Influenza vaccines respiratory disease

Influenza. The ACIP recommends annual influenza vaccination for all persons who are at risk from infections of the lower respiratory tract and for all older persons. Influen2a vimses types A and B are responsible for periodic outbreaks of febrile respiratory disease. 

Adults at high risk for certain diseases (eg, pneumocoacal and influenza vaccines for individuals with serious respiratory disorders)... 

Haemophilus influenzae is a bacterial respiratory pathogen that causes a wide spectrum of disease ranging from colonization of the airways to bacterial meningitis. It causes considerable morbidity and mortality, especially in children less than 5 years of age. H. influenzae is either encapsulated or unencapsulated. The encapsulated strains can be further differentiated into six antigenically distinct serotypes, a through f. H. influenzae type b was primarily found in cerebrospinal fluid and blood of children with meningitis, while the unencapsulated strains were found in the upper respiratory tract of adults. Before the introduction of the vaccine, H. influenzae was responsible for 20,000 to 25,000 cases of invasive disease annually and was the most common cause of bacterial meningitis. Since the introduction of the vaccine, invasive disease due to H. influenzae type b has been nearly eliminated. 

The trivalent inactivated influenza vaccine can be administered to all age groups and risk populations. It is recommended that the vaccine be administered yearly to children older than 6 months of age at risk for complications from influenza, such as those with asthma, cardiac disease, sickle cell disease, human immunodeficiency virus (HIV) infection, diabetes, and other conditions that compromise respiratory function. Healthy children 6 to 23 months of age should be vaccinated because of the increased risk for influenza-related... 

Influenza vaccine should be given yearly to all adults 50 years of age or older. Younger adults with chronic disorders of the cardiovascular or pulmonary systems, chronic metabolic diseases, renal dysfunction, immunosuppression, or disorders that compromise respiratory function should also be vaccinated. Women who will be pregnant during the winter months should be vaccinated against influenza. 

Composition and Methods of Manufacture. Two types of influenza viruses, A and B, are responsible for causing periodic outbreaks of febrile respiratory disease. The manufacture of an effective vaccine is complicated by antigenic variation or drift, which can occur from year to year within the two vims types, making the previous year s vaccine less effective. Each year, antigenic characterization is important for selecting the vims strains to be included in the vaccine. 

Making the influenza vaccine is a highly seasonal business, and when the virus strain of the year is identified one needs the production apparatus to produce 20 to 100 million doses of this relatively simple and cheap viral vaccine. When the strain is mistakenly identified as it was in the 2003-2004 season, there is no time to regear. One has to hope for some cross-reactivity of the immune response to the vaccine with the real virus. Much depends on a good flu vaccine or drug today when the population s average age is high and heart and respiratory disease are prevalent. While influenza is serious in most patients, it can be lethal in those who are compromised by age and heart or respiratory disease. The flu is a big health concern and big business. 

In a study of the interaction between 23-valent pneumococcal polysaccharide vaccine and influenza vaccine, 152 adults with chronic respiratory disease were... 

Fletcher TJ, Tunnicliffe WS, Hammond K, Roberts K, Ayres JG. Simultaneous immunisation with influenza vaccine and pneumococcal polysaccharide vaccine in patients with chronic respiratory disease. BMJ 1997 314(7095) 1663-5. 

Neuraminidase inhibitors inhibit an enzyme, neuraminidase, that is produced by virus infected cells and which helps viruses to leave infected host cells. Zanamivir and oselta-mivir are examples, which are used to treat influenza A and B in vulnerable individuals (those over 65 years or those with chronic respiratory disease, cardiovascular disease, renal disease, immunosuppression or diabetes). They must be used within a few hours and up to 48 hours of onset of symptoms to be effective. However, vaccination against influenza is considered the most effective way of preventing influenza and drugs should not be seen as a substitute. There are NICE guidelines on the use of zanamivir and oseltamivir. 

Fioutjne immunization of infants and chiidren (see Rg. 54-1) Immunization of adults against tetanus Adults at high risk for certain diseases (eg, pneumococcal and influenza vaccines for individuals with serious respiratory disorders) Children or adults at risk for exposure to a partioilar disease (, hepatitis B for health care workers)... 

Because influenza vaccine contains only noninfectious viruses, it cannot cause influenza. Respiratory disease after vaccination represents coincidental illness unrelated to influenza vaccination. The most frequent side effect of vaccination is soreness at the vaccination site that lasts up to 2 days (86-88). These local reactions generally are mild and rarely interfere with the ability to conduct usual daily activities. In addition, two types of systemic reactions have occurred ... 

Any respiratory infections associated with the disease should be treated with antibiotics and followed by preventive measures (such as vaccination against influenza virus, avoidance of large crowds, and avoidance of people with obvious respiratory infections) in order to prevent the subsequent development of new infections. The patient should also be placed on a dietary regimen that will maintain adequate nutrition and hydration of bronchial secretions. 

The first effective and safe treatments for Alzheimer s, Parkinson s, chronic graft rejection, permanent graft acceptance, obesity, chronic obstructive pulmonary disease (COPD), adult respiratory distress syndrome (ARDS), sepsis, and vaccines [common cold, respiratory syncytial virus (RSV), severe acute respiratory syndrome (SARS), AIDS, malaria. Avian Influenza, radiation, contraception, emerging new infections] will be multibillion-dollar products [15,16]. 

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