Biosecurity News in Brief

Subscribe | About | Current Issue | RSS | Archive

HHS Issues Guidance on Antiviral Drug Use During a Pandemic

By Kunal Rambhia, December 22, 2008

On December 16, 2008, HHS released a revised version of its Guidance on Antiviral Drug Use during an Influenza Pandemic. This document replaces HHS’s 2005 pandemic influenza plan.¹ HHS makes the following recommendations, which are designed to slow the spread of disease, reduce health effects, and minimize societal and economic disruption during a pandemic:

• Focus treatment and post-exposure prophylaxis (PEP) on targeted individuals and geographic locations
• Employ border policies to reduce introduction of infection into the U.S.
• Administer early treatment to those who present for care
• Use prophylaxis to protect high-risk healthcare workers and emergency services personnel throughout the pandemic
• Offer PEP to healthcare and emergency services workers who are not high-risk; to immune-compromised individuals less likely to benefit from a vaccine; and to individuals in group homes, nursing homes, prisons and other facilities should infection occur.¹

The new guidance also offers a strategy for stockpiling antivirals. The Strategic National Stockpile (SNS) currently holds 81 million regimens of influenza antiviral drugs for the public, 6 million of which are specifically intended to contain and slow the entry of pandemic disease into the U.S.¹ The SNS supply of antiviral drugs is approximately 80% oseltamivir (Tamiflu^®) and 20% zanamivir (Relenza^®), both of which are neuraminidase inhibitors. The SNS also includes several million doses of rimantadine, an M2 inhibitor. However, M2 inhibitors are not a major part of the strategy because of existing M2 resistance in circulating influenza A strains.¹ Additionally, HHS recommends that governments, healthcare organizations, businesses, and families stockpile antiviral drugs as well. Some guidance on prioritization of antiviral use when supplies are limited is provided. Finally, HHS suggests steps to further improve the strategy and recommendations.

References

1. U.S. Department of Health and Human Services. Guidance on Antiviral Drug Use during an Influenza Pandemic. December 16, 2008. http://www.pandemicflu.gov/vaccine/antiviral_use.pdf. Accessed December 19, 2008.