Intended for healthcare professionals


How to deal with influenza?

BMJ 2004; 329 doi: (Published 16 September 2004) Cite this as: BMJ 2004;329:633
  1. Tom Jefferson, coordinator (
  1. Cochrane Vaccines Field, Via Adige 28a, 00061 Anguillara Sabazia, Rome, Italy

    Real time surveillance providing information on circulating agents is the key

    Why is our rich and powerful society unable to prevent, defeat, or even contain the yearly onslaught of influenza? A clutch of papers in this issue provides glimpses of the answers.

    What is commonly known as influenza or the flu is a syndrome, not a disease. Each year scores of different respiratory viruses (and a few bacteria) cause a mostly benign illness, which cannot be distinguished clinically by causal agent. The syndrome should be referred to as influenza-like illness rather than just influenza. Influenza should be reserved for the illness caused by influenza A or B viruses. Influenza-like illness gives a better idea of the difficulties in diagnosis. Useful pointers may be the seasonality of the epidemic (respiratory syncytial virus and influenza A and B are usually autumnal or winter epidemics) or the age group concerned (respiratory syncytial virus has an affinity for very young people). Another exception may be the presence of a pandemic or a local epidemic in which the causal agent has been identified. However, our knowledge of the annual microbiological breakdown …

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