Influenza
Identifieur interne : 000C74 ( Pmc/Curation ); précédent : 000C73; suivant : 000C75Influenza
Auteurs : Tom JeffersonSource :
- BMJ Clinical Evidence [ 1752-8526 ] ; 2009.
Abstract
During the autumn-winter months (influenza seasons), influenza circulates more frequently, causing a greater proportion of influenza-like illness, and sometimes serious seasonal epidemics. The incidence of infection depends on the underlying immunity of the population.
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of vaccines to prevent influenza? What are the effects of antiviral chemoprophylaxis of influenza? What are the effects of antiviral medications to treat influenza? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: vaccines, amantadine, oseltamivir, zanamivir, rimantadine.
Url:
PubMed: 19445759
PubMed Central: 2907815
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Influenza</title><author><name sortKey="Jefferson, Tom" sort="Jefferson, Tom" uniqKey="Jefferson T" first="Tom" last="Jefferson">Tom Jefferson</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19445759</idno><idno type="pmc">2907815</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907815</idno><idno type="RBID">PMC:2907815</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000C74</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000C74</idno><idno type="wicri:Area/Pmc/Curation">000C74</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000C74</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Influenza</title><author><name sortKey="Jefferson, Tom" sort="Jefferson, Tom" uniqKey="Jefferson T" first="Tom" last="Jefferson">Tom Jefferson</name></author></analytic><series><title level="j">BMJ Clinical Evidence</title><idno type="eISSN">1752-8526</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>During the autumn-winter months (influenza seasons), influenza circulates more frequently, causing a greater proportion of influenza-like illness, and sometimes serious seasonal epidemics. The incidence of infection depends on the underlying immunity of the population.</p></sec><sec><title>Methods and outcomes</title><p>We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of vaccines to prevent influenza? What are the effects of antiviral chemoprophylaxis of influenza? What are the effects of antiviral medications to treat influenza? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).</p></sec><sec><title>Results</title><p>We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. </p></sec><sec><title>Conclusions</title><p>In this systematic review we present information relating to the effectiveness and safety of the following interventions: vaccines, amantadine, oseltamivir, zanamivir, rimantadine.</p></sec></div></front></TEI><pmc article-type="review-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMJ Clin Evid</journal-id><journal-id journal-id-type="iso-abbrev">BMJ Clin Evid</journal-id><journal-id journal-id-type="publisher-id">Clinical Evidence</journal-id><journal-title-group><journal-title>BMJ Clinical Evidence</journal-title></journal-title-group><issn pub-type="epub">1752-8526</issn><publisher><publisher-name>BMJ Publishing Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19445759</article-id><article-id pub-id-type="pmc">2907815</article-id><article-id pub-id-type="publisher-id">0911</article-id><article-categories><subj-group subj-group-type="heading"><subject>Infectious Diseases</subject></subj-group><subj-group subj-group-type="secondary-section"><subject>Social and Community Health</subject></subj-group></article-categories><title-group><article-title>Influenza</article-title><alt-title alt-title-type="abridged">Influenza</alt-title></title-group><contrib-group><contrib contrib-type="author" deceased="no"><name><surname>Jefferson</surname><given-names>Tom</given-names></name><aff><institution>Cochrane Vaccines Field</institution><addr-line>Rome</addr-line><country>Italy</country></aff></contrib></contrib-group><author-notes><fn><p>TJ is the co-author of some of the reviews cited in this review.</p><p><italic>We would like to acknowledge the previous contributors of this review, including Timothy Uyeki and Lucy Hansen.</italic></p></fn></author-notes><pub-date pub-type="epub"><day>12</day><month>3</month><year>2009</year></pub-date><pub-date pub-type="collection"><year>2009</year></pub-date><volume>2009</volume><elocation-id>0911</elocation-id><permissions><copyright-statement>© BMJ Publishing Group Ltd, All Rights Reserved</copyright-statement><copyright-year>2009</copyright-year></permissions><self-uri xlink:type="simple" xlink:href="http://www.clinicalevidence.bmj.com/ceweb/pmc/2009/03/911/">This article is available from http://www.clinicalevidence.bmj.com/ceweb/pmc/2009/03/911/</self-uri><abstract><sec><title>Introduction</title><p>During the autumn-winter months (influenza seasons), influenza circulates more frequently, causing a greater proportion of influenza-like illness, and sometimes serious seasonal epidemics. The incidence of infection depends on the underlying immunity of the population.</p></sec><sec><title>Methods and outcomes</title><p>We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of vaccines to prevent influenza? What are the effects of antiviral chemoprophylaxis of influenza? What are the effects of antiviral medications to treat influenza? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).</p></sec><sec><title>Results</title><p>We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. </p></sec><sec><title>Conclusions</title><p>In this systematic review we present information relating to the effectiveness and safety of the following interventions: vaccines, amantadine, oseltamivir, zanamivir, rimantadine.</p></sec></abstract><abstract abstract-type="key-points"><title>Key Points</title><p>Influenza viruses are constantly altering their antigenic structure, and every year the WHO recommends which strains of influenza should be included in vaccines.
