Indeed, worldwide, it is incon-trovertably indicated and neglecting to protect these categories of individuals with influenza vaccine arguably borders on medical negligence. With respect to routine immunization of healthy persons over 65 years of age, the United Kingdom has recently fallen into line with European and American recommendations for universal routine immunization of all persons over the age of 65 and this recommendation has now also ceased to be controversial any more. In addition, all contacts of high risk patients, e.g. health-care workers and other professional attenders of patients, family members, and persons living in the same house, should all be routinely immunized. Following on these findings, influenza immunization was made a covered Medicare benefit in 1993. In the majority of North American and European countries, influenza immunization is reimbursable by medical insurance.
Influenza is undoubtedly an eminently vaccine-preventable disease.
Nevertheless the practice of routine immunization of employees to reduce winter related absenteeism has been controversial in the past because some early studies carried out during winters with low influenza activity failed to demonstrate a clear cost-benefit, while a correspondingly equal number of studies showed definite cost benefits. In South Africa, the first such study has recently been published in the Journal of Occupational Health, vol. The recommendations of the Department of Health have recently been published in the South African Medical Journal, Feb. 1997, pages 190-191. The otitis externa was associated with marked diffuse swelling of the external auditory canal. However, over the ensuing few days the patient's condition worsened, with increasing severe ear pain, necessitating pethidine analgesia.