1/4. neuraminidase inhibitors in the treatment of influenza A and B--overview and case reports.Influenza viruses type A and B can cause a wide spectrum of illness, and they are responsible for considerable mortality and morbidity. With the new neuraminidase inhibitors, of which zanamivir was the first drug to be licensed, the physician has antivirals at his disposal which are safe and effective against both influenza virus type A and type B. Available data from clinical Phase III studies indicate benefits in terms of a reduction in the median time to alleviation of major symptoms by 1.5 to 3 days when treatment is started within 36 to 48 h after onset of influenza. Similar results have been obtained with oseltamivir. neuraminidase inhibitors provide a valuable treatment option, particularly for individuals not protected by vaccination, and those at high risk of influenza-related complications. The study results obtained so far indicate that patients with pre-existing diseases and those with severe influenza symptoms profit most from the treatment. This is confimed by our own experience in treating severe influenza conditions.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. occupational exposure to influenza--introduction of an index case to a hospital.The epidemiology of influenza in the hospital is frequently confounded by failure to separate community-acquired from nosocomial transmission. An 83-year-old woman was hospitalized one day after returning from asia with complications resulting from acute influenza A (H3N2) infection; she was the first culture-confirmed case in the region during the 1987-1988 influenza season, and her illness antedated other influenza cases in the area by at least four weeks. The patient shed virus at least four days after admission and transmitted influenza to her primary physician; both had received trivalent influenza vaccine four weeks earlier. Surveillance data from the 28 health care providers (HCPs) in contact with the index case (mean age: 34.5 years; median time of contact: four hours, none receiving vaccine) revealed no evidence of transmission as detected by paired type-specific complement-fixation antibodies and throat culture (20 subjects) or acute serologies and culture (7 subjects). No febrile respiratory illnesses were detected among other patients on the same ward, although three were reported among HCPs. Thus, neither secondary spread of influenza from infected patient to hospital HCPs nor nosocomial transmission apparently took place, although transmission did occur to the primary physician.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
3/4. Atypical bacterial infections explained by a concomitant virus infection.Because both viral and bacterial infections are common during early childhood, dual infections are not unexpected. However, the clinical manifestation of such combined infections may be, difficult to interpret, and they are often misdiagnosed as "atypical bacterial infection." Five patients with concomitant viral-bacterial infections are described. In all five cases, virus detection enabled the physicians to better understand an otherwise puzzling clinical presentation. In view of the recent progress in rapid viral diagnoses and the potential of antiviral drugs, the possibility of dual infection should be investigated more often.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. Septicemic melioidosis. Occurrence following acute influenza A six years after exposure in vietnam.Septicemic melioidosis in association with acute influenza A was diagnosed in a vietnam veteran. The case illustrates that activation of melioidosis can occur long after exposure to a known endemic area and may be precipitated by infections with other common pathogens. Hence, physicians must maintain a high index of suspicion of melioidosis when dealing with unexplained sepsis in vietnam veterans. Prolonged therapy with appropriate antimicrobial agents is needed to eradicate this infection.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |