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Avian influenza: Critical considerations for the primary care physician

机译：禽流感：基层医疗医生的关键考虑因素

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PURPOSE: To provide an overview of avian influenza H5N1 and present current management guidelines. EPIDEMIOLOGY: In 1997, several individuals became infected with an emerging strain of avian influenza H5N1 associated with diseased chickens, resulting in the destruction of Hong Kong poultry flocks. Since 2003, avian influenza A H5N1 has moved from Southeast Asia into Europe, killing more than 150 million birds and more than 50% of the more than 200 persons infected. REVIEW SUMMARY: Seasonal influenza results in 36 000 deaths in the United States annually. An influenza pandemic occurs when a new influenza virus emerges for which people have little or no immunity, the virus spreads readily from person to person, and no vaccine is available. Experts consider H5N1 a potential pandemic virus. Vaccine based upon Vietnamese H5N1 is not widely available. Two classes of antiviral medications treat seasonal influenza; H5N1 developed resistance to M blockers, and resistance may be increasing against neuraminidase inhibitors, which remain the only widely available countermeasures. TYPE OF AVAILABLE EVIDENCE: National and international guidelines, expert reviews, and retrospective studies. Some prospective animal studies. GRADE OF AVAILABLE EVIDENCE: Fair CONCLUSION: Avian influenza H5N1 is a highly virulent strain of influenza; if it mutates into a virus capable of person-to-person transmission, a pandemic will likely ensue. Containment depends upon early diagnosis and treatment, with rapid implementation of infection control.
机译：目的：概述禽流感H5N1并提出当前的管理指南。流行病学：1997年，几个人被与病鸡有关的新型H5N1禽流感病毒感染，导致香港家禽群遭到破坏。自2003年以来，甲型H5N1禽流感已从东南亚转移到欧洲，杀死了1.5亿多只禽鸟，并感染了200多人中的50％以上。概述：季节性流感在美国每年导致36000例死亡。当出现新的流感病毒而人们几乎没有免疫力或没有免疫力时，就会发生流感大流行，这种病毒很容易在人与人之间传播，并且没有可用的疫苗。专家认为H5N1是潜在的大流行病毒。基于越南H5N1的疫苗尚未广泛使用。两类抗病毒药物可治疗季节性流感。 H5N1对M受体阻滞剂产生了抗药性，并且对神经氨酸酶抑制剂的抗药性可能正在增加，而神经氨酸酶抑制剂仍然是唯一可广泛使用的对策。可用证据的类型：国家和国际准则，专家评论和回顾性研究。一些前瞻性动物研究。可用的证据等级：合理的结论：禽流感H5N1是一种高毒力的流感病毒株。如果它变异为能够人对人传播的病毒，则可能会导致大流行。遏制取决于早期诊断和治疗，并迅速实施感染控制。

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