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Flu Antivirals Stockpiles, Treatment for Prevention and Infection
  Download the PDF here: IDSA Guidelines Flu Diagnosis, Treatment, Prophylaxis
Reported by Jules Levin
This video from the CDC linked to below discusses the new swine flu and the use of antiviral therapy for prevention and treatment, and of note they discuss issues related to people at increased risk, which includes HIV+ individuals. The issues are interesting because my understanding is that in the USA the government stockpile of antivirals is intended to be adequate to provide antivirals for those individuals infected with the virus and is limited by not being designed to provide antivirals for family or caretakers for someone who might have this flu for prophylasix purposes; the government stockpile may be inadequate to include enough for access for these individuals. As well, my understanding is that doctors are not currently easily handing out prescriptions for antivirals unless one has been diagnosed with the virus but it takes several days to get diagnosis results back and this may be too late. My understanding is that stockpiles in certain Western European countries have been accumulated to include providing antivirals for family and caretakers of a person who might or does have the flu. Caretakers may include hospital personnel, first response personnel, and family or household members who may get exposed by a person they live with. It is generally recommended to begin therapy within 48 hours of infection by the flu to achieve the best results so if a person experiences flu symptoms it can take 2-3 days to get results back from a lab test to confirm if it is actually a flu or the swine flu. If one waits to receive a prescription and start antiviral medication until the lab results are back and the doctor contacts you and you receive that contact and go to pharmacy to get medication it might be longer than the 48 hours. It is also my understanding that doctors are not necessarily providing prescriptions upon initial presentation with flu symptoms until confirmation of the diagnosis is returned from the lab. That is exactly what happened to me when I presented to my doctor's office with flu symptoms. I was told that a prescription for antivirals was not given out until after the lab test with a confirmed diagnosis, and it is my understanding these instructions come from the CDC. My understanding is that antiviral treatment can include for the infected person, the person suspected of being infected particularly if the person is at greater risk such as if they have HIV, for potentially exposed people living with the person and for prophylaxis in certain prescribed situations. It appears is though USA CDC/Federal policy and stockpiles are inadequate and planning for a potential pandemic has not been yet done very well. The IDSA Guidelines say:
Who Should Be Treated with Antivirals?
15. Treatment should be considered for both adults and children with influenza virus infection who meet the following criteria:
b. Outpatients with laboratory-confirmed or highly suspected influenza virus infection who are not at increased risk of complications, whose onset of symptoms is !48 h before presentation, and who wish to shorten the duration of illness and further reduce their relatively low risk of complications (A-I) or who are in close contact with persons at high risk of complications secondary to influenza infection (table 3). Those whose onset of symptoms occurred 148 h before presentation with persisting moderate to severe illness may also benefit from treatment, but safety and efficacy in this population have not been evaluated prospectively (B-III).
CDC YouTube - H1N1 Flu and Antiviral Drugs
May 2, 2009 ... This podcast discusses the use of antiviral drugs for treating and preventing the H1N1 flu virus.
CDC H1N1 Flu | Antiviral Drugs and H1N1 Flu
CDC: April 29, 2009. This CDC report is a full discussion of antiviral therapy for H1N1, benefits of treatment, CDC recommendations, interim CDC guidance, antiviral resistance, prophylaxis “antiviral use for control of novel H1N1 influenza outbreaks, children under 1 year of age, pregnant women, adverse events and contraindications
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