INFLUENZA, INFLUENZA VACCINE, AND AMANTADINE RIMANTADINE/

Influenza viruses are highly contagious Viruses that are transmitted f rom person to person, usually by the airborne route. Persons in semi-c losed or crowded environments, such as students and residents of nursi ng homes, are at high risk of exposure. The illness attack rate in chi ldren ranges from 14% to 40% yearly. Fatality rates are highest in per sons who have chronic medical conditions, such as chronic obstructive lung disease, cardiovascular disease, and diabetes mellitus, particula rly if they are elderly. The effectiveness of influenza vaccine in pre venting or attenuating illness varies, depending primarily on (1) the degree of similarity between the virus strains included in the vaccine and those that circulate during the influenza season, and (2) the age and immunocompetence of the Vaccine recipient. When there is a good m atch between vaccine and circulating viruses, influenza Vaccine has be en shown to prevent illness in approximately 70% to 90% of healthy per sons less than 65 years of age. Adverse events following influenza vac cine include mild, local reactions at the injection site (up to 20%) a nd occasionally fever in approximately 1% of vaccinees. Despite the av ailability of an effective vaccine, only 55% of persons 65 years of ag e and older reported receiving influenza vaccine in 1994. Vaccination levers are even lower in persons less than 65 years of age with highri sk medical conditions. Important procedures to improve vaccination rat es are (1) assessment of a practice's or medical facility's current Va ccination rates, (2) identification of target populations for vaccinat ion, (3) formation of a specific goat (ie, percentage of target popula tion to be immunized), (4) development of a plan of action, and (5) pr ovision of ongoing feedback to the individual physicians about vaccina tion rates of their own patients.