CDC Issues New Guidelines for Antivirals

Tamiflu, generic
Tamiflu, generic (EN Hattie Kauffman piece)
CBS

Tuesday, the Centers for Disease Control said that most people who come down with the 2009 H1N1 flu virus should just ride it out and not take antiviral medications like Tamiflu and Relenza, reports CBS News medical correspondent Dr. Jon LaPook.

"The majority of adolescents and adults and children can be cared for with mom's chicken soup at home, rest, and lots of fluids," said Dr. Anne Schuchat of the CDC.

But certain people need prompt treatment within 48 hours of symptoms -- those hospitalized or at high risk: patients under age 5, over 65, pregnant or with chronic medical problems.

There's a key change for patients at high risk who may have been exposed to the flu virus. Before Tuesday, the CDC advised giving them medication to prevent the illness. But now …

"Instead of just definitely starting antiviral medicines we give providers an option to do what we call watchful waiting and wait and see whether fever develops," Schuchat said.

The new advice tries to close a door that government doctors had left open with earlier guidance in May. Back then, they didn't rule out sometimes using the drugs to stop H1NI's spread and prevent illness even in children who had no symptoms.

H1N1, or swine flu, was first identified in April and is now responsible for almost all flu cases in the United States. It has caused more than 1 million illnesses so far, though most were mild and not reported, the CDC estimates. Nearly 600 lab-confirmed deaths and more than 9,000 hospitalizations have been reported.

Six states have reported widespread flu cases, according to the government's most recent data. Most are in the Southeast, possibly because schools reopen for classes earlier in this region so there is more opportunity for the virus to spread among children. Flu-like illnesses last week led 25 schools in Alabama, Georgia, Missouri and Tennessee to dismiss students, affecting more than 12,000 pupils.

And in the Pacific Northwest, college officials said 2,000 Washington State University students were sickened by swine flu during the first two weeks of classes on the Pullman campus. None were hospitalized and the illnesses seem to be tapering off, officials said this week.

Overall, it's unclear whether swine flu is more dangerous than seasonal flu, which plays a role in an estimated 36,000 deaths each year. The virus has not mutated into a deadlier form since it first appeared, but health officials are concerned about the possibility.

Many parents are worried, too, leading to reported shortages of antiviral medicines in some parts of the country. Another reason for limiting the use of antivirals is to make sure they keep working.

"The more we overuse antivirals, the more chance there is for developing resistant strains of H1N1 that will not respond to those particular medications," said Dr. Irwin Redliner, president and co-founder of the Children's Health Fund.

The bottom line is these medications should be used for people at risk for complications - and not for otherwise healthy adults who are likely to recover on their own.