Contemporary Concise Review 2024: Respiratory Infections

Since public health measures against COVID-19 were relaxed, widespread outbreaks of respiratory infections such as influenza and respiratory syncytial virus (RSV), as well as infectious diseases transmitted by droplets and droplet nuclei, have been reported around the world. While there is evidence of antiviral drug efficacy against non-severe influenza, the emergence of two genetic mutations (I223V or S247N) that reduce susceptibility to neuraminidase inhibitors has been confirmed. Influenza vaccines are less effective in older people than in younger people; so high-dose influenza vaccines are recommended. RSV infection has a high disease burden among elderly people; however, vaccination is expected to limit or prevent severe disease. Macrolide-resistant strains of Mycoplasma species and Bordetella pertussis are common in East Asia, but an increase in resistant strains has also been observed in other Asian regions. Pneumonia in elderly people often leads to a decline in physical function. In a super-aging society, aspiration pneumonia occurs frequently. Hence, there is increasing awareness of the need for advance care planning discussions for pneumonia as well as malignant diseases. The use of inhaled steroids in bronchiectasis is not recommended because of the increased risk of infection; but in clinical practice, inhaled steroids are frequently used and are effective in some patients with bronchiectasis.