Clinical and Epidemiological Overview of Influenza: A Literature Review
DOI:
10.29303/jbt.v25i4.10278Published:
2025-10-17Downloads
Abstract
Influenza is an acute contagious respiratory infection that remains a major global health concern due to its high transmissibility and ability to undergo genetic variations through antigenic drift and shift. This review aims to provide a comprehensive understanding of the definition, epidemiology, pathophysiology, clinical manifestations, diagnostic methods, management, complications, and preventive strategies of influenza based on recent scientific evidence. A narrative review method was employed by analyzing publications from 2008 to 2025, sourced from PubMed, ScienceDirect, and Google Scholar, using keywords such as “influenza,” “respiratory infection,” “antiviral therapy,” and “influenza vaccination.” The findings show that influenza affects approximately one billion people globally each year, with 3–5 million severe cases and 290,000–650,000 respiratory deaths, particularly among vulnerable groups including children, the elderly, pregnant women, and individuals with chronic diseases. The infection is caused by influenza viruses type A, B, C, and D, with type A being the most associated with epidemics and pandemics. Diagnosis is primarily based on clinical assessment supported by RT-PCR as the gold standard, while neuraminidase inhibitors such as oseltamivir and zanamivir remain the mainstay of therapy when administered early. Annual vaccination remains the most effective preventive measure, complemented by non-pharmacological interventions such as hand hygiene, mask use, and respiratory etiquette. In conclusion, strengthening surveillance systems, improving vaccination coverage, and enhancing early diagnostic capacity are essential strategies to reduce the global burden of influenza and its complications.
Keywords:
Antivirals Clinical features Diagnosis Influenza Respiratory infection Orthomyxoviridae Vaccination PreventionReferences
Byambasuren, S., & Brydak, L. B. (2018). Laboratory diagnosis of influenza. Pediatria i Medycyna Rodzinna, 14(3), 286–292. https://doi.org/10.15557/PiMR.2018.0032
CDC. (2024). Preventing Seasonal Flu. https://www.cdc.gov/flu/prevention/?CDC_AAref_Val=https://www.cdc.gov/flu/prevent/prevention.htm
Dunning, J., Thwaites, R. S., & Openshaw, P. J. M. (2020). Seasonal and pandemic influenza: 100 years of progress, still much to learn. Mucosal Immunology, 13(4), 566–573. https://doi.org/ 10.1038/s41385-020 0287-5
Gu, Y., Zuo, X., Zhang, S., Ouyang, Z., Jiang, S., Wang, F., & Wang, G. (2021). The mechanism behind influenza virus cytokine storm. Viruses, 13(7). https://doi.org/10.33 90/v13071362
Hafner, S. W. B. J. W. (2023). Influenza. StatPearls.https://www.ncbi.nlm.nih.gov/books/NBK459363/
Huanga, W. T., Chang, C. H., Hsu, Y. F., & Chuang, J. H. (2014). Prognostic factors for mortality in patients hospitalized with influenza complications, in Taiwan. International Health, 7(1), 73–75. https://doi.org/10.1093/inthealth/ihu083
Iuliano, A. D., Roguski, K. M., Chang, H. H., Muscatello, D. J., Palekar, R., Tempia, S., Cohen, C., Gran, J. M., Schanzer, D., Cowling, B. J., Wu, P., Kyncl, J., Ang, L. W., Park, M., Redlberger-Fritz, M., Yu, H., Espenhain, L., Krishnan, A., Emukule, G., … Mustaquim, D. (2018). Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. The Lancet, 391(10127), 1285–1300. https://doi.org/10.1016/S0140-6736(17)33 293-2
Kalil, A. C., & Thomas, P. G. (2019). Influenza Fisiopatología. Critical Care, 23(258), 1–7.
Kim, H. K., Min, K. D., & Cho, S. il. (2023). Analysis of the effectiveness of non-pharmaceutical interventions on influenza during the Coronavirus disease 2019 pandemic by time-series forecasting. BMC Infectious Diseases, 23(1), 1–12. https://doi.org/10.1186/s12879-02308640y
Lepelletier.D Michael J. Smart, Robert B. Noland, G. B. (2020). INfluenza. Elsevier, January, 19–21.
Loscalzo, J. (2017). Harrison’s Pulmonary and Critical Care Medicine. 3rd edition.
