Combating Influenza with Antiviral Therapy in the Pediatric Population

Abstract

Influenza viruses are accountable for annual epidemics worldwide that result in significant morbidity and mortality. In preschool and school-aged children, prospective surveillance of influenza demonstrates yearly infection rates of 15-42%. Children can easily transmit the virus to other children, to employees in day-care and school settings, and to family members. Two classes of antiviral drugs, the adamantine derivatives (amantadine, rimantadine) and neuraminidase inhibitors (zanamivir and oseltamivir), have been approved for treatment and prophylaxis of influenza in the pediatric population. Duration of clinical symptoms decreases and daily activities are resumed sooner when therapy is begun within 48 hours of the onset of influenza symptoms. Mechanism of action, adverse effects, and development of resistant variants differ between the two drug classes. To our knowledge, head-to-head clinical trials between the classes and involving the neuraminidase inhibitors are nonexistent. Antiviral agents do not replace the annual influenza vaccine, and clinical trials indicate that amantadine, rimantadine, zanamivir, and oseltamivir are safe and effective for administration in the pediatric population.

Evaluation of a novel micro/nanofluidic chip platform for the detection of influenza A and B virus in patients with influenza-like illness

“…Pathogen diagnosis of influenza-like illness (ILI) has received increasing attention due to outbreaks of influenza and increased threat to human health from avian influenza (Bedford et al 2015; Li et al 2014; Zhu et al 2019). Prompt and accurate detection of influenza virus is essential for patients with ILI, which helps to avoid unnecessary use of antibiotic therapy and to prevent nosocomial transmission of influenza virus (Neuzil et al 2000; Townsend and Eiland 2006). Here, we introduced a novel micro/nanofluidic chip platform (MNCP) for influenza virus identification and its value in clinical application was evaluated by comparing MNCP with a rapid influenza diagnostic test (RIDT) and real-time reverse transcription polymerase chain reaction (rRT-PCR).…”

Molecular Dynamics Analysis of Antibody Recognition and Escape by Human H1N1 Influenza Hemagglutinin

“…Humans fight influenza infection through innate and adaptive immune responses (6) including vaccination or use of pharmaceutical drugs such as Tamiflu or Relenza (7). The adaptive immune response involves the recognition of HA epitopes by human immune cells and the production of antibodies against HA.…”

Canadian Acute Respiratory Illness and Flu Scale (CARIFS) for Clinical Detection of Influenza in Children

“…Early treatment with neuraminidase inhibitors, such as oseltamivir, has been associated with reductions in symptom duration, risk of complications (such as secondary pneumonia and secondary bacterial infections) and frequency of hospitalizations, emergency department (ED), and clinic visits. [6][7][8] Use of neuraminidase inhibitors is especially important in children with asthma and other highrisk respiratory conditions, as it decreases rates of related complications from influenza infection. Therefore, early identification and treatment has great potential to improve morbidity and mortality in children infected with influenza.…”