GRİP VE AŞI

Grip, influenza virüsleri tarafından gelişen, akut, ciddi ve salgınlara yol açabilen bir enfeksiyon hastalığıdır. Üç tip (A, B ve C) influenza virüsü tanımlanmış olup, İnfluenza A bu tipler içerisinde en ağır seyirli olandır. Hastalık solunum yoluyla bulaşır ve kış aylarında daha sıktır. Pnömoni, en önemli komplikasyonu olmakla birlikte, kardiyak ve merkezi sinir sistemi komplikasyonları da görülebilir. Tanı genellikle klinik olarak konulmakla birlikte, tanıyı desteklemek için moleküler testler de kullanılabilir. Oseltemivir ve zanamivir tedavide kullanılabilecek antivirallerden olup, hastalığın erken evrelerinde kullanıldıklarında hastalığın süresini ve komplikasyon riskini azaltırlar. Aşı, risk faktörü bulunan kişilerde altta yatan hastalığın daha da kötüleşmesinin, morbiditenin ve mortalitenin önündeki en önemli önleyici seçenektir. Kontrendikasyonu olmayan ≥6 aylık tüm kişiler için rutin yıllık influenza aşısı önerilmektedir. 2018-19 sezonunda da standart dozda, adjuvanlanmamış, inaktif influenza aşıları, üçlü (Trivalan) (IIV3) ve dörtlü (Tetravalan) (IIV4) formülasyonlarda piyasaya sunulmuştur. Üçlü influenza aşılarında A/Michigan/45/2015 (H1N1) pdm09 benzeri virüs, A/Singapur/INFIMH-16-0019/2016 (H3N2) benzeri virüs ve B/Colorado/06/2017 benzeri virüs (Victoria soyu) bulunurken, dörtlü influenza aşıları, bu üç virüs suşuna ek olarak bir influenza B aşı virüsü olan B/Phuket/3073/2013-benzeri virüs (Yamagata soyu) ile sunulmuştur. Aşıların endikasyonları, kontrendikasyonları ve alınacak önlemler yazıda tartışılmaktadır.

Anahtar Kelimeler:

Grip, aşılama, trivalan aşı, tetravalan aşı

Influenza and Vaccine

Influenza is an acute, severe infectious disease caused by influenza viruses and it can lead to pandemics. Three types of Influenza viruses (A, B and C) are determined and type A causes the most severe infection. The disease spreads via respiratory route and occurs commonly in winter. While pneumonia is the most important complication, central nervous system complications can also be seen. The diagnosis is usually established by clinical findings but molecular techniques can also be used for supporting the diagnosis. Oseltamivir and Zanamivir are the antivirals used for treatment and they shorten the duration of the disease and decrease the complication risk. Vaccination is the most important tool for protecting the patients with comorbidities from worsening of the underlying disease as well as mortality and morbidity. The vaccine is also recommended annually for everyone ≥6 months of age without contraindications. In the 2018-2019 season, vaccines without adjuvants, inactive influenza vaccines, quadrivalent (IIV4) and trivalent (IIV3) formulations were also launched. While the trivalent vaccine contains, A/Michigan/45/2015 (H1N1) pdm09 like virus, A/Singapur/INFIMH-16-0019/2016 (H3N2) like virus and B/Colorado/06/2017 like virus (Victoria strain), the quadrivalent vaccine contains one more B/Phuket/3073/2013-like virus (Yamagata strain), which is an influenza B virus, in addition to these three viruses. The indications, contraindications of the vaccines and the precautions to be taken are discussed in this article.

Keywords:

Influenza, prophylaxy, trivalent vaccine, quadrivalent vaccine,

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