Influenza, influenza vaccine, and amantadine/rimantadine.
Influenza, influenza vaccine, and amantadine/rimantadine.
复制标题
流感、流感疫苗和金刚烷胺/金刚乙胺。
作者：
R. Zimmerman;F. Ruben;E. Ahwesh
流感病毒是具有高度传染性的病毒，通常通过空气传播途径在人与人之间传播。半封闭或拥挤环境中的人员，例如学生和疗养院居民，接触风险很高。儿童的患病率每年在 14% 至 40% 之间。患有慢性阻塞性肺病、心血管疾病和糖尿病等慢性疾病的人的死亡率最高，尤其是老年人。流感疫苗在预防或减轻疾病方面的有效性各不相同，主要取决于（1）疫苗中包含的病毒株与流感季节期间传播的病毒株之间的相似程度，以及（2）疫苗接种者的年龄和免疫能力。当疫苗和流行病毒之间存在良好匹配时，流感疫苗已被证明可以预防约 70% 至 90% 的 65 岁以下健康人患病。流感疫苗接种后的不良事件包括注射部位的轻微局部反应（高达 20%），以及约 1% 的接种者偶尔发烧。尽管有有效的疫苗，但 1994 年，只有 55% 65 岁及以上的人报告接种了流感疫苗。65 岁以下患有高危疾病的人的疫苗接种水平甚至更低。提高疫苗接种率的重要程序包括 (1) 评估诊所或医疗机构当前的疫苗接种率，(2) 确定疫苗接种的目标人群，(3) 制定具体目标（即要免疫的目标人群的百分比），(4) 制定行动计划，以及 (5) 向个别医生提供有关其患者的疫苗接种率的持续反馈。
Influenza viruses are highly contagious viruses that are transmitted from person to person, usually by the airborne route. Persons in semi-closed or crowded environments, such as students and residents of nursing homes, are at high risk of exposure. The illness attack rate in children ranges from 14% to 40% yearly. Fatality rates are highest in persons who have chronic medical conditions, such as chronic obstructive lung disease, cardiovascular disease, and diabetes mellitus, particularly if they are elderly. The effectiveness of influenza vaccine in preventing or attenuating illness varies, depending primarily on (1) the degree of similarity between the virus strains included in the vaccine and those that circulate during the influenza season, and (2) the age and immunocompetence of the vaccine recipient. When there is a good match between vaccine and circulating viruses, influenza vaccine has been shown to prevent illness in approximately 70% to 90% of healthy persons less than 65 years of age. Adverse events following influenza vaccine include mild, local reactions at the injection site (up to 20%) and occasionally fever in approximately 1% of vaccinees. Despite the availability of an effective vaccine, only 55% of persons 65 years of age and older reported receiving influenza vaccine in 1994. Vaccination levels are even lower in persons less than 65 years of age with high-risk medical conditions. Important procedures to improve vaccination rates are (1) assessment of a practice's or medical facility's current vaccination rates, (2) identification of target populations for vaccination, (3) formation of a specific goal (ie, percentage of target population to be immunized), (4) development of a plan of action, and (5) provision of ongoing feedback to the individual physicians about vaccination rates of their own patients.