/popclock.html http://www.cdc.gov/flu/professionals/diagnosis/rapidlab.htm http://www.cdc.gov/flu/professionals/diagnosis/rapidlab.htm http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_04_08/en/index.html http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_04_08/en/index.html http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_04_08/en/index.html
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