In the face of influenza, does oseltamivir need to be stocked? Do I need to prepare other medications?

Recently, an increase in influenza cases has been reported in many places in China. In the latest weekly report on the outbreak released by the Beijing Municipal Center for Disease Control and Prevention on February 22, the number of reported cases of influenza topped the list.

"Flu A" related terms frequently rushed to the hot search, and the influenza "miracle drug" oseltamivir was out of stock. According to the latest report from the World Health Organization, the reason for the rise in influenza infections in China since February is related to the simultaneous transmission of two influenza A virus subtypes.

Subtypes of influenza viruses reported by China to Flunet. Image source: World Health Organization

Is Flu A really that scary?

In China, according to the different modes and speeds of transmission of infectious diseases and the degree of harm to human beings, infectious diseases are divided into three categories: A, B and C, and classified management is implemented (Class A> Class B > Class C).

"Flu A" is abbreviated, usually nail type H1N1 influenza, which is a class C infectious disease. Influenza A and B viruses circulate seasonally each year, with influenza A viruses causing global pandemics.

Image source: 123RF

China's influenza surveillance results show that every October, various places have entered the winter and spring epidemic season of influenza.

Influenza A has been adjusted from Class B tube to Class C infectious disease in China:

On April 30, 2009, influenza A(H1N1) was included in Class B infectious diseases, and prevention and control measures for Class A infectious diseases were taken;

In 2013, human infection with H7N9 avian influenza was classified as a Class B infectious disease, and influenza A(H1N1) was adjusted from Category B to Class C.

From the perspective of infectious disease grading, in the face of the frequent occurrence of this round of influenza, everyone does not have to worry too much.

Does the "miracle drug" oseltamivir need to be stockpiled?

First conclusion: not required. Although oseltamivir can be used to prevent and treat A flu, its use is limited. At the same time, oseltamivir has a certain degree of drug resistance and should not be taken for a long time.

Let's first look at the role of oseltamivir:

Oseltamivir (Oseltamivir) is a specific inhibitor acting on neuraminidase to inhibit further increases in the number of influenza viruses, thereby inhibiting the transmission of influenza viruses in the body to reduce pathogenicity. It is mainly used for the treatment and prevention of influenza A and B.

So how is oseltamivir used for the prevention and treatment of influenza A and B?

Prophylaxis:

According to China's Influenza Diagnosis and Treatment Plan (2020 Edition), post-exposure drug prophylaxis is recommended for close contacts (who have not been vaccinated or have not acquired immunity after vaccination) with risk factors for severe influenza, and it is recommended to take the drug no later than 48 hours after exposure. Oseltamivir or zanamivir may be used (at the same dose as the therapeutic amount, once daily for 7 days).

In layman's terms, oseltamivir is recommended for prevention only if the following two conditions are met:

are in a high-risk group and have not received influenza vaccines, or have immunological abnormalities, do not respond to vaccines, or have been vaccinated for less than 2 weeks;

People who have been exposed to suspected/confirmed influenza, or have recently traveled to a public outbreak site.

High-risk groups requiring oseltamivir prophylaxis:

• 1 child < 5 years old (age < 2 years are more likely to develop serious complications);
• 2 Seniors ≥ 65 years old;
• 3 Accompanied by the following diseases or conditions: chronic respiratory diseases, cardiovascular diseases (except hypertension), kidney diseases, liver diseases, blood system diseases, nervous system and neuromuscular diseases, metabolic and endocrine system diseases, malignant tumors, immune function suppression, etc.;
• 4. Obese people [body mass index (BMI) greater than 30];
• 5. Pregnant and perinatal women.

Treat:

In the "Influenza Diagnosis and Treatment Plan (2020 Edition)" suggests: after high-risk groups are infected with influenza, it is best to take oseltamivir as soon as possible within 48 hours, which can shorten the course of the disease, relieve symptoms, and reduce the rate of severe disease.

High-risk groups requiring oseltamivir:

• 1Children under 5 years of age (under 60 months);
• Seniors over 265 years of age;
• 3. Chronic diseases (such as chronic heart disease, lung disease, kidney disease, metabolic disease, neurodevelopmental disease, liver disease, blood disease);
• 4 in a state of immunosuppression (e.g., HIV/AIDS, chemotherapy or steroid therapy, malignancy);
• 5 obese people;
• 6. Pregnant and perinatal women.

Image source: 123RF

For non-high-risk groups, children aged 6 years and older, because influenza is not harmful to healthy people, it generally only causes fever, general pain, fatigue and mild respiratory symptoms, and most of them can heal on their own without treatment.

Note:

Oseltamivir is a prescription drug, take the drug according to the doctor's advice, do not self-medicate, do not stop at will, especially children under 1 year of age, pregnant women, lactating women;

Taking oseltamivir, preferably with meals, improves tolerance, reduces vomiting symptoms, and relieves gastrointestinal pressure.

In the face of influenza, whether other drugs need to be prepared

General principle: When you suspect that you may have influenza A, you should go to the hospital for testing. It is up to the doctor to determine whether it is a high-risk group and whether hospitalization is required. If you are not hospitalized, you can do it at home as follows:

01

Non-hospitalized patients are isolated at home, rooms are ventilated, and masks are worn. Get plenty of rest, drink plenty of water, and eat a diet that is easy to digest and nutritious.

02

Watch closely for changes, especially in children and older patients.

People at high risk of influenza virus infection are prone to severe influenza, and early antiviral treatment can reduce symptoms, reduce complications, shorten the course of the disease, and reduce the mortality rate.

03

Avoid blind or inappropriate use of antimicrobials. Use antimicrobials only when bacterial infection is indicated. In addition to oseltamivir described above, zanamivir (inhalation spray) can also be used, and it should be noted that zanamivir is suitable for adults and adolescents over 7 years of age.

04

Reasonable selection of antipyretic drugs, children should not use aspirin or aspirin-containing and other salicylic acid preparations.

Resources:

[1] Influenza Diagnosis and Treatment Protocol, 2020 edition

[2] WHO "Seasonal Influenza" https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)?gclid=CjwKCAiAr4GgBhBFEiwAgwORrcDvb3McPb0ff5dgbGlAvojMn4WFes_jSO2Z_ QNmAAgbNOHIbDLmexoCQX0QAvD_BwE

[3] Chinese Medical Journal "Chinese Expert Consensus on the Treatment and Prevention of Influenza Antiviral Therapy" (2016 edition)

Disclaimer: WuXi AppTec's content team focuses on global biomedical health research progress. This article is for informational purposes only, and the views expressed in this article do not represent the position of WuXi AppTec, nor do they represent WuXi AppTec's support or disapproval of the views expressed herein. This article is also not a treatment recommendation. For guidance on treatment options, go to a regular hospital.

Share, like, watch, spread health knowledge