Swine flu antiviral prophylaxis not advised

IT would be premature to recommend taking neuraminidase inhibitors for swine flu prophylactically, leading researcher Professor Robert Booy says.

However, should a pandemic be declared, it was reassuring that the US Centers for Disease Control had found the drugs oseltamivir and zanamivir to be sensitive to the swine influenza A/H1N1.

Professor Booy, co-director of the National Centre for Immunisation Research and Surveillance, Sydney, said people might want to take a supply of the drugs with them in case they got the flu overseas, but taking it prophylactically “every day for a month’s holiday” would be costly and might eventually threaten commercial supplies.

Australia’s chief medical officer Professor Jim Bishop said last week that the antivirals were recommended for confirmed and probable cases of swine flu, and their close contacts.

Definitions of suspected, probable and confirmed cases are available from the RACGP and Commonwealth Health Department websites.

“There is no current recommendation for oseltamivir to be used prophylactically by travellers visiting affected countries, apart from Mexico,” Professor Bishop wrote last week.

In addition, young, healthy people arriving at surgeries in droves to be immunised against swine flu, should be advised that the current seasonal influenza vaccination would not protect them, Professor Booy said.

However, the threat of a pandemic might prompt GPs to urge those at high risk of complications from seasonal influenza – including the elderly, chronically ill and pregnant women – to get vaccinated.

“It would be a disaster for these people to get both a seasonal flu and swine flu at the same time, so you can reduce the risk of serious illness with vaccination in the medically at-risk,” he said.

Professor Booy said most patients could be advised that “it’s quite unlikely they would gain benefit against swine flu from the seasonal vaccination”.

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