<list list-type="bullet"><list-item><p>During the autumn-winter months, influenza circulates more frequently (influenza seasons), causing a greater proportion of influenza-like illness, and sometimes serious seasonal epidemics.</p></list-item><list-item><p>The incidence of infection depends on the underlying immunity of the population.</p></list-item></list></p><p>When a significantly different form of influenza occurs by mutation, it can greatly increase infection rates, as well as morbidity and mortality (a pandemic).</p><p>Influenza and influenza-like illness (caused by a range of other viruses) are clinically indistinguishable.
<list list-type="bullet"><list-item><p>Trials of vaccines assess how to prevent the symptoms and consequences of both, as well as infection rates.</p></list-item></list></p><p><xref ref-type="sub-article" rid="BMJ_0911_I6">Vaccines</xref> are effective in reducing infection and school absence in children over 2 years old, but there is no evidence that they reduce transmission, hospitalisation, pneumonia, or death.</p><p>Live or inactivated vaccines are effective in reducing infection and in slightly reducing absence from work in adults, but there is no evidence that they reduce transmission, hospitalisation, pneumonia, or death.</p><p>There is poor-quality evidence from cohort studies that vaccines are effective in elderly people living in institutions, but there is little good-quality evidence for the elderly population in general.</p><p><xref ref-type="sub-article" rid="BMJ_0911_I3">Zanamivir</xref> and <xref ref-type="sub-article" rid="BMJ_0911_I4">oseltamivir</xref> provide symptomatic relief, or prevent symptoms if administered early in the disease, but do not prevent infection.
<list list-type="bullet"><list-item><p>Zanamivir and oseltamivir interrupt household transmission of seasonal influenza, prevent hospitalisations, and reduce, but do not suppress, viral excretion from the nose.</p></list-item><list-item><p>These agents cause fewer adverse effects than amantadine and rimantadine, and there is less evidence of resistance.</p></list-item></list></p><p>Although <xref ref-type="sub-article" rid="BMJ_0911_I1">amantadine</xref> and <xref ref-type="sub-article" rid="BMJ_0911_I2">rimantadine</xref> provide symptomatic relief or prevent symptoms if administered early in influenza A, they engender viral resistance.
<list list-type="bullet"><list-item><p>Amantadine and rimantadine do not prevent infection and transmission, and cause harms, especially in a prophylactic role.</p></list-item></list></p><p>Amantadine was ineffective in the 1968-1969 pandemic, and zanamivir, oseltamivir, and newer vaccines are untested in a pandemic.</p><p>Symptomatic relief with echinacea, vitamin C, and decongestants in influenza-like illness is covered in the review on the common cold.</p><p>Single studies reporting data for one or two seasons are difficult to interpret, and not easy to generalise from, because of the marked variability of viral circulation.</p></abstract><counts><table-count count="13"></table-count><ref-count count="40"></ref-count></counts></article-meta><notes notes-type="disclaimer"><sec><title>Disclaimer</title><p>The information contained in this publication is intended for medical professionals. Categories presented in Clinical Evidence indicate a judgement about the strength of the evidence available to our contributors prior to publication and the relevant importance of benefit and harms. We rely on our contributors to confirm the accuracy of the information presented and to adhere to describe accepted practices. Readers should be aware that professionals in the field may have different opinions. Because of this and regular advances in medical research we strongly recommend that readers' independently verify specified treatments and drugs including manufacturers' guidance. Also, the categories do not indicate whether a particular treatment is generally appropriate or whether it is suitable for a particular individual. Ultimately it is the readers' responsibility to make their own professional judgements, so to appropriately advise and treat their patients.To the fullest extent permitted by law, BMJ Publishing Group Limited and its editors are not responsible for any losses, injury or damage caused to any person or property (including under contract, by negligence, products liability or otherwise) whether they be direct or indirect, special, incidental or consequential, resulting from the application of the information in this publication.</p></sec></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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