Tuesday, April 28, 2009

CDC: Interim Guidance on Antiviral Use

Early this morning, CDC released guidance on the use of antivirals for treating suspected and confirmed cases of swine flu in additon to pre- and post-exposure chemoprophylaxis for certain high-risk populations.

Antiviral Sensitivity:
This swine influenza A (H1N1) virus is sensitive (susceptible) to the neuraminidase inhibitor antiviral medications zanamivir and oseltamivir.

It is resistant to the adamantane antiviral medications, amantadine and rimantadine.

Treatment
Antiviral treatment should be considered for
  • Confirmed,
  • Probable, and
  • Suspected cases of swine influenza A (H1N1) virus infection

Treatment is prioritized for hospitalized patients and patients at higher risk for influenza complications.

Antiviral treatment with zanamivir or oseltamivir should be initiated as soon as possible after the onset of symptoms; studies have shown benefits from treatment from seasonal influenza are strongest in the first 48 hours after onset. However, treatment for priority populations should be started even after this 48 hour window as it may reduce mortality and duration of hospitalization.

Recommended duration of treatment is five days.

Chemoprophylaxis Recommendations:
Antiviral chemoprophylaxis (pre-exposure or post-exposure) with either oseltamivir or zanamivir is recommended for the following individuals:
  • Household close contacts of confirmed, probable or suspected cases who are at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women)
  • School-age children with chronic medical conditions who had close contact with a confirmed, probable, or suspected case.
  • Travelers to Mexico who are at high-risk for complications of influenza (e.g., persons with certain chronic medical conditions, persons 65 or older, children younger than 5 years old, and pregnant women).
  • Health care workers or public health workers who were not using appropriate personal protective equipment during close contact with an ill confirmed, probable, or suspect case of swine influenza A (H1N1) virus infection during the case’s infectious period (1 day prior and 7 days after illness onset).
For the full interim guidance, please refer to CDC: http://www.cdc.gov/swineflu/recommendations.htm

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