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Chapter 11. Influenza and Antibiotic Res... > Seasonal Influenza Virus Is Controll... - Pg. Vol1-167

Chapter 11 Influenza and Antibiotic Resistance Summary: Influenza is a viral disease that displays rapid dissemination of antibiotic resistance. The seasonal form of influenza moves around the world each winter, causing a mild, self-limiting infection for most persons. Vaccines are generally quite effective, but some patients fail to mount an adequate immune response. For such persons, antibiotics specific to flu virus have been developed. The adamantanes block productive infection of cells, whereas the neuraminidase inhibitors interfere with virus release and cell-to-cell spread. Resistance to the adamantanes has been extensive since 2005; resistance became significant for the neuraminidase inhibitors in the 2007­08 season. Pandemic influenza, exemplified by the 1918­19 outbreak and more recently by the 2009 H1N1 swine flu, sweeps around the world in a less predictable manner. Because vaccine can be produced only after human transmission is firmly established and the circulating virus strain is identified, antiviral agents are needed until a vaccine takes effect. For the 2009 H1N1 pandemic, vaccine was prepared and deployed; however, a lag of six months occurred. Thus, we know how long antibiotics will be needed. Avian flu, which has spread globally among birds, is monitored as a potential source of a new influenza pandemic. Adamantane resistance is widespread among avian flu isolates, and cases of resistance to neuraminidase inhibitors have been reported. The utility of these agents, which have been stockpiled, is unknown because resistance can emerge and spread rapidly with influenza.