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Published on: December 1, 2017
Influenza guideline for South Africa--update 2008
Summary
This guideline updates influenza management for South Africa, recommending specific 2008 vaccines and reserving neuraminidase inhibitors for high-risk patients. It also includes new data on treatment and pediatric influenza.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- The South African Thoracic Society (SATS) previously published an influenza management guideline in 1999.
- Influenza viruses, particularly Type A, pose significant clinical and epidemiological challenges due to antigenic variation in their surface proteins (HA and NA).
- Antigenic drift in the haemagglutinin (HA) protein allows influenza viruses to evade host immune responses, necessitating regular vaccine updates.
Purpose of the Study:
- To revise the 1999 Guideline for Influenza Management in Adults.
- To incorporate the specific viral strains for the 2008 influenza vaccine.
- To include updated information on influenza treatment, pediatric influenza, and management strategies for HIV-infected individuals.
Main Methods:
- Review and synthesis of current data on influenza virology, vaccination, and treatment.
- Identification of recommended influenza vaccine strains for the 2008 season.
- Inclusion of specific recommendations for managing influenza in children and HIV-infected individuals.
Main Results:
- The recommended influenza vaccine formulation for 2008 includes A/Solomon Islands/3/2006 (H1N1), A/Brisbane/10/2007 (H3N2), and B/Florida/4/2006 or B/Brisbane/3/2007.
- Influenza vaccination is recommended for high-risk individuals, including those with chronic medical conditions and immunosuppressed individuals (e.g., HIV-infected persons).
- Neuraminidase (NA) inhibitors are recommended as an adjunct for influenza prevention and treatment but should be reserved for high-risk or severely ill patients due to resistance concerns. Amantadine and rimantadine are not recommended for influenza A treatment or prophylaxis.
Conclusions:
- The revised guideline provides updated recommendations for influenza prevention and management in South Africa for 2008.
- Vaccination remains the primary strategy for influenza prevention, particularly for high-risk populations.
- Judicious use of antiviral agents like NA inhibitors is crucial for effective influenza treatment while mitigating resistance.
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