J Korean Med Assoc.  2010 Jan;53(1):43-51. 10.5124/jkma.2010.53.1.43.

The Diagnosis and Treatment of Influenza

• Lee CS

• KMID: 2188232
• DOI: http://doi.org/10.5124/jkma.2010.53.1.43

Abstract

Influenza viruses cause annual epidemics and occasional pandemics that have claimed the millions of lives. On December 4th 2009, more than 207 countries and overseas territories have reported laboratory confirmed cases of pandemic influenza H1N1 2009, which has claimed at least 8768 lives. Up to this date, the pandemic influenza H1N1 2009 has spread throughout the world with unprecedented speed. Accurate and rapid diagnosis of this influenza virus is critical for minimizing further spread, combined with timely implementation of antiviral treatment and public health based measures. Recently, the percentage of oseltamivir-resistant human seasonal H1N1 has increased to 98.5% in USA, and 99.8% in Korea. Fortunately, the pandemic influenza H1N1 2009 is sensitive to neuraminidase inhibitors, including oseltamivir. However, the percentage oseltamivir-resistant pandemic influenza H1N1 2009 is expected to increase with time. In this review, the various diagnostic method and the antiviral agents that have been reported in the literature will be discussed.

Keyword

Influenza; Pandemic; Diagnosis; Treatment

MeSH Terms

Antiviral Agents
Humans
Influenza, Human
Korea
Neuraminidase
Orthomyxoviridae
Oseltamivir
Pandemics
Public Health
Seasons
Antiviral Agents
Neuraminidase
Oseltamivir

Reference

1. Schnitzler SU, Schnitzler P. An update on swine-origin influenza virus a/h1n1: A review. Virus Genes. 2009. 10. 07. [Epub ahead of print].

2. Wright PF, Neumann G, Kawaoka Y. Orthomyxoviruses. Fields' Virology. 2007. 5th ed. New York: Wolters Kluwer Health, Lippincott Williams & Wilkins;1691–1740.

3. Dawood FS, Jain S, Finelli L, Shaw MW, Lindstrom S, Garten RJ, Gubareva LV, Xu X, Bridges CB, Uyeki TM. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med. 2009. 360:2605–2615.

4. Zimmer SM, Burke DS. Historical perspective-emergence of influenza A (H1N1) viruses. N Engl J Med. 2009. 361:279–285.

5. Shinde V, Bridges CB, Uyeki TM, Shu B, Balish A, Xu X, Lindstrom S, Gubareva LV, Deyde V, Garten RJ, Harris M, Gerber S, Vagasky S, Smith F, Pascoe N, Martin K, Dufficy D, Ritger K, Conover C, Quinlisk P, Klimov A, Bresee JS, Finelli L. Triple-reassortant swine influenza A (H1) in humans in the united states, 2005~2009. N Engl J Med. 2009. 360:2616–2625.

6. Morens DM, Taubenberger JK, Fauci AS. The persistent legacy of the 1918 influenza virus. N Engl J Med. 2009. 361:225–229.

7. Kluska V, Macku M, Mensik J. Demonstration of antibodies against swine influenza viruses in man. Cesk Pediatr. 1961. 16:408–414.

8. Carrat F, Vergu E, Ferguson NM, Lemaitre M, Cauchemez S, Leach S, Valleron AJ. Time lines of infection and disease in human influenza: A review of volunteer challenge studies. Am J Epidemiol. 2008. 167:775–785.

9. Doyle WJ, Skoner DP, Hayden F, Buchman CA, Seroky JT, Fireman P. Nasal and otologic effects of experimental influenza a virus infection. Ann Otol Rhinol Laryngol. 1994. 103:59–69.

10. Hobbins TE, Hughes TP, Rennels MB, Murphy BR, Levine MM. Bronchial reactivity in experimental infections with influenza virus. J Infect Dis. 1982. 146:468–471.

11. Lee CS, Kim SH, Lee KA, Lee JH. Clinical characteristics of pandemic influenza A (H1N1) in a tertiary care university hospital in Korea. Infect Chemother. 2009. 41:Supple 2. S159.

12. Schwarzmann SW, Adler JL, Sullivan RJ Jr, Marine WM. Bacterial pneumonia during the Hong Kong influenza epidemic of 1968~1969. Arch Intern Med. 1971. 127:1037–1041.

13. Bisno AL, Griffin JP, Van Epps KA, Niell HB, Rytel MW. Pneumonia and Hong Kong influenza: A prospective study of the 1968~1969 epidemic. Am J Med Sci. 1971. 261:251–263.

14. Treanor JJ. Influenza viruses, including avian influenza and swine influenza. Mandenll, Douglass, and Bennett's Principles and practice of Infectious Disease. 2009. 7th ed. United States: Churchill Livingstone Elsevier;2265–2288.

15. Interim guidance on specimen collection, processing, and testing for patients with suspected novel influenza A (H1N1) virus infection. Center for Disease Control and Prevention (CDC). Accessed 3 Dec 2009. http://www.cdc.gov/h1n1flu/specimencollection.htm.

16. Interim recommendations for clinical use of influenza diagnostic tests during the 2009-10 influenza season. Center for Disease Control and Prevention (CDC). Accessed 03 Dec 2009. http://www.cdc.gov/h1n1flu/guidance/diagnostic_tests.htm.

