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Review
. 2022 Aug 27;400(10353):693-706.
doi: 10.1016/S0140-6736(22)00982-5.

Influenza

Timothy M Uyeki  1 , David S Hui  2 , Maria Zambon  3 , David E Wentworth  4 , Arnold S Monto  5
Affiliations
Review

Influenza

Timothy M Uyeki et al. Lancet. .

Abstract

Annual seasonal influenza epidemics of variable severity caused by influenza A and B virus infections result in substantial disease burden worldwide. Seasonal influenza virus circulation declined markedly in 2020-21 after SARS-CoV-2 emerged but increased in 2021-22. Most people with influenza have abrupt onset of respiratory symptoms and myalgia with or without fever and recover within 1 week, but some can experience severe or fatal complications. Prevention is primarily by annual influenza vaccination, with efforts underway to develop new vaccines with improved effectiveness. Sporadic zoonotic infections with novel influenza A viruses of avian or swine origin continue to pose pandemic threats. In this Seminar, we discuss updates of key influenza issues for clinicians, in particular epidemiology, virology, and pathogenesis, diagnostic testing including multiplex assays that detect influenza viruses and SARS-CoV-2, complications, antiviral treatment, influenza vaccines, infection prevention, and non-pharmaceutical interventions, and highlight gaps in clinical management and priorities for clinical research.

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Conflict of interest statement

Declaration of interests DSH reports grant support unrelated to contributions to the Clinical spectrum and clinical complications, Clinical management, and Prevention and control interventions health-care settings sections, and, outside the submitted work support, from F Hoffmann-La Roche for a research nurse to enrol participants in a phase 3, randomised, double-blind, placebo-controlled, multicentre study to evaluate the efficacy and safety of baloxavir marboxil in combination with standard-of-care neuraminidase inhibitor in hospitalised patients with severe influenza. DEW reports research unit support (CRADA) from Seqirus for evaluation of virus isolation and propagation of viruses for the implementation of cell-based vaccines (US$200 000 per year) unrelated to contributions to the virology and pathogenesis sections and outside the submitted work. MZ reports being a member of the WHO Strategic Advisory Group of Experts on Immunization, the J Craig Venter Institute, and the UK New and Emerging Respiratory Virus Threats Advisory Group, and is Chair of the International Society of Influenza and Respiratory Viruses, unrelated to contributions to the influenza surveillance and diagnosis sections and outside the submitted work. ASM reports serving on a Roche advisory board unrelated to the contributions to the Influenza vaccines and vaccine effectiveness sections and outside the submitted work. TMU declares no competing interests. The views expressed are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the UK Health Security Agency.

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