Management of Influenza in Households: A Prospective, Randomized Comparison of Oseltamivir Treatment With or Without Postexposure Prophylaxis

Abstract

We determined the efficacy of postexposure prophylaxis (PEP) and treatment of ill index cases with oseltamivir, in an attempt to prevent influenza transmission in households, in a study conducted in 277 households with 298 index cases (62% with laboratory-confirmed influenza) and 812 contacts aged > or =1 year. Contacts were randomized by household to receive treatment (5 days; n=402), if illness developed, or PEP for 10 days (n=410), and the number of households with at least 1 contact developing laboratory-confirmed influenza was measured. PEP provided a protective efficacy of 58.5% (95% confidence interval [CI], 15.6%-79.6%; P=.0114) for households against proven influenza and 68.0% (95% CI, 34.9%-84.2%; P=.0017) for individual contacts, compared with treatment of index cases alone. No oseltamivir-resistant variants were detected in treated index cases or contacts. PEP of household contacts of those with influenza reduces the secondary spread of influenza in families when the initial household case is treated.

Pandemic influenza A (H1N1) 2009: the experience of the first six months

“…The latter group includes children under the age of 2 years or adults older than 65 years, pregnant patients and those up to 2 weeks postpartum, people with chronic or immunosuppressive conditions and people younger than 19 years receiving long-term aspirin therapy (see also Table 1) (58). Antiviral chemoprophylaxis for seasonal influenza with oseltamivir or zanamivir has been shown to be effective among household contacts (59,60), and is reserved for any of these high-risk groups or health care workers following contact with a confirmed or suspected case of pandemic H1N1/09, although early antiviral treatment is an emphasised alternative to prophylaxis (58). Oseltamivir may also be combined with amantadine or rimantadine if infection with either the seasonal or pandemic H1N1/09 strain is suspected (58).…”

Clinical and epidemiological efficacy of antiviral drug Ingavirin

“…Известно, что прекращение передачи вирусной инфекции при длительных тесных контактах между людьми невозможно только за счет лечения заболев ших. Важную роль для прерывания путей передачи инфекции и в борьбе с эпидемией играет профилак тика, повышающая протективный эффект более чем на 50 % [21]. Результаты проведенного исследования свидетельствуют о том, что противовирусный препа рат Ингавирин ® является эффективным средством внутриочаговой профилактики ОРВЗ среди контакт ных лиц в эпидемическом очаге.…”

Antiviral Therapy and Prophylaxis for Influenza in Children

“…26 In this setting, in which the index case was also treated with oseltamivir, the protective efficacy against proven influenza for individual contacts was 68%. 26 In a similar multicenter study for household contacts 12 years and older, oseltamivir was 89% effective in the prevention of laboratory-confirmed symptomatic influenza infection when used within 48 hours of contact with an index case who had not been treated. 27 Adverse events reported in treated subjects in this study, including gastrointestinal tract symptoms, were not different from those in controls.…”