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2017-2018 年度儿童流感预防和控制建议

Recommendations for Prevention and Control of Influenza in Children, 2017 - 2018.

出版信息

Pediatrics. 2017 Oct;140(4). doi: 10.1542/peds.2017-2550. Epub 2017 Sep 4.

Abstract

This statement updates the recommendations for routine use of the seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children. The American Academy of Pediatrics recommends annual seasonal influenza immunization for everyone 6 months and older, including children and adolescents. Highlights for the upcoming 2017-2018 season include the following:1. Annual universal influenza immunization is indicated with either a trivalent or quadrivalent (no preference) inactivated vaccine;2. The 2017-2018 influenza A (H1N1) vaccine strain differs from that contained in the 2016-2017 seasonal vaccines. The 2017-2018 influenza A (H3N2) vaccine strain and influenza B vaccine strains included in the trivalent and quadrivalent vaccines are the same as those contained in the 2016-2017 seasonal vaccines: a. trivalent vaccine contains an A/Michigan/45/2015 (H1N1)pdm09-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (B/Victoria lineage); and b. quadrivalent vaccine contains an additional B virus (B/Phuket/3073/2013-like virus [B/Yamagata lineage]);3. Quadrivalent live attenuated influenza vaccine (LAIV4) is not recommended for use in any setting in the United States during the 2017-2018 influenza season. This interim recommendation, originally made in 2016, followed observational data from the US Influenza Vaccine Effectiveness Network revealing that LAIV4 performed poorly against influenza A (H1N1)pdm09 viruses in recent influenza seasons;4. All children with an egg allergy of any severity can receive an influenza vaccine without any additional precautions beyond those recommended for any vaccine;5. All health care personnel should receive an annual seasonal influenza vaccine, a crucial step in preventing influenza and reducing health care-associated influenza infections, because health care personnel often care for individuals at high risk for influenza-related complications; and6. Pediatricians should attempt to promptly identify children suspected of having influenza infection for timely initiation of antiviral treatment, when indicated, to reduce morbidity and mortality. Best results are seen when treated within 48 hours of symptom onset.

摘要

本声明更新了关于季节性流感疫苗在儿童中的预防和治疗常规使用的建议。美国儿科学会建议所有 6 个月及以上的人,包括儿童和青少年,每年接种季节性流感疫苗。即将到来的 2017-2018 季节的重点包括以下内容:

  1. 无论是使用三价还是四价(无偏好)灭活疫苗,每年都要进行通用的流感免疫;

  2. 2017-2018 年甲型(H1N1)流感疫苗株与 2016-2017 年季节性疫苗中包含的疫苗株不同。2017-2018 年甲型(H3N2)流感疫苗株和三价和四价疫苗中包含的乙型流感疫苗株与 2016-2017 年季节性疫苗中包含的疫苗株相同:a. 三价疫苗含有 A/Michigan/45/2015(H1N1)pdm09 样病毒,A/Hong Kong/4801/2014(H3N2)样病毒和 B/Brisbane/60/2008 样病毒(B/Victoria 谱系);b. 四价疫苗含有额外的 B 病毒(B/Phuket/3073/2013 样病毒[B/Yamagata 谱系]);

  3. 不建议在 2017-2018 流感季节的美国任何环境中使用四价减毒活流感疫苗(LAIV4)。这一临时建议最初于 2016 年提出,是根据美国流感疫苗效力网络的观察数据做出的,该数据显示,在最近的流感季节中,LAIV4 对甲型(H1N1)pdm09 病毒的效果不佳;

  4. 所有有任何严重程度鸡蛋过敏的儿童都可以接种流感疫苗,而无需采取任何超出任何疫苗建议的额外预防措施;

  5. 所有医护人员都应每年接种季节性流感疫苗,这是预防流感和减少与医疗保健相关的流感感染的关键步骤,因为医护人员通常会照顾有流感相关并发症高风险的个人;

  6. 儿科医生应尽快识别疑似患有流感感染的儿童,以便及时开始抗病毒治疗,以降低发病率和死亡率。最好在症状出现后 48 小时内进行治疗。

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