FLU NEWS SCAN: Antivirals for flu patients, mild H5N1 cases

Mar 13, 2012

Study: Many hospitalized flu patients didn't get antiviral treatment
The Minnesota Department of Health (MDH) found that only 65% of patients who were hospitalized with confirmed influenza in the 2010-11 season in the Twin Cities area received antiviral treatment, despite a longstanding recommendation for such treatment, according to a report presented today at the International Conference on Emerging Infectious Diseases (ICEID) in Atlanta. As part of a flu surveillance program, MDH researchers reviewed the charts of all patients who were hospitalized with confirmed flu during the season. They found that 291 of 446 patients received an antiviral. Of the 291, 288 (99%) received oseltamivir (Tamiflu), and 244 (84%) were treated on the day of admission or the day after. The antiviral treatment rate was lower in patients under age 2 (54%) and highest in those over 65 (73%). Among 333 patients who had a known comorbidity, 223 (76%) were treated. Five (2%) of the treated patients died, compared with seven (5%) of those who did not receive an antiviral (P = 0.1). The authors say hospital-based treatment protocols and provider education may increase antiviral treatment rates for hospitalized flu patients, especially small children.
ICEID abstracts (see page 132)

Report details mild H5N1 infections in Bangladesh
Bangladesh, which confirmed three more H5N1 avian flu cases this year to bring its total to six, remains the only country in the world with more than one H5N1 case yet no fatalities. An ICEID poster presentation today detailed two of those cases, both in young children who experienced mild forms of the disease in 2011. Researchers also detailed a mild H9N2 infection in a child younger than 5 years old. All cases were identified through surveillance. All the patients were previously healthy and had fever, cough, and/or runny nose. One H5N1 patient received oseltamivir, but all recovered without hospitalization or complications. All of the children had a history of poultry contact 7 to 10 days before symptom onset. H5N1 viruses isolated from the two patients were of clade 2.2, closely related to viruses circulating in Bangladeshi poultry. The researchers say the details highlight "the importance of surveillance in areas where avian influenza in poultry is endemic, in order to assess the risk of human infection."
ICEID program, with abstracts (see page 160)
Mar 12 WHO global H5N1 case count

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