Influenza: prospects for control.

Influenza is a disease of antiquity that annually imposes a major burden of morbidity and mortality. The available inactivated vaccine is effective for preventing influenza and the serious disease and death that can accompany it. However, annual recommendations for vaccination among persons at risk have never been adequately implemented. This remains the most pressing current need for control of influenza. Amantadine, rimantadine, and the newly available drugs zanamivir and oseltamivir are effective for influenza prevention and treatment (the former two for influenza A only). The availability of four antiviral agents that effectively prevent and treat influenza provides the physician with considerable flexibility for their use in influenza control. Optimal application of the currently available vaccine and antiviral agents should substantially reduce the impact of influenza. Other methods for influenza treatment and control are under development, and a live attenuated vaccine with substantial potential for control is nearing approval. However, better inactivated vaccines, better rapid diagnostic tests, and an increased understanding of options for use of antiviral agents are still needed. When all of these things are available and optimally applied, effective control of influenza should result. The prospect is compelling. Full participation by the practicing physician will be necessary to achieve this goal.