The Centers for Disease Control and Prevention (CDC) has issued a notice regarding increased influenza A(H3N2) activity and its clinical implications, a summary of influenza antiviral drug treatment recommendations, an update about approved treatment drugs and supply for the 2017-2018 season, and background information for patients about influenza treatment. Recommendations include:
- CDC recommends antiviral medications for the treatment of influenza as an important adjunct to annual influenza vaccination.
- All hospitalized, severely ill, and high-risk patients with suspected confirmed influenza should be treated with antivirals.
- Antiviral treatment should be started as soon as possible after illness onset and should not be delayed even for a few hours to wait for the results of testing.
- The most accurate influenza tests are molecular assays.
- Neuraminidase inhibitors can benefit other individuals with influenza. Three prescription neuraminidase inhibitor antiviral medications are recommended for use the US during the 2017-2018 season: iseltamivir (Tamiflu), zanamivir (Relenza), and peramivir (Rapivab).
- Additional considerations for clinicians include bacterial infections and adverse events with antiviral use.
Centers for Disease Control and Prevention. Seasonal influenza A(H3N2) activity and antiviral treatment of patients with influenza. December 27, 2017. https://emergency.cdc.gov/han/han00409.asp. Accessed December 30, 2017.
The CDC announced that the predominant circulating influenza virus this year is influenza A(H3N2). In general vaccine effectiveness in the past has been lower against A(H3N2) viruses than against influenza A(H1N1), and in the past the vaccine was only approximately 30% effective in protecting against A(H3N2). This means that the use of antiviral therapy for high-risk patients may be particularly important during this year’s flu outbreak. High risk individuals include:
- Adults aged 65 years and older.
- Persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, hematological (including sickle cell disease), and metabolic disorders (including diabetes mellitus), or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy).
This Week's Must Reads
Adherence Rates to Secondary Prevention Meds, Circulation; ePub 2018 Jan 31; Mathews, et al
Low-Dose CT Screening for Lung Cancer, CHEST; ePub 2018 Jan 25; Mazzone, et al
Catheter Ablation for AF in Patients with HF, N Engl J Med; 2018 Feb 1; Marrouche, et al
Changes in Physical Activity & Risk of HF, Circulation; ePub 2018 Jan 31; Florido, et al
Should Patients with Syncope be Evaluated for PE?, JAMA Intern Med; ePub 2018 Jan 29; Costantino, et al
Must Reads in Infectious Diseases
Benzodiazepine Use & Risk of Pneumonia, CHEST; 2018 Jan; Chen, Winkelman, et al
Seasonal Influenza A & Antiviral Tx for Patients, CDC Health Advisory; 2017 Dec 27; CDC
Oral Capsule vs Colonoscopy FMT for CDI, JAMA; 2017 Nov 28; Kao, Roach, et al
HIV Testing & Impact of Delayed Diagnosis, MMWR; 2017 Dec 1; Dailey, Hoots, et al
ACP Guideline for HBV Vaccination & Screening, Ann Intern Med; ePub 2017 Nov 21; Abara, et al