Innovations in the treatment and prevention of influenza in children and adolescents

In September 2024, an Expert Council via videoconference was held to discuss innovative approaches to the tactics of diagnosis and therapy of influenza in children and adolescents in Russian Federation. Influenza is characterized by high morbidity and mortality, leading to 28,000 deaths annually worldwide among children. Influenza causes significant economic damage, ranking 4th among all infectious diseases in 2023 in Russian Federation. During the 2022­2023 period, there was an increase in influenza incidence with a traditionally high rate of infection among children. Newborns, children under 5 years old, and children with comorbidities are at high risk for complications. An analysis of influenza mortality shows that comorbidity is an aggravating factor in almost half of the cases. Timely diagnosis and etiotropic therapy are key in the treatment of influenza. The focus should be on etiological confirmation of the diagnosis within the first 24 hours from disease manifestation to prescribe specific antiviral therapy. Although laboratory confirmation of the diagnosis is recommended, during periods of high incidence, the diagnosis can be made based on clinical and epidemiological data. For final verification of the “influenza” diagnosis, the widespread use of certified rapid tests is proposed. According to the updated WHO guidelines published in September 2024, two medicines are recommended for the treatment of influenza — baloxavir and oseltamivir. Baloxavir marboxil significantly reduces the virus shedding time and has a favorable safety profile for children and adolescents. This makes it the medicine of choice, especially in cases of high risk of complicated influenza infection. Given the high importance of influenza in the structure of childhood morbidity, it is crucial to continue improving methods of prevention, diagnosis, and treatment of this disease, especially in children.