[International trends in influenza control: preparing for the next pandemic and vaccination]

The prevention of influenza continues to be a major public health concern, and a program of vaccination has been promoted, especially to high-risk individuals such as the elderly. In addition, concerted efforts are being expended in many developed countries in order to better cope with the next influenza pandemic. These efforts include enhancing influenza virus surveillance, improving vaccine production and its delivery systems, centralizing vaccine distribution and establishing priorities, etc. In Japan, on the other hand, influenza is only considered a minor illness, and thus little attention has been give to measures against influenza. To disseminate information on recent international trends in influenza control to Japanese public health specialists, I herein outline the recommendations made at two recent international meetings: "Pandemic Influenza: Confronting a Reemergent Threat" held in the u.s., at Bethesda, Maryland, in December 1995; and "The 7th European Meeting of Influenza and Its Prevention" held in Berlin. Germany, in September 1993. Since a routine system capable of responding adequately to annual epidemics is considered to be the best defense against a pandemic, I also describe the present state of influenza control in other countries to contrast it with that in Japan: the target groups for special vaccination programs recommended by the U.S. Advisory Committee on Immunization Practices; the recommendations for influenza vaccination and reimbursement for the vaccination of recommended groups in developed countries: and influenza vaccine distribution in Japan and the U.S., 1980-1994. At present in Japan, the efficacy of the currently used inactivated vaccine is regarded as either very low or none at all. There is also no official national recommendations as to what groups should be targeted for active immunization, nor any system for vaccination reimbursement. Public health specialists in Japan, therefore need to fully understand Japan's peculiar situation and, as a result, better recognize the importance of influenza and its prevention.