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Keep swine flu drugs for serious cases, says WHO
Published in Saudi Press Agency on 21 - 08 - 2009


Healthy patients who get H1N1
swine flu without suffering complications do not need to be
treated with antivirals like Tamiflu, Reuters quoted the World Health
Organisation (WHO) as saying today.
But the drugs are strongly recommended for pregnant women,
patients with underlying medical conditions and children under
5, since they are at increased risk of more severe illness.
However, judging who will need antivirals is not easy for
doctors since the risk of developing severe illness from the new
flu strain is not restricted to people who have chronic
conditions such as heart disease, diabetes or asthma.
"Worldwide, around 40 percent of severe cases are now
occurring in previously healthy children and adults, usually
under the age of 50," the U.N. agency said in its latest
guidelines on drug use.
"Some of these patients experience a sudden and very rapid
deterioration in their clinical condition, usually on day 5 or 6
following the onset of symptoms," it said.
Despite the WHO's conclusion that underlying medical
conditions do not predict a severe infection, the fact that 6
out of 10 patients suffering serious bouts of swine flu do have
previous conditions chimes with other medical research.
A study published on Thursday by France's Institute for
Public Health Surveillance concluded that about half the people
dying from swine flu were pregnant or had other health
conditions, especially diabetes or conditions linked with
obesity.
The WHO said doctors should give Tamiflu to patients with
severe illness or whose condition deteriorates, or to
high-risk groups including pregnant women, but not to healthy
people with no complications, as most of these recover fully
within a week.
International experts who reviewed the latest evidence found
that Tamiflu, made by Switzerland's Roche, "can significantly
reduce the risk of pneumonia", a leading cause of death for both
pandemic and seasonal flu, it said.
Viral pneumonia, which does not respond to antibiotics, can
lead to the failure of multiple organs, including the heart,
kidneys and liver, so patients will require intensive care and
additional treatment to antivirals.
"Studies show that early treatment, preferably within 48
hours after symptom onset, is strongly associated with better
clinical outcome," the WHO said.
The recommendation applies to all patients, including
pregnant women and all age groups including infants.
When oseltamivir, the generic name for Tamiflu, is not
available or cannot be used for any reason, zanamivir, made by
GlaxoSmithKline under licence from Biota and sold under the
brand name Relenza, may be given, it said.
The WHO said it has been notified of 12 cases where the H1N1
virus had been resistant to treatment with Tamiflu, as a result
of a mutation. There was no evidence of onward transmission of
the virus in these cases, it said.
The H1N1 strain has now spread to 177 countries, causing at
least 1,799 deaths, the WHO said in a separate statement.


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