[Infectious Diseases News Brief]

Influenza: United States
A retrospective pooled analysis of data from high-risk patients in studies completed before or during the 1998-1999 winter season was performed to investigate the efficacy and safety of inhaled zanamivir (10 mg twice daily for 5 days) for the treatment of confirmed influenza. All studies were randomized, double-blind, and placebo-controlled with 21- to 28-day follow-up. A total of 2,751 patients was recruited. Of these, 321 (12%) were considered high risk and 154 were randomized to zanamivir. Zanamivir-treated high-risk patients had a treatment benefit of 2.5 days compared with those given placebo. Patients treated with zanamivir returned to normal activities 3.0 days earlier and had an 11% reduction in the median total symptom score over 1 to 5 days relative to those taking placebo. In addition, zanamivir reduced the incidence of complications requiring antibiotic use by 43% relative to placebo users. This pooled analysis shows that zanamivir is an effective and well-tolerated treatment for influenza in patients considered at high-risk of developing influenza-related complications.
Source: Archives of Internal Medicine, Vol 161, No 2, January 22, 2001

Influenza: England
The National Institute for Clinical Excellence (NICE) has published guidelines for prescribing zanamivir. These state that it can be prescribed only when the Royal College of General Practitioner (RCGP) consultation rates for influenza rise above 50 per 100,000 in one or more regions of the country and the PHLS observes that influenza viruses (confirmed by laboratory tests) are circulating. In addition, NICE recommends that zanamivir should only be prescribed to elderly people or those who have an increased risk of developing complications of influenza. To date, the overall consultation rates for influenza and influenza-like illness in England have remained at "baseline" (0-50 consultations per 100,000 population); however, in the week ending January 28, the overall rate increased from 33 to 45 consultations per 100,000 population with rates of 52, 50 and 37 in the northern, central and southern regions of England, respectively. This recent increase in clinical consultation rates has been associated with an increasing number of laboratory reports of influenza B viruses. The threshold has now been reached across a large part of England and advice from the PHLS and RCGP is that this is soon likely to be reflected in the overall national figure. Accordingly, doctors are advised to consider the prescription of zanamivir in suitable patients in all regions of England.
Source: United Kingdom Department of Health, February 1, 2001

Septicemia: United States
Rates of hospitalization due to septicemia in the US elderly population for 1986-1997 were examined, using Medicare administrative data. Age group, sex-, and race-adjusted rates more than doubled from 1986 through 1997, from 3.42 to 7.42 per 1,000 beneficiaries. The 1997 rates of septicemia increased with age, from 4.47 per 1,000 beneficiaries among persons 65-74 years old to 18.1 per 1,000 beneficiaries among persons 85 years old. The rates of septicemia were slightly greater among men (7.46 per 1000 beneficiaries) than among women (7.39 per 1,000 beneficiaries) and were higher among blacks (13.61 per 1000 beneficiaries) than among whites (6.89 per 1,000 beneficiaries). The most likely sites of the origin of the septicemia were the urinary tract (40.1%) and lungs (15.3%). Escherichia coli and Staphylococcus species were the most frequently reported organisms. Diabetes was listed as a comorbidity in 24.5% of the hospitalizations. The cost to Medicare for septicemia hospitalizations in 1997 was estimated at >$1.8 billion.
Source: Journal of Infectious Diseases, Vol 183, No 4, February 15, 2001

The details given are for information only and may be very provisional. Where incidents are considered of national importance and are ongoing, the initial report will be updated as new information becomes available.

[Infectious Diseases News Brief]