title: Use of neuraminidase inhibitors to combat pandemic influenza.
abstract: Since the last influenza pandemic in 1968, neuraminidase (NA) inhibitors have been licensed for the treatment and prophylaxis of seasonal influenza. Continuing outbreaks of highly pathogenic avian influenza H5N1 since 2004 have focused attention on the timing of the next pandemic and preparedness plans. Although immunization is the principal means of influenza prophylaxis, a well-matched efficacious vaccine is unlikely to be widely available for several months following the emergence of the pandemic strain. NA inhibitors could be used to contain and eliminate an emerging pandemic virus at source. If unsuccessful, they could still play a crucial role in reducing the medical impact of pandemic influenza as it spreads through countries. Accordingly, many authorities are creating stockpiles of NA inhibitors. However, the use of stockpiled drugs for treatment or prophylaxis, the rapid delivery to newly diagnosed cases and unknown characteristics of an emergent pandemic strain pose significant challenges to determining optimal use of stockpiles.
authors.affiliation: Infectious Diseases Unit, Leicester Royal Infirmary, Leicester LE1 5WW, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Democratis
authors.forename: Manish
authors.initials: M
authors.lastname: Pareek
authors.forename: Iain
authors.initials: I
authors.lastname: Stephenson
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use*; D001717:Birds; D004196:Disease Outbreaks / Q000517:prevention & control*; D024882:Drug Resistance, Viral; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype; D005585:Influenza in Birds / Q000821:virology*; D007251:Influenza, Human / Q000188:drug therapy* / Q000517:prevention & control* / Q000635:transmission / Q000821:virology; D009439:Neuraminidase / Q000037:antagonists & inhibitors*
chemical_list: D000998:Antiviral Agents; D004791:Enzyme Inhibitors; D009439:Neuraminidase