H1N1 - CDC Advisory - Rapid Flu Test Not Working - Many Need Tamiflu Anyway

[maroo]

The CDC has released an advisory...I have bolded parts of this...

Link to source:

http://www.cdc.gov/h1n1flu/recommendations.htm


"Recommendations for Early Empiric Antiviral Treatment in Persons with Suspected Influenza who are at Increased Risk of Developing Severe Disease

Summary Recommendations: When treatment of influenza is indicated in a patient with suspected influenza, health care providers should initiate empiric antiviral treatment as soon as possible. Waiting for laboratory confirmation of influenza to begin treatment with antiviral drugs is not necessary. Patients with a negative rapid influenza diagnostic test should be considered for treatment if clinically indicated because a negative rapid influenza test result does not rule out influenza virus infection. The sensitivity of rapid influenza diagnostic tests for 2009 H1N1 virus can range from 10% to 70%, indicating that false negative results occur frequently.

***

Early empiric treatment should be considered for persons with suspected or confirmed influenza who are at higher risk for complications, even if not hospitalized, including:

o Children younger than 2 years old

o Adults 65 years and older

o Pregnant women

o Persons with the following conditions:

· Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), or metabolic disorders (including diabetes mellitus);

· Disorders that that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders)

· Immunosuppression, including that caused by medications or by HIV;

· Persons younger than 19 years of age who are receiving long-term aspirin therapy, because of an increased risk for Reye syndrome.






~~ This is a change from the previous guidelines. It indicates that more people should be prescribed an antiviral (like Tamiflu) ASAP - even if they have a NEGATIVE flu test. The flu test is not working - it is only 10% - 70% accurate. ~~

 

[wdwmom2]

Unfortunately, in my area, there have been docs and ERs who have been handing it out like Halloween candy. I'm not talking about patients who really need it, I am talking about people who fit nowhere into the guidelines for needing it, and have a mild case. We have patients calling because they have been around someone who has been around someone who tested postive. They want Tamiflu "just in case". If we prescribed it for all the "just in cases" we definitely wouldn't have it for the "I need it NOW!" group. Now we have patients who really need it and can't find it at any pharmacy around!!!! What a frustrating situation to be in!

Stay well EVERYONE

 

[maroo]

Unfortunately, in my area, there have been docs and ERs who have been handing it out like Halloween candy. I'm not talking about patients who really need it, I am talking about people who fit nowhere into the guidelines for needing it, and have a mild case. We have patients calling because they have been around someone who has been around someone who tested postive. They want Tamiflu "just in case". If we prescribed it for all the "just in cases" we definitely wouldn't have it for the "I need it NOW!" group. Now we have patients who really need it and can't find it at any pharmacy around!!!! What a frustrating situation to be in!

Stay well EVERYONE

This is very true! I know a part of me wants to have some around if someone that REALLY needs it needs it and can't get it...but I have been fighting the urge to get some to allow those who need it now to get it.

It may be that the pandemic causing epidemic amounts of deaths in October is enough to release some of the national strategic stockpile? At what point do they consider that? There is a lot of Tamiflu around...but they seem to be saving it for a rainy day. It seems pretty cloudy to me. It isn't the bird flu - thank God - but it would be nice to have enough Tamiflu to go around to those that are sick and need it.

I think many people are being told that they just have "bronchitis" or even "pneumonia" but not being treated for the flu.

 

[wdwmom2]

I work in pediatrics and I am exposed to it EVERY day that I work. Most of the children that we see have mild cases. There have only been a few cases, that I know of, that have needed Tamiflu. But it is early in the flu season. I would think that we will see some more severe cases before the season ends. But I really hope not!!!! Keeping my fingers crossed!

 

[maroo]

I work in pediatrics and I am exposed to it EVERY day that I work. Most of the children that we see have mild cases. There have only been a few cases, that I know of, that have needed Tamiflu. But it is early in the flu season. I would think that we will see some more severe cases before the season ends. But I really hope not!!!! Keeping my fingers crossed!

Both of the children I take care of (one with severe CP and one with immunodef) had to have Tamiflu in late September. We were glad to have it for them.

Their ped even gave it to the one with CP the day before she got symptoms since her brother had it. We believe this kept her out of the hospital (as most of the time she ends up in the hospital if she gets the flu) - she got pretty sick, but not too terribly sick and were very grateful for it.

I just see the parents of some of our at risk kids getting flu like symptoms and being told "not to worry about it." They test negative for the flu and that is it...no "decision making" on the provider's part to be able to tell if they could have the flu but a negative test.

The test is flawed. And even the CDC is saying that now. So hopefully the medical community will take this to heart and prescribe it before the patient gets too sick.