Gaps in the clinical management of influenza

While influenza surveillance and access to vaccines have come a long way since a catastrophic influenza pandemic struck a century ago, experts say there is still much room for improvement. This point is driven home by the return of a 50-year-old influenza strain during the U.S. 2017–18 season.

While influenza surveillance and access to vaccines have come a long way since a catastrophic influenza pandemic struck a century ago, experts say there is still much room for improvement. This point is driven home by the return of a 50-year-old influenza strain during the U.S. 2017–18 season. The impact of this most recent cycle, they say, exposes the continuing gaps that characterize clinical management of seasonal influenza. It also underscores the need for ongoing prospective, multiyear, multinational, and multiregional clinical research networks to support randomized clinical trials that explore interventions that could narrow those gaps. Existing networks must be expanded, new ones must be established, and coordinating them must become a priority. Through them, researchers can seek to resolve unknowns such as the optimal antiviral treatment for hospitalized noncritically ill and critically ill patients; the best antibiotic regimens for patients with influenza pneumonia and secondary bacterial infection; the viability of immunomodulating therapy for hospitalized noncritically ill and critically ill patients; whether advanced organ support strategies can improve outcomes for patients with influenza-related critical illness; and whether biomarkers accurately predict development of severe disease in influenza patients.