Do Not Over-Use Antivirals
North Carolina public health officials are asking health care providers across the state to adhere to guidance pertaining to the use of antivirals for the 2009 H1N1 influenza virus. Caregivers are being reminded that the use of oseltamivir (Tamiflu) and zanamivir (Relenza) as a preventative measure should be limited to people at higher risk for influenza complications and the health care workers who care for them.
The call for strict adherence to CDC (Centers for Disease Control and Prevention) and state medical treatment guidelines comes on the heels of CDC testing two North Carolina viral samples found to have resistance to oseltamivir. Both samples, taken in July, were from people who were receiving oseltamivir as a preventative measure after they had been exposed to others who had the virus. Both had mild illness and have since recovered. The two cases were discovered by the CDC through testing of samples submitted by the N.C. State Laboratory of Public Health.
“When it comes to the use of antivirals, our primary concern is that they be used for those who really need them,” State Epidemiologist Megan Davies said. “Healthy people who are exposed to the flu don’t need to take antivirals for prevention.”
Dr. Davies said that care givers across the state are being reminded that use of antivirals as prevention may be considered for persons at higher risk for complications due to flu or for health care workers with an unprotected exposure to influenza. However, watching carefully for symptoms after an exposure and treating early if symptoms develop could be an appropriate alternative in these settings, and could reduce the potential for developing antiviral resistance.
Antiviral treatment is recommended for all patients with confirmed, probable or suspected cases of 2009 influenza H1N1 virus infection who are hospitalized or who are at higher risk for influenza complications.
“Most infections with the novel H1N1 are uncomplicated and resolve without treatment,” Dr. Davies said. “And the best way to prevent the spread of flu is to continue following the precautions you’ve heard before; wash your hands frequently with soap and water or alcohol-based hand rub, cover your mouth and nose when coughing or sneezing, avoid close contact with those who are sick, and stay at home if you are sick.”