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The dose-related safety, immunogenicity, and protective efficacy of an experimental trivalent influenza virus hemagglutinin (rHAO) vaccine produced in insect cells were determined using recombinant baculoviruses. The findings suggested that it is possible to generate a substantial amount of protection in an immunologically primed population against influenza with a pure hemagglutinin vaccine, even in the presence of significant antigenic drift.

A chemical that inhibits the enzyme neuraminidase in the influenza virus may protect against the disease and reduce symptoms in those who have it. Neuraminidase is important in viral reproduction and probably allows the virus to penetrate respiratory epithelial cells. Four studies tested the chemical GG167 on 160 people to see if the chemical could prevent influenza or reduce its symptoms. Some studies gave GG167 nose drops to the volunteers four hours before they were experimentally infected with the influenza A virus and some gave the GG167 drops 1 to 2 hours after infection. Altogether, 112 got the GG167 drops and 48 volunteers got a placebo. GG167 significantly reduced viral shedding and the incidence of influenza in those who received it prophylactically. It also significantly reduced symptoms in those who received it after developing influenza. There were no significant side effects., Objective.--the current study evaluated whether intranasal administration of the sialic acid analog 4-guanidino-Neu5Ac2en (GG167), an inhibitor of influenza virus neuraminidase, was effective and safe in either preventing or treating experimental human influenza. Methods.--Four randomized, double-blind, placebo-controlled trials involving three prophylaxis limbs, two early treatment limbs, and one delayed treatment limb were conducted. Setting.--Isolation in individual rooms. Participants.--Susceptible (serum hemagglutination-inhibition antibody titer [less than or equal to]1:8) adult volunteers (n=166) were inoculated intranasally with [10.sup.5] [TCDI.sub.50] influenza A/Texas/91 (H1N1) virus. Intervention.--GG167, 3.6 to 16 mg, was administered intranasally two or six times daily beginning 4 hours before inoculation (prophylaxis) or 1 or 2 days afterward (early or delayed treatment). Main Outcomes.--Virological measures were frequency of infection based on viral shedding and/or seroconversion (prophylaxis) or quantitative viral shedding based on titers and duration of virus recovery (treatment). Clinical measures were the frequency of febrile illness and symptom severity scores. Results.--Intranasal GG167 was well tolerated for both prophylaxis and therapy. For all dose groups combined, GG167 prophylaxis was 82% effective in preventing laboratory evidence of infection and 95% effective in preventing febrile illness (P

Picornaviruses, including the rhinoviruses and enteroviruses, are common causes of infections in the developed world and the most common reason for prescribing antibiotics. These ubiquitous pathogens are increasingly being recognized in more serious illnesses, such as sinusitis, exacerbations of asthma, exacerbations of cystic fibrosis, myocarditis, meningitis, and severe neonatal sepsislike disease. Recent advances have improved our ability to diagnosis and treat these infections. Arch Fam Med. 2000;9:913-920

The drug oseltamivir may be effective in reducing the symptoms of influenza. Researchers randomly assigned 627 people with the flu to take 150 milligrams of oseltamivir per day, 300 milligrams of oseltamivir per day or a placebo. Patients who took oseltamivir had less severe illness, fewer symptoms, and recovered faster than those who took a placebo. The drug also reduced the risk of complications such as bronchitis and sinusitis. Patients who took oseltamivir returned to their regular activities 2 to 3 days sooner than those who took a placebo.

The drug oseltamivir may be effective in preventing influenza and in reducing symptoms in people who have it. This drug inhibits a viral enzyme called neuraminidase, which is thought to be necessary for the virus to reproduce in humans. Researchers randomly assigned 117 healthy volunteers who were susceptible to influenza to take oseltamivir or a placebo. All were inoculated intranasally with the influenza virus. Only 38% who took the drug got influenza compared to 67% of the placebo group. None of those who took the drug shed any virus whereas half the placebo group did. The drug also reduced symptoms in those who did get influenza.

The drug tremacamra appears to reduce the symptoms of cold and may prevent colds entirely. Tremacamra is a form of the intercellular adhesion molecule 1 (ICAM-1), which is a cell receptor that cold viruses bind to. Therefore, the drug should stop the virus from infecting cells. Researchers randomly assigned 177 healthy volunteers to receive tremacamra or a placebo and then exposed them to rhinoviruses, which cause most colds. Over 85% of the people in both groups became infected but those who took tremacamra were less likely to develop a cold and also had fewer symptoms when they did.