Zanamivir: a rational approach to influenza B

Influenza B viruses have co-circulated with the HIN1 and H3N2 subtypes of influenza A since 1977. Influenza A viruses are found in various animals, whereas influenza B viruses are probably restricted to humans. The lack of an animal reservoir means that the virus has no potential for genetic reassortment across species. In addition, influenza B viruses are more serologically homogeneous than influenza A viruses. Thus, the chance of influenza B causing a pandemic is much lower than that of influenza A. However, influenza B viruses are still a frequent cause of local disease outbreaks and epidemics as a result of antigenic drift. Any prophylactic or therapeutic measure must, therefore, be effective against both influenza A and B viruses. Zanamivir is the first widely approved neuraminidase inhibitor for the treatment of influenza. It is delivered directly to the primary site of viral replication, the respiratory tract, and is well tolerated and effective in the treatment of both influenza A and B. Data in prophylaxis are also encouraging. Zanamivir is the only drug proven to be clinically effective against both influenza A and B virus infections.