Neuraminidase inhibitor (NAI) antiviral medications should be brought to bear early and often to stave off severe and fatal flu infections due to a vaccine mismatch this season, the CDC recommends.¹

“The CDC recommends antiviral medications for treatment of influenza as an important adjunct to annual influenza vaccination,” the agency stated in its health advisory. “Treatment with neuraminidase inhibitors has been shown to have clinical and public health benefit in reducing illness and severe outcomes of influenza based on evidence from randomized controlled trials, meta-analyses of randomized controlled trials, and observational studies during past influenza seasons and during the 2009 H1N1 pandemic.… All hospitalized, severely ill, and high-risk patients with suspected or confirmed influenza should be treated with antivirals.”

Some of the key CDC recommendations are summarized as follows.

Any patient with suspected or confirmed influenza in the following categories should be treated as soon as possible with a neuraminidase inhibitor:

• a patient who has severe, complicated, or progressive illness — this may include outpatients with severe or prolonged progressive symptoms or who develop complications such as pneumonia but are not hospitalized;
• a patient who is at higher risk for influenza complications but not hospitalized. Patients in this group include children younger than two years;
• people with chronic pulmonary problems, including asthma; cardiovascular, renal, hepatic, hematological, and metabolic disorders, or neurologic and neurodevelopment conditions such as stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury;
• people with immunosuppression, including that caused by medications or by HIV infection;
• women who are pregnant or postpartum (within two weeks after delivery);
• people aged younger than 19 years who are receiving long-term aspirin therapy;
• American Indians and Alaska Natives;
• people with extreme obesity (i.e., body mass index equal to or greater than 40);
• residents of nursing homes and other chronic care facilities.

REFERENCE

1. CDC. Seasonal Influenza A(H3N2) Activity and Antiviral Treatment of Patients with Influenza. Health Alert Network. Dec. 27, 2017. Available at: http://bit.ly/2E9AstE.