Williams James M
Methodist Specialty & Transplant Hospital, San Antonio, TX, USA.
Curr Med Res Opin. 2009 Apr;25(4):817-28. doi: 10.1185/03007990802708244.
Influenza A and B virus infections account for substantial morbidity and mortality and adversely affect quality of life and productivity in millions of Americans every year. Because of antigenic drifts and shifts, influenza is difficult to manage, presenting primary care clinicians with two major challenges every year: 'Who should be vaccinated?' and 'How should patients who present with symptoms of influenza be managed?'
A search from 1995 to 2008 of the National Library of Medicine, the Cochrane Database of Systematic Reviews, the US Centers for Disease Control and Prevention (CDC) website, and the reference lists of retrieved articles was conducted to identify the most current and relevant information to address these two major challenges and the questions they generate in primary care. Emphasis was placed on influenza vaccination and antiviral agents.
In all, 275 articles met the search criteria. Emphasis was placed on recommendations developed by the Advisory Committee on Immunization Practices for 2008-2009, as well as several advisories issued by the US Food and Drug Administration and the US CDC.
Eighty-five percent of the US population is eligible for influenza vaccination. Several measures have been demonstrated to improve vaccination rates. Diagnosis of influenza should be confirmed with testing such as a rapid viral test. Management of persons with influenza includes treatment with neuraminidase inhibitors and symptom-specific therapy.
The implementation of more aggressive measures is needed in the primary care setting to prevent and treat influenza.
甲型和乙型流感病毒感染导致大量发病和死亡，每年对数百万美国人的生活质量和生产力产生不利影响。由于抗原漂移和转变，流感难以控制，每年给基层医疗临床医生带来两大挑战：“谁应该接种疫苗？”以及“出现流感症状的患者应如何处理？”
检索了1995年至2008年的美国国立医学图书馆、考克兰系统评价数据库、美国疾病控制与预防中心（CDC）网站以及检索文章的参考文献列表，以确定解决这两大挑战及其在基层医疗中引发问题的最新和相关信息。重点关注流感疫苗接种和抗病毒药物。
共有275篇文章符合检索标准。重点关注了免疫实践咨询委员会制定的2008 - 2009年建议，以及美国食品药品监督管理局和美国疾病控制与预防中心发布的多项咨询意见。
85%的美国人口有资格接种流感疫苗。已证明多项措施可提高疫苗接种率。流感诊断应通过快速病毒检测等检测加以确认。流感患者的处理包括使用神经氨酸酶抑制剂治疗和对症治疗。
在基层医疗环境中需要采取更积极的措施来预防和治疗流感。
