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US Respiratory Disease 2011;7(1):49-52
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Influenza kills approximately 3,000 to 49,000 Americans per year1 and the potential for a pandemic—as seen in 1918, 1957, 1968, and 2009—looms large and has prompted the US government, healthcare facilities, and healthcare workers to undertake extensive pandemic preparation. Activities include hospital planning, vaccination schedules, as well as antiviral medication stockpiling. To this last end, the US government has developed a Strategic National Stockpile (SNS) of antiviral medications for use during a pandemic for treatment as well as prophylaxis.
However, clinical practice with seasonal influenza is varied and falls short of the competence needed in a pandemic or severe seasonal outbreak, as evidenced by several cases in which antiviral therapy administration to patients was delayed during the 2009 H1N1 pandemic.2 Moreover, the current state of resistance of both H1N1 and H3N2 influenza A isolates to various classes of drugs has become cumbersome for clinicians to comprehend and the knowledge of some virulence-enhancing features of influenza strains is not well known to clinicians. This review will present some of the most important new developments in the clinical management of influenza.