Thursday, March 25, 2010

Does Oseltamivir Reduce Influenza Transmission?

Oseltamivir is an effective treatment for influenza, but little is known about whether it reduces infectiousness. To explore this possibility, researchers performed a secondary analysis of a community-based trial that took place in Hong Kong during the influenza seasons of 2007 and 2008, before the 2009 influenza A (H1N1) epidemic. Individuals were enrolled in the trial at the time of influenza diagnosis and were followed, along with household members, for 7 to 10 days. Decisions regarding oseltamivir use were made by the treating physician.
Of the 384 eligible study participants, 90 received oseltamivir; the rest received no antiviral therapy. Oseltamivir use was associated with a significant reduction in the time to resolution of all symptoms (P=0.01) and of respiratory symptoms (P=0.03), in particular. However, the drug was not associated with a significant reduction in the duration of viral shedding or in the likelihood that household contacts would become infected. The secondary attack rate did vary, though, according to the time of initiation of oseltamivir: 4.7% when it was initiated within 24 hours of symptom onset, 6.0% when it was initiated within 24 to 48 hours after symptom onset, and 7.0% when it was initiated >48 hours after symptom onset (P for trend<0.01).

Reference: Journal Watch Infectious Diseases (March 24, 2010)

Take home message: Oseltamivir is effective in reducing severity of influenza symptoms and shortens recovery time. However, it may not have an effect on decreasing the infectiousness unless administered early on in the course of the infection.

FDA Tells Physicians to Temporarily Stop Using Rotarix Vaccine

The FDA is advising clinicians to temporarily stop using the rotavirus vaccine Rotarix because components of a separate virus, porcine circovirus 1 (PCV1), have been detected in the vaccine.
PCV1 is not known to cause illness in humans, and according to FDA Commissioner Dr. Margaret Hamburg, "there is no evidence at this time that there is a safety concern."
The agency says that children who've already received one dose of Rotarix can receive RotaTeq instead for the next two doses to complete the series.
The FDA will continue to investigate the finding and expects to make additional recommendations on the use of rotavirus vaccines after an expert advisory committee meets in about 4 to 6 weeks.

Reference: Physician's First Watch

Background information:
Retrovirus causes stomach flu, it is a common infection that affects infants and young children worldwide. Once a child has had the infection, immunity develops. Rotavirus infection leads to vomiting, diarrhea, malabsorption and a low grade fever. Covnetional treatment focuses on symptom management ensuring adequate re-hydration and electrolyte replacement. In severe cases, death can result, however, with proper management, prognosis is excellent.
For those of you with new babies, it is important to read the following!!

"Infantino has recalled 1 million of its SlingRider and Wendy Bellissimo infant slings because they pose a suffocation hazard, according to the U.S. Consumer Product Safety Commission.
Consumers should immediately stop using the slings in infants younger than 4 months and contact the company for replacement products. Three infants died in these slings in 2009."

To read the news release by the Consumer Product Safely Commission, go to: http://www.cpsc.gov/cpscpub/prerel/prhtml10/10177.html

Source: Physician's First Watch