Influenza – Related resources

Cochrane reviews

• Influenza vaccines appear to have a modest effect in reducing influenza symptoms and working days lost in healthy adults, but there is no evidence that they affect complications, such as pneumonia, or transmission .
• Influenza vaccines are efficacious in children older than two years but little evidence is available for children under two .
• Neuraminidase inhibitors are effective in shortening illness duration and hastening return to normal activity in previously healthy children with a clinical or laboratory diagnosis of influenza .
• Influenza vaccine seems unlikely to worsen asthma, but research is needed to determine whether asthma attacks are prevented by influenza vaccination .
• Paediatric oncology patients receiving chemotherapy appear to be able to generate an immune response to the influenza vaccine. However, it remains unclear whether this immune response protects them from influenza infection or its complications .

Other evidence summaries

• Early use of neuraminidase inhibitors in patients with severe H1N1 pandemic influenza may decrease admissions to intensive care units and improve survival .
• The protection rate against influenza appers not to decrease over years when vaccination is given annually . Both patient-focused and provider-focused interventions appear to be effective, probably with an additive effect when used simultaneously .
• Influenza vaccination in healthy people aged 65-74 years may reduce the rate of self-reported influenza-like illness but may not reduce GP attendance for such illness .

• Glezen WP. Clinical practice. Prevention and treatment of seasonal influenza. N Engl J Med 2008 Dec 11;359(24):2579-85.
• Gambotto A, Barratt-Boyes SM, de Jong MD, Neumann G, Kawaoka Y. Human infection with highly pathogenic H5N1 influenza virus. Lancet 2008 Apr 26;371(9622):1464-75.
• Management of Influenza in the Southern Hemisphere Trialists Study Group. Randomised trial of efficacy and dafety of inhaled zanamivir in treatment of influenza A and B virus infection. Lancet 1998;352:1877–1881
• Nicholson KG, Aoki FY, Osterhaus AD, Trottier S, Carewicz O, Mercier CH, Rode A, Kinnersley N, Ward P. Efficacy and safety of oseltamivir in treatment of acute influenza: a randomised controlled trial. Neuraminidase Inhibitor Flu Treatment Investigator Group. Lancet 2000 May 27;355(9218):1845-50.
• Kaiser L, Keene ON, Hammond JM, Elliott M, Hayden FG. Impact of zanamivir on antibiotic use for respiratory events following acute influenza in adolescents and adults. Arch Intern Med 2000 Nov 27;160(21):3234-40.
• Cox NJ, Subbarao K. Influenza. Lancet 1999 Oct 9;354(9186):1277-82.
• Heikkinen T, Silvennoinen H, Peltola V, Ziegler T, Vainionpaa R, Vuorinen T, Kainulainen L, Puhakka T, Jartti T, Toikka P, Lehtinen P, Routi T, Juven T. Burden of influenza in children in the community. J Infect Dis 2004 Oct 15;190(8):1369-73.
• Moscona A. Neuraminidase inhibitors for influenza. N Engl J Med 2005 Sep 29;353(13):1363-73.
• Rothberg MB, Haessler SD, Brown RB. Complications of viral influenza. Am J Med 2008 Apr;121(4):258-64.