Every winter, influenza makes many thousands of people ill, prevents them from working and places major demands on health care. In the UK, influenza causes at least 3000-4000 deaths in an average year, mainly in older people with chronic illness, and the figure can far exceed this during an epidemic year. Annual immunisation with inactivated strains of influenza virus, given before the flu season, is the main way of protecting those who would be at high risk if they became infected. [symbol: see text] Zanamivir (Relenza-GlaxoWellcome) is a new inhaled antiviral treatment, licensed for use in people aged 12 years and over who present with symptoms of influenza, when the virus is circulating in the community. The manufacturer claims that treatment with zanamivir "reduces the duration of flu by up to 40% compared with placebo" and, in trials, "resulted in a significant reduction in complications due to flu". The new National Institute for Clinical Excellence has evaluated zanamivir and advised against its use in the NHS for the present. Here, we discuss zanamivir and consider its place in the management of suspected influenza infection.
