Intended for healthcare professionals


Zanamivir for influenza: a public health perspective

BMJ 1999; 319 doi: (Published 11 September 1999) Cite this as: BMJ 1999;319:655

Its use will require careful management by GPs

  1. Jonathan S Nguyen-Van-Tam, senior lecturer (
  1. Division of Public Health Medicine and Epidemiology, University of Nottingham Medical School, Queens Medical Centre, Nottingham NG7 2UH

    Influenza epidemics cause much disruption, including time off school and work, and increased demands on health services. Though the incidence of infection is highest in children and young adults, serious complications, including death, are commonest in elderly people and those suffering from “high risk” chronic illnesses.1 In Britain annual influenza vaccination is therefore recommended for high risk patients and those aged 75 years and over. Despite offering worthwhile reductions in both mortality and hospital admissions, influenza vaccine is underused.2 3

    Zanamivir has recently been licensed in Australia, Sweden, and the United Kingdom for treating influenza. Another similar compound, ostelamivir, is waiting in the wings. Created by computer assisted design, the drug works by inhibiting the neuraminidase activity of both influenza type A and B viruses.4 5 Although its bioavailability through oral administration is poor, zanamivir is successfully delivered as a nasal spray or dry powder inhalation.

    Randomised, double blind, placebo controlled trials of zanamivir for preventing and treating experimental human influenza have established that the drug is safe, well tolerated, and reduces viral shedding by a median of three days.6 In a large randomised, double blind, placebo controlled trial among healthy adults, zanamivir …

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