[Influenza: prevention and treatment]

Prevention of influenza for persons at risk with inactivated vaccine remains the best way for attenuating the impact of influenza epidemics if persons to be vaccinated are correctly identified. In current recommendations, the lower cut off age is controversial, but new arguments on mortality associated with influenza suggest to lower the age to 45 for vaccination. Moreover immunization of health care workers is essential by decreasing transmission to susceptible patients and by reducing absenteeism of essential people during epidemics. Intranasal attenuated live vaccine seems to be of particular importance essentially in children and could replace the current vaccine in a near future. The role of chemoprophylaxis by inhibitors of neuraminidase needs further studies, but preliminary controlled trials have demonstrated a certain efficacy by controlling outbreaks in health care institutions. Treatment of influenza by these latter antivirals already has defined indications and a larger use currently lies on convincing arguments. By reducing inappropriate use of antibiotics, an extended use of neuraminidase inhibitors is of particular interest even if it is not a valuable argument, stricto sensu, for good medical practices.