By David Brown
Washington Post Staff Writer
Wednesday, September 9, 2009
With pandemic influenza cases on the rise across the country, federal public health authorities on Tuesday urged physicians to prescribe antiviral medicines to high-risk patients promptly but reminded the public that most people won't need, and shouldn't expect to get, the drugs if they come down with the flu.
The guidance is aimed at getting optimal benefit from Tamiflu and Relenza while preventing overuse, hoarding and shortages of the drugs, as was seen briefly during the spring outbreak of swine flu.
Specifically, authorities said, practitioners shouldn't wait for lab tests to confirm the presence of the novel strain of the H1N1 virus before starting antivirals in high-risk patients who show symptoms of flu. The drugs work best when started within 48 hours of illness.
"We think that [time] window is very important," said Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.
She added, however, that "the majority of adolescents and adults and most children won't need antiviral treatment and can be cared for with Mom's chicken soup at home."
About 70 percent of people hospitalized with the new flu strain have had conditions such as pregnancy, diabetes or emphysema that put them at risk for serious complications. For such people, treatment with an antiviral drug if they show signs of flu is "generally recommended," Schuchat said during a telephone news conference.
Doctors should also consider giving preventive treatment to high-risk patients who have been exposed to someone with the flu. However, in a change from the guidance this spring, the CDC now says it is also acceptable for practitioners to watch such patients carefully and prescribe an antiviral only if a fever develops.