Case Characteristics and Use of Oseltamivir in Children and Household Contacts

Abstract

In May 2009, the onset of pandemic influenza A (H1N1) began in Buenos Aires schools and a containment program was implemented. We report the first 191 school-aged cases. Influenza (H1N1) was a mild disease in children. Oseltamivir was well tolerated and resulted in a significantly reduced duration of symptoms in this group. Oseltamivir was also effective at preventing secondary cases.

Use of Neuraminidase Inhibitors for Rapid Containment of Influenza: A Systematic Review and Meta-Analysis of Individual and Household Transmission Studies

“…Sensitivity analyses of the oseltamivir data demonstrated pooled estimates for individual protection comparable to the primary analysis for experimental studies of seasonal influenza (n = 4 studies [27] – [29] , [34] ; OR = 0.15; 95% CI 0.07 to 0.33; p<0.001; I 2 = 37.3%) and observational studies of influenza A(H1N1)pdm09 (n = 4 studies [35] , [37] , [38] , [41] ; OR = 0.09; 95% CI 0.04 to 0.19; p<0.001; I 2 = 61.7%). Meta-analysis of prophylaxis with oseltamivir against seasonal influenza for household protection also showed statistically significantly lower pooled odds of laboratory confirmed influenza compared to placebo or no therapy (n = 2 studies [27] , [34] ; OR = 0.23; 95% CI 0.09 to 0.59; p<0.002; I 2 = 39.0%; see Fig.…”

“…The RCTs (n = 9) [26] – [34] and observational studies (n = 8) [6] , [35] – [41] involved 10,532 and 8,740 individuals respectively (total = 19,272). We found no articles on avian influenza that met our study eligibility criteria.…”

“…Post-exposure prophylaxis against seasonal influenza provided statistically significant protective efficacy of 58.5% and 84% for household contacts respectively [27] , [34] . Six observational studies evaluated oseltamivir for post-exposure prophylaxis against influenza A(H1N1)pdm09 [35] – [38] , [40] , [41] and one observational study against seasonal influenza [6] . The secondary attack rate (SAR) among household contacts was found to be lower in those given prophylaxis (0%) compared to those not (8.5%).…”

“…There was a significant reduction in influenza R 0 from 1.91 (95% CI 1.50 to 2.36) before prophylactic intervention to 0.11 after intervention (95% CI 0.05 to 0.20; Bayesian posterior hypothesis p<0.001) [37] . Meta-analysis of oseltamivir prophylaxis for individual protection irrespective of study design, influenza strain and combining pre- and post-exposure studies showed the pooled odds of laboratory confirmed influenza was statistically significantly lower compared to placebo or no therapy (n = 8 studies [27] – [29] , [34] , [35] , [37] , [38] , [41] ; OR = 0.11; 95% CI 0.06 to 0.20; p<0.001; I 2 = 58.7%; see Fig. 3 ).…”

Oseltamivir Treatment for Influenza in Hospitalized Children Without Underlying Diseases

“…[7][8][9][10][11][12][13][14] In a recent analysis performed by Wang et al, 15 the authors concluded that the use of antiviral agents for treating influenza infection in healthy children with no underlying medical conditions has only shown a modest benefit in reducing the duration of illness, did not reduce mortality and readmission rate and was associated with a significantly increased risk of vomiting. On the contrary, although transmission of oseltamivir-resistant viruses is exceptional, person-to-person transmission of oseltamivir-resistant viruses has been reported.…”