Pandemic Influenza Plan - Questar III

Section 7: Antiviral Medication Procurement, Distribution, and Use
• Post-Exposure Prophylaxis
Planning Considerations
o Post-exposure prophylaxis (PEP) is the administration of antivirals after a
person has been exposed to the pandemic virus.
o PEP generally lasts for 10 days.
PEP After Contact with an Influenza Case
o PEP may be useful to control small, well-defined disease clusters.
o PEP may be useful to prevent disease in household contacts of pandemic
influenza patients.
o PEP may be useful to protect key personnel after vaccination and during the
period between vaccination and the development of immunity (usually 2
weeks). The administration of antivirals does not interfere with the
development of antibodies to influenza virus after the administration of an
inactivated vaccine.
o State and local health departments in consultation with CDC will recommend
which contacts should receive PEP, depending on availability of antivirals and
the epidemiology of the pandemic.
B. Timing of the Use of Antiviral Medications
Recommendations during the Interpandemic and Pandemic Alert Periods: Use of
Antivirals in the Management of Cases with a Novel Influenza Strain
o The term “novel strain of influenza” is used to refer to avian or animal
influenza strains that can infect humans (like the H5N1 strain), and new or reemergent
human influenza viruses that cause cases or clusters of human
disease. See Section 2: Surveillance and Laboratory Testing for a discussion
of the detection and identification of novel strains.
o A person with a suspected case of a novel strain of influenza should be
isolated as described in Section 8: Travel-Related Disease Control and
Community Prevention, and treated according to the clinical algorithm
described in Section 5: Clinical Guidelines, ideally within 48 hours.
o State and local health departments may consider the use of antivirals to
contain small clusters of infection as a community-wide measure. This should
be considered only during a small outbreak or in a well-defined setting such as
military base or nursing home.
o Feasibility would need to be evaluated in terms of antiviral supply, and
whether rapid delivery and administration could be accomplished.
Recommendations for the Pandemic Period: When pandemic influenza is reported
abroad, or sporadic pandemic influenza cases are reported in the United States,
without evidence of spread
o Consider the use of antivirals in treatment, prophylaxis, or PEP in the context
of containing limited outbreaks or in contained settings.
February 7, 2006 7-6