INFECTIOUS DISEASES NEWS AND VIEWS*
WHO guidelines for antiviral treatment for H1N1 and other influenza,2009
The World Health Organization (WHO) has recently issued guidelines for antiviral treatment of novel influenzaA(H1N1)andother influenza.Thepurposeofthenewrecommendations, which were posted online recently, is to provide a basis for advice to clinicians regarding the use of the currently available antivirals for patients presenting with illness caused by influenzavirusinfection, as well as considerations regarding potential use of these antiviral medications for chemoprophylaxis.
H1N1 influenzainfectiontransmittedpersonto person was firstdetectedbyWHOinApril2009. Although the firstcaseswerelimitedto Mexico and the United States, subsequent spread overseas resulted in WHO declaring on June 11, 2009, the firstinfluenzapandemictooccur in 41 years.
On the basis of a review of data collected with previously circulating strains, and treatment of human H5N1 influenzavirusinfections, the new guidelines expand on recommendations published in May 2009, titled «Clinical management of human infection with new influenzaA(H1N1)virus:Initialguidance.» These new guidelines do not change recommendations in the WHO rapid advice
comguidelines on pharmacological management of humans infected with highly pathogenic avian influenzaA(H5N1)virus.
In April 2009, sustained person to person infections with H1N1 virus in Mexico and the United States have been reported to WHO. Although the firstcaseswerelimitedtothesetwo nations, subsequent international spread led WHO to declare on 11 June 2009 that the firstinfluenzapandemicin41yearshadoccurred.This 2009 pandemic H1N1 influenzavirushasnow spread worldwide, with confirmedcasesof pandemic H1N1 virus infection reported in more than 100 countries in all 6 WHO regions. This has led to the need to add to the existing guidance on the use of antivirals.
The new recommendations highlight oseltamivir and zanamivir, which are neuraminidase inhibitors, and amantadine and rimantadine, which are M2 inhibitors. Suggestions are also provided regarding the use of some other potential pharmacological treatments, such as ribavirin, interferons, immunoglobulins, and corticosteroids.
Management of patients with pandemic influenza(H1N1)2009virusinfectionistheprimary focus of the statement, although it also includes guidance regarding the use of the antivirals for treatment of other seasonal influenzavirusstrains,aswellasforinfectionsresulting from novel influenzaAvirusstrains.
The guidelines urge country and local public health authorities to issue local recommendations for clinicians periodically, based on epidemiological and antiviral susceptibility data on the locally circulating influenzastrains.Astheprevalenceandseverity of the current pandemic evolves,
WHO anticipates that additional data will be forthcoming that may require revision of the current recommendations. WHO therefore plans to review the guidance no later than September 2009 to determine whether modificationstotherecommendationsareneeded
The World Health Organization (WHO) has recently issued guidelines for antiviral treatment of novel influenzaA(H1N1)andother influenza.Thepurposeofthenewrecommendations, which were posted online recently, is to provide a basis for advice to clinicians regarding the use of the currently available antivirals for patients presenting with illness caused by influenzavirusinfection, as well as considerations regarding potential use of these antiviral medications for chemoprophylaxis.
H1N1 influenzainfectiontransmittedpersonto person was firstdetectedbyWHOinApril2009. Although the firstcaseswerelimitedto Mexico and the United States, subsequent spread overseas resulted in WHO declaring on June 11, 2009, the firstinfluenzapandemictooccur in 41 years.
On the basis of a review of data collected with previously circulating strains, and treatment of human H5N1 influenzavirusinfections, the new guidelines expand on recommendations published in May 2009, titled «Clinical management of human infection with new influenzaA(H1N1)virus:Initialguidance.» These new guidelines do not change recommendations in the WHO rapid advice
comguidelines on pharmacological management of humans infected with highly pathogenic avian influenzaA(H5N1)virus.
In April 2009, sustained person to person infections with H1N1 virus in Mexico and the United States have been reported to WHO. Although the firstcaseswerelimitedtothesetwo nations, subsequent international spread led WHO to declare on 11 June 2009 that the firstinfluenzapandemicin41yearshadoccurred.This 2009 pandemic H1N1 influenzavirushasnow spread worldwide, with confirmedcasesof pandemic H1N1 virus infection reported in more than 100 countries in all 6 WHO regions. This has led to the need to add to the existing guidance on the use of antivirals.
The new recommendations highlight oseltamivir and zanamivir, which are neuraminidase inhibitors, and amantadine and rimantadine, which are M2 inhibitors. Suggestions are also provided regarding the use of some other potential pharmacological treatments, such as ribavirin, interferons, immunoglobulins, and corticosteroids.
Management of patients with pandemic influenza(H1N1)2009virusinfectionistheprimary focus of the statement, although it also includes guidance regarding the use of the antivirals for treatment of other seasonal influenzavirusstrains,aswellasforinfectionsresulting from novel influenzaAvirusstrains.
The guidelines urge country and local public health authorities to issue local recommendations for clinicians periodically, based on epidemiological and antiviral susceptibility data on the locally circulating influenzastrains.Astheprevalenceandseverity of the current pandemic evolves,
WHO anticipates that additional data will be forthcoming that may require revision of the current recommendations. WHO therefore plans to review the guidance no later than September 2009 to determine whether modificationstotherecommendationsareneeded
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