Pandemic Influenza Plan - Questar III

Section 7: Antiviral Medication Procurement, Distribution, and Use
o Use of antivirals to contain small, well-defined disease clusters in order to
possibly delay or reduce spread to other communities could be considered.
When there is limited transmission of pandemic influenza in the United
States
o Treatment decisions would be based on:
– Laboratory-confirmed identification of the pandemic subtype by viral
isolation, RT-PCR, or other means recommended by CDC, OR
– Detection of influenza A by rapid antigen test, OR
– Epidemiologic and clinical characteristics
o Treatment should be initiated before laboratory confirmation is obtained since
early treatment is more effective. As infection becomes more common false
negatives from rapid antigen tests are more likely, and treatment should
continue while awaiting confirmatory tests.
When there is widespread transmission of pandemic influenza in the United
States:
o Treatment decisions will be based on clinical features and epidemiologic risk
factors, taking into account updated knowledge of the epidemiology of the
pandemic strain.
o Laboratory results will no longer be needed to initiate and continue treatment.
• Prophylaxis
Planning Considerations
o Prophylaxis requires the long-term use of antiviral medications to protect the
recipient from acquiring influenza.
o There will be limited supplies, increasing risk of side effects, and the potential
emergence of resistance with long-term use.
o Prophylaxis must be continued until the risk of exposure is reduced.
o Prophylaxis may be more effective than therapy in maintaining quality
healthcare and public safety.
o The need may decrease as vaccine becomes available.
o The number of persons who receive prophylaxis should be minimized,
primarily to extend supplies available to treat persons at highest risk of serious
morbidity and mortality.
Prophylaxis against Influenza Disease
o Prophylaxis will be administered according to supply and priority group.
o Prophylaxis may be used early in the pandemic to control limited outbreaks or
in contained settings.
o Prophylaxis use will be determined by the susceptibility of the circulating
influenza strain and the epidemiology of the pandemic.
February 7, 2006 7-5