Prevention and control of influenza in persons with chronic obstructive pulmonary disease

Figures & data

Figure 1 Influenza virus cycle.

Abbreviations: RNA, ribonucleic acid.

Table 1 Hospitalization rates for acute respiratory disease in patients with and without chronic conditions

Population	Year of study	Age	Hospitalizations per 100,000 persons with high-risk conditions	Hospitalizations per 100,000 persons without high-risk conditions
HealthMaintenance Organizations (Barker et al 1980)	1968–1969, 1970–1971, 1972–1973	15–44 years	56–110	23–25
		45–64 years	392–635	13–23
		≥65 years	399–518	-
TennesseeMedicaid (Neuzil et al 2000)	1973–1993	0–11 months	1900	496–1038
		2–4 years	800	196
		5–17 years	320	86
			92	41
Kaiser Permanente (Izurieta et al 2000)	1992–1997	0–1 years	1181	231
		2–4 years	713	53
		5–17 years	386	19
Group Health Cooperative (Izurieta et al 2000)	1992–1997	0–1 years	772	193
		2–4 years	458	21
		5–17 years	216	16
Population of Houston (Glezen et al 1987)	1978–1981	All ages	197	93

Table 2 Inactivated influenza vaccine compared with live attenuated influenza vaccine

	Inactivated vaccine (TIV)	Live attenuated vaccine(LAIV)
Type of vaccine	Killed virus	Live virus
Route of administration	Intramuscular injection	Intranasal spray
Vaccine strains updated	Annually	Annually
Number of strains included	2 influenza A	2 influenza A
	1 influenza B	1 influenza B
Influenza A strains in 2005 vaccine	California/7/2004 (H3N2)	California/7/2004 (H3N2)
	New Caledonia/20/99 (H1N1)	New Caledonia/20/99 (H1N1)
Influenza B strain in 2005 vaccine	Shanghai/361/2002	Shanghai/361/2002
Approved age	≥6 months	5–49 years
Approved for persons with chronic obstructive pulmonary disease	Yes	No
Approved for other high-risk persons	Yes	No
Can be administered to family members or close contacts of high-risk persons not severely immunosuppressed	Yes	Yes
Can be administered to family members or close contacts of immunosuppressed persons not requiring a protected environment	Yes	Yes
Can be administered to family members or close contacts of immunosuppressed persons requiring a protected environment	Yes	Inactivated vaccinepreferred
Can be administered simultaneously with other vaccines	Yes	Yes
Can be administered within 4 weeks of another inactivated vaccines	Yes	Yes
Can be administered within 4 weeks of another live vaccines	Yes	Yes, but prudent to space 4 weeks apart

Table 3 Comparison of antiviral drugs for the treatment and prophylaxis of influenza

Drug	Indication	Dosage in individuals aged >12 years	Effective against influenza	Precautions in patients with:
				Side effects %	COPD	Renal problems	Hepatic problems
Amantadine	Treatment	100 mg bid*	A	0–70	No	Yes	Yes
	Prophylaxis	100 mg bid*
Rimantadine	Treatment	100 mg bid*	A	0–2	No	Yes	Yes
	Prophylaxis	100 mg bid*
Oseltamivir	Treatment	75 mg bid	A and B	5–10	No	Yes	No
	Prophylaxis	75 mg/day
Zanamivir	Treatment	10 mg bid	A and B	<1	Yes	No	No
	Prophylaxis	not approved

Abbreviations: bid, twice per day; COPD, chronic obstructive pulmonary disease.

Notes: *100 mg/day in the elderly.

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