Influenza

Zusammenfassung

Die Influenza tritt seit vielen hundert Jahren epidemisch und pandemisch auf. Die letzte Pandemie 2009 verlief weniger schwer als befürchtet, die Zahl der gemeldeten Todesfälle mit bestätigter Influenzainfektion war niedrig. Aktuelle Analysen zeigen, dass die Schwere der Pandemie eher unterschätzt wurde. Zusätzlich sind klinische Daten publiziert, die den Einsatz einer antiviralen Therapie bei schwer kranken Influenza-Patienten unterstützen. Neue quadrivalente Impfstoffe wurden entwickelt, da sich die beiden zirkulierenden Influenza-B-Varianten zunehmend divergent entwickeln. Diese Vakzinen werden von der WHO ausdrücklich empfohlen. Auch zur Frage der Narkolepsie nach adjuvantierter Influenza-Impfung sind neue Daten publiziert. Aviäre Viren sind in alle Pandemien des 20. Jahrhunderts involviert gewesen; die Surveillance dieser Viren wird als wichtiges Instrument zur Verhinderung schwerer Pandemien gesehen. In diesem Jahr ist ein neuer Virusstamm, H7N9, von Vögeln auf Menschen übertragen worden, bisher ohne weitere relevante Übertragung von Mensch zu Mensch. Dieser Stamm zeigt geringe Pathogenität bei Vögeln und stellt deshalb für die Surveillance eine besondere Herausforderung dar.

Abstract

Yearly epidemics and occasional pandemics with Influenza have been observed for several hundred years. During the last pandemic the reported deaths due to confirmed influenza was lower than expected. New epidemiologic analyses demonstrate that the severity has probably been underestimated. In addition, cohort data from severely ill patients support the use of neuraminidase inhibitors in complicated influenza infections. Due to the increasing divergence of the two circulation Influenza B strains, WHO has recommended a quadrivalent vaccine. Several quadrivalent vaccines have been successfully developed. The association of adjuvanted 2009 pandemic vaccine and narcolepsy is still debated, new data from several countries contribute to this discussion. Avian viruses have fuelled all pandemics since 1918. Surveillance of avian influenza viruses is thus regarded essential for pandemic preparedness. In 2013 a new avian influenza virus, H7N9 has cause human infections and deaths. This new strain has low pathogenicity in birds and thus surveillance is especially challenging.

Schlüsselwörter

Influenza - aviäre Influenza - Pandemie - Neuraminidaseinhibitor - Impfung

Keywords

influenza - avian influenza - pandemic - neuraminidase inhibitor - immunisation

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