Treatment of Swine flu Influenza

Antiviral Treatment:

• Should be considered for confirmed, probable, or suspected cases of swine flu virus infection.
• Oseltamivir and zanamivir should be initiated as soon as possible after the onset of symptoms.
• Recommended duration of treatment is five days.
• Doses recommended for treatment are the same as those recommended for seasonal influenza.
• Oseltamivir use in children <1 year old was recently approved by the FDA under an Emergency Use Authorization (EUA).
  

Antiviral Chemoprophylaxis:

• Chemoprophylaxis is recommended for:
  • Household close contacts who are at high-risk for complications of influenza (eg, certain medical conditions, persons ≥65 years old, children <5>
  • School children who are at high-risk for complications of influenza and who had close contact with a confirmed, probable, or suspected case.
  • Travelers to Mexico who are at high-risk for complications of influenza.
  • Healthcare workers and public health workers who were not using appropriate protective equipment during close contact with an ill confirmed, probable, or suspected case during the infectious period.
• Chemoprophylaxis (pre-exposure) may be considered for:
  • Healthcare workers at high-risk for complications of influenza and who are working in areas that contain patients with confirmed illness or who are caring for patients with acute febrile respiratory illness.
  • Non-high risk persons who are travelers to Mexico, first responders, or border workers who are in areas with confirmed cases.
• Oseltamivir or zanamivir may be used.
• Post-exposure: duration of chemoprophylaxis is 10 days after last known exposure to ill confirmed case.
• Pre-exposure: chemoprophylaxis should be given during potential exposure period and for 10 days after last known exposure.
• Oseltamivir may be used for chemoprophylaxis in children <1>

level of swine influenza pandemic alert raised from phase 3 to phase 4

Human cases of swine influenza A/H1N1 virus infection also have been confirmed internationally: US has reported 40, Canada has reported 6 confirmed human cases of infection; Spain has reported 1 case; Scotland has reported 2 cases. Mexico has reported 26 cases of infection, including 7 deaths.

On the advice of the Emergency Committee of the World Health Organization, the Director-General has raised the level of influenza pandemic alert from phase 3 to phase 4. The change to a higher phase of pandemic alert indicates that the likelihood of a pandemic has increased, but not that a pandemic is inevitable.

The Emergency Committee's recommendation is based on the available data on confirmed outbreaks of A/H1N1 swine influenza in the United States, Mexico, and Canada. The Committee also considered reports of possible spread to additional countries.

The decision was based primarily on epidemiological data demonstrating human-to-human transmission and the ability of the virus to cause community-level outbreaks.

Given the widespread presence of the virus, the Director-General considered that containment of the outbreak is not feasible. The current focus should be on mitigation measures.

In Mexico, the suspected number of cases is reportedly as high as 1,600, and the suspected number of deaths in Mexico is up to 80. Potential new cases also have been reported in France, Hong Kong, and New Zealand. These numbers and reports are not yet confirmed.

Laboratory testing has found the swine influenza A/H1N1 virus is susceptible to the prescription antiviral drugs oseltamivir and zanamivir.