Low, Z. Y., Wong, K. H., Wen Yip, A. J., & Choo, W. S. (2023). The convergent evolution of influenza A virus: Implications, therapeutic strategies and what we need to know. Current Research in Microbial Sciences, 5(September), 100202. https://doi.org/10.1016/j.crmicr.2023.1002
Meijer, W. J., Linn, F. H. H., Wensing, A. M. J., Leavis, H. L., van Riel, D., GeurtsvanKessel, C. H., Wattjes, M. P., & Murk, J. L. (2016). Acute influenza virus-associated encephalitis and encephalopathy in adults: A challenging diagnosis. JMM Case Reports, 3(6), 1–10. https://doi.org/10.1099/jmmcr.0.005076
Paget, J., Spreeuwenberg, P., Charu, V., Taylor, R. J., Iuliano, A. D., Bresee, J., Simonsen, L., & Viboud, C. (2019). Global mortality associated with seasonal influenza epidemics: New burden estimates and predictors from the GLaMOR Project. Journal of Global Health, 9(2), 1–12. https://doi.org/10.7189/jogh.09.020421
PBIDI. (2017). Panduan Praktik Klinis Bagi Dokter di Fasilitas Pelayanan Kesehatan Primer. Menteri Kesehatan Republik Indonesia, 1–440.
Sautto, G. A., Kirchenbaum, G. A., & Ross, T. M. (2018). Towards a universal influenza vaccine: Different approaches for one goal. Virology Journal, 15(1), 1–12. https://doi.org/10.1186/s12985-017-0918y
Sembiring, J., & Sianipar, O. (2018). Epidemiologi Dan Diagnosis Kedokteran Laboratorik Infeksi Virus H1N1. Indonesian Journal of Clinical Pathology and Medical Laboratory, 16(3), 140–148. https://doi.org/10.24293/ijcpml.v16i3.1040
Taubenberger, J. K., & Morens, D. M. (2008). The Patology of Influenza Infections. Annu Rev Pathol, 3, 499–522. https://www .ncbi.nlm.nih.gov/pmc/articles/PMC3624763/pdf/nihms412728.pdf
Timothy M. Uyeki, Henry H. Bernstein, John S. Bradley, Janet A. Englund, Thomas M. File Jr, Alicia M. Fry,1 Stefan Gravenstein, Frederick G. Hayden, Scott A. Harper, Jon Mark Hirshon, Michael G. Ison, B. Lynn Johnston, Shandra L. Knight, Allison McGeer, L, and A. T. P. (2019). Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza. Anesteziologie a Intenzivni Medicina, 30(2), 97–98. https://doi.org/ 10.1093/cid/ciy866
Trombetta, C. M., Kistner, O., Montomoli, E., Viviani, S., & Marchi, S. (2022). Influenza Viruses and Vaccines: The Role of Vaccine Effectiveness Studies for Evaluation of the Benefits of Influenza Vaccines. Vaccines, 10(5), 1–18. https://doi.org/10.3390/ vaccines10050714
Van Asten, L., Luna Pinzon, A., De Lange, D. W., De Jonge, E., Dijkstra, F., Marbus, S., Donker, G. A., Van Der Hoek, W., & De Keizer, N. F. (2018). Estimating severity of influenza epidemics from severe acute respiratory infections (SARI) in intensive care units. Critical Care, 22(1), 1–10. https://doi.org/10.1186/s13054-018-22748
Warren-Gash, C., Blackburn, R., Whitaker, H., McMenamin, J., & Hayward, A. C. (2018). Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: A selfcontrolled case series analysis of national linked datasets from Scotland. European Respiratory Journal, 51(3), AR. https://doi.org/10.118 3/13993003.01794-2017
Warren-Gash, C., Smeeth, L., & Hayward, A. C. (2009). Influenza as a trigger for acute myocardial infarction or death from cardiovascular disease: a systematic review. The Lancet Infectious Diseases, 9(10), 601–610. https://doi.org/10.1016 /S1473-3099(09)70233-6
Wells BG, Dipiro JT, Dipiro CV, Schwinghammer TL. (2009). Pharmacotherapy Handbook. 7, 31–42.
WHO. (2025a). Influenza (seasonal). https:// www.who.int/news-room/fact-sheets/detail /influenza-(seasonal)
WHO. (2025b). Influneza. https://www.who. int/teams/health-product-policy-andstandar /standards-and-specifications /norms-and-standards/vaccinestandardization/influenza
Zhou, F., Li, H., Gu, L., Liu, M., Xue, C. xue, Cao, B., & Wang, C. (2018). Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1) pdm09 patients. Respiratory Medicine, 134, 86–91. https://doi.org/10.1016/j.rmed. 2017.11.017.
License
Copyright (c) 2025 Muhammad Rifki, Amanda Azkiyah Rachman, Tsania Zulfa Salsabila, Anak Agung Ayu Regina Larasati, Andi Frieskha Naurah Paradiesta
This work is licensed under a Creative Commons Attribution 4.0 International License.
Jurnal Biologi Tropis is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the received article shall be assigned to the author as the owner of the paper. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to the published articles.
Authors are permitted to disseminate published articles by sharing the link/DOI of the article at the journal. Authors are allowed to use their articles for any legal purposes deemed necessary without written permission from the journal with an acknowledgment of initial publication to this journal.
