CDC is urging healthcare providers to give rapid antiviral treatment to high-risk patients with suspected influenza
Influenza activity remains high across the U.S. and is expected to last several more weeks, says the Centers for Disease Control and Prevention (CDC) in a recent health advisory. The agency recommends clinicians be on the alert for suspected cases and to provide rapid treatment to infected patients. CDC says the nation is dealing with an increasing proportion of activity due to influenza A(H3N2) viruses, continued circulation of influenza A(H1N1) viruses, and low levels of influenza B viruses and that flu should be considered as a possible diagnosis for patients with respiratory illness while local influenza activity remains elevated.
“Because influenza A(H3N2) viruses may be associated with severe disease in older adults, this health advisory serves as a reminder that early empiric treatment with influenza antiviral medications is recommended for hospitalized and high-risk patients, especially those 65 years and older,” said the CDC in its advisory. “Antiviral treatment should be started as soon as possible after illness onset and should not wait for laboratory confirmation.”
CDC says influenza A(H1N1) viruses dominated most of the country early in the season and still do but during the three weeks ending March 16, influenza A(H3N2) viruses are surfacing more frequently than A(H1N1) viruses in most areas. “In the past, A(H3N2) virus-predominant influenza seasons have been associated with more hospitalizations and deaths in people 65 years and older than A(H1N1) virus-predominant seasons,” the CDC stated. “Influenza vaccine effectiveness is generally lower against influenza A(H3N2) viruses than against A(H1N1) or B viruses. In addition, one genetic clade of A(H3N2) viruses, the 3C.3a clade, has recently become predominant among circulating A(H3N2) viruses and according to laboratory testing these viruses are antigenically distinct from the A(H3N2) virus included in this season’s vaccine.”
The CDC says even if an infected patient has been vaccinated for influenza, antiviral medications should be administered right away, as research shows it’s been proven to reduce illness, severe outcomes and provide public health benefits. In addition, the CDC says antiviral treatment may be prescribed for any previously healthy (non-high risk) outpatient with suspected or confirmed influenza who presents within two days after illness onset.
Below is a brief on the CDC’s recommendations. For the entire detailed guideline, including approved treatments and dosing, please visit CDC’s advisory.
All hospitalized, severely ill, and high-risk patients with suspected or confirmed influenza should be treated with antivirals. Antiviral treatment is recommended as early as possible for any patient with suspected or confirmed influenza who is hospitalized, has severe, complicated, or progressive illness, and is at high risk for influenza complications but not hospitalized - this includes:
· Adults 65 years and older
· Children younger than two years. Although all children younger than five years are considered at higher risk for complications from influenza, the highest risk is for those younger than two years
· People with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, hematological (including sickle cell disease), and metabolic disorders (including diabetes mellitus)
· People with neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury)
· People with immunosuppression, including that caused by medications or by HIV infection.
· Women who are pregnant or postpartum (within two weeks after delivery)
· People younger than 19 years who are receiving long-term aspirin therapy
· American Indians and Alaska Natives
· People with extreme obesity (i.e., body-mass index is equal to or greater than 40)
· Residents of nursing homes and other chronic-care facilities