Influenza surveillance during winter 1997-1998 in Israel.

BACKGROUND: Each winter influenza activity is a major cause of morbidity and mortality both in Israel and worldwide. OBJECTIVES: To identify the influenza viruses active in Israel during the winter season and to assess the extent of influenza morbidity. METHODS: Information was collected on a population of 18,684 individuals enrolled in two community clinics in central Israel. It included the total number of visits for acute respiratory infection--including influenza and influenza-like illness (ARI/flu-like)--during a 20 week surveillance period (23 November 1997 to 27 March 1998) and the percent of influenza virus isolates in nasopharyngeal specimens from a sample of patients with ARI/flu-like collected on a weekly basis during the same period. RESULTS: A total of 5,947 visits for ARI/flu-like were recorded among 18,684 enrolled patients in two community clinics (18.1%). The progressive increase in the number of visits for ARI/flu-like reached a peak on week 2/98 with 597 visits and a rate of 31.95 visits per 1,000 population. After this, a decrease to the initial values was evident by week 12/98. Most affected patients were in the age groups 5-14 and 65 years and over, with a rate of 733.5 and 605.3 visits per 1,000 population, respectively. Influenza virus was isolated from 92 of the 426 nasopharyngeal specimens (21.6%). The most commonly detected strain was A/Sydney/5/97 (H3N2) like (77.2%). The peak rate of isolates was recorded at the beginning of January (01/98). CONCLUSIONS: A/Sydney/5/97 (H3N2) like-strain was the dominant influenza virus. Its presence did not prevent the simultaneous activity of influenza A/H1N1 virus. The dynamic of the clinical disease as expressed by the weekly visit rate for ARI/flu-like was similar to the temporal pattern of the virological findings. The extent of morbidity suggests moderate epidemic activity.

Use of complementary and alternative medicine among primary care patients.

OBJECTIVE: Complementary and alternative medicine use is increasing worldwide, and the expenses are high while its effectiveness is still in debate. The aim of this survey was to evaluate the utilization of complementary and alternative medicine in Israel. METHOD: Four-hundred and eighty patients in two primary care clinics have participated in the survey and answered an anonymous questionnaire. RESULTS: Ninety patients (18.7%) have consulted an alternative medicine therapist at least once in the past. Both younger (0-19) and older (65 and older) age groups were associated with a low rate of complementary and alternative medicine utilization. In the adult population, an academic education was associated with a higher utilization rate. The most frequently used methods were homeopathy (34.6%) and reflexology (18.7 %). Musculo-skeletal (20.6%) and respiratory (15.9%) complaints were the most frequent causes for complementary and alternative medicine consultation. The subjective outcome of complementary and alternative medicine treatment was considered beneficial in almost half of the cases and partially beneficial in another 34.6%. CONCLUSIONS: Utilization of complementary and alternative medicine is as widespread in Israel as in other Western countries. Utilization rates were found to be associated with age and education but not with gender or origin.