17. Interim guidance for the detection of novel influenza a virus using rapid influenza diagnostic tests. Center for Disease Control and Prevention (CDC). Accessed 03 Dec 2009. http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm.

18. Faix DJ, Sherman SS, Waterman SH. Rapid-test sensitivity for novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med. 2009. 361:728–729.

19. Vasoo S, Stevens J, Singh K. Rapid antigen tests for diagnosis of pandemic (swine) influenza A/H1N1. Clin Infect Dis. 2009. 49:1090–1093.

20. Ginocchio CC, Zhang F, Manji R, Arora S, Bornfreund M, Falk L, Lotlikar M, Kowerska M, Becker G, Korologos D, de Geronimo M, Crawford JM. Evaluation of multiple test methods for the detection of the novel 2009 influenza A (H1N1) during the New York city outbreak. J Clin Virol. 2009. 45:191–195.

21. Kim JS, Cho HJ, Ahn YM, Hwang YO. Clinical usefulness of rapid antigen test on the diagnosis of influenza. Korean J Pediatr. 2005. 48:1348–1353.

22. Kim JY, Yoon YK, Lee CG, Cho KH, Lee KC, Sohn JW, Kim MJ. Clinical manifestation and usefulness of rapid antigen test in pandemic influenza A (H1N1) 2009. Infect Chemother. 2009. 41:Suppl 2. S195.

23. Heo JY, Noh JY, Jo YM, Choi WS, Song JY, Kim WJ, Cheong HJ. Clinical usefulness of a rapid antigen test for novel influenza A (H1N1) virus. Infect Chemother. 2009. 41:Suppl 2. S198.

24. Ryu SW, Lee SJ, Oh WS, Kim WJ, Lee HS, Kim JK, Ahn SY, Shim JO, Suh IB, Kim JG. Rapid influenza diagnostic test in populations with high prevalence of pandemic influenza A (H1N1). Infect Chemother. 2009. 41:Suppl 2. S274.

25. Lee JY, Lee H, Joo SI, Park SS, Kim EJ. Comparative study of rapid antigen test to diagnose new influenza A (H1N1). Infect Chemother. 2009. 41:Suppl 2. S275.

26. Kim YK, Kim HY, Uh Y, Chun JK. Usefulness of rapid influenza antigen test for novel influenza A/H1N1. Infect Chemother. 2009. 41:Suppl 2. S158.

27. Pollock NR, Duong S, Cheng A, Han LL, Smole S, Kirby JE. Ruling out novel h1n1 influenza virus infection with direct fluorescent antigen testing. Clin Infect Dis. 2009. 49:e66–e68.

28. Carr MJ, Gunson R, Maclean A, Coughlan S, Fitzgerald M, Scully M, O'Herlihy B, Ryan J, O'Flanagan D, Connell J, Carman WF, Hall WW. Development of a real-time rt-pcr for the detection of swine-lineage influenza A (H1N1) virus infections. J Clin Virol. 2009. 45:196–199.

29. Ginocchio CC, St George K. Likelihood that an unsubtypeable influenza a virus result obtained with the luminex xtag respiratory virus panel is indicative of infection with novel A/H1N1 (swine-like) influenza virus. J Clin Microbiol. 2009. 47:2347–2348.

30. Poon LL, Chan KH, Smith GJ, Leung CS, Guan Y, Yuen KY, Peiris JS. Molecular detection of a novel human influenza (H1N1) of pandemic potential by conventional and real-time quantitative rt-PCR assays. Clin Chem. 2009. 55:1555–1558.

31. Lee JY. The resistance situation of antiviral agent in Korea: 2008~2009 oseltamivir resistance of seasonal influenza A/H1N1. Infect Chemother. 2009. 41:Suppl 2. S20–S24.

32. Hauge SH, Dudman S, Borgen K, Lackenby A, Hungnes O. Oseltamivir-resistant influenza viruses A (H1N1), Norway, 2007~2008. Emerg Infect Dis. 2009. 15:155. 162.

33. Interim recommendations for the use of influenza antiviral medications in the setting of oseltamivir resistance among circulating influenza A (H1N1) viruses, 2008~2009 influenza season. Center for Disease Control and Prevention (CDC). Accessed 03 Dec 2009. http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00279.

34. Center for Disease Control and Prevention (CDC). Intensive care patients with severe novel influenza A (H1N1) virus infection-Michigan, June 2009. MMWR Morb Mortal Wkly Rep. 2009. 58:749–752.

35. Updated interim recommendations for the use of antiviral medications in the treatment and prevention of influenza for the 2009~2010 season. Center for Disease Control and Prevention (CDC). Accessed 03 Dec 2009. http://www.cdc.gov/h1n1flu/recommendations.htm.

36. Pregnant women and novel influenza A (H1N1) virus: Considerations for clinicians. Center for Disease Control and Prevention (CDC). Accessed 03 Dec 2009. http://www.cdc.gov/h1n1flu/clinician_pregnant.htm.

37. Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, Lindstrom S, Louie JK, Christ CM, Bohm SR, Fonseca VP, Ritger KA, Kuhles DJ, Eggers P, Bruce H, Davidson HA, Lutterloh E, Harris ML, Burke C, Cocoros N, Finelli L, MacFarlane KF, Shu B, Olsen SJ. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009. 374:451–458.