Microsoft word - swine flu guide 110105.doc


What is tamiflu?
Tamiflu is the more well-known antiviral treatment for swine flu. The other antiviral treatment is called Relenza. Antiviral treatments are currently being offered to all people who have been clinically diagnosed with swine flu, but especially those who are in the at-risk groups. You are entitled to one course of treatment within 7 days of symptoms starting. Am I in an at-risk group?
You are in an at-risk group if you are considered to be at increased chance of developing complications if you got flu. Examples of at-risk groups are: children aged 5 years and under, those aged 65 years or over, those with chronic lung or heart disease (e.g., asthma, chronic bronchitis, heart failure, angina, stroke), those with liver or kidney disease, those with neurological disorders (e.g., MS, parkinson’s), those with suppressed immune systems (e.g., on steroids, cancer drugs), What are the complications of flu?
The complications of flu include chest infections, pneumonia, worsening of existing heart disease, and rarely, meningitis, encephalitis (inflammation of the brain) and acute inflammation of nerves. Most people recover without complications. I have been diagnosed with swine flu – do I need antiviral treatment?
In answering this question, you may wish to consider the following information about antiviral treatment: GOOD POINTS ABOUT ANTIVIRAL TREATMENT
• It can reduce the duration of symptoms by a day or two • It is not a cure for swine flu or any other flu-like illness • It can reduce the severity of symptoms • You still need to self-treat your flu illness with paracetamol, • It can reduce the chance of transmitting the virus to another • If more than 48 hours have passed since your symptoms • It may reduce the chance of serious complications from flu started, antiviral treatment is unlikely to be of any benefit • Serious side effects can occur (see below) • Swine flu is generally mild compared to normal seasonal flu so you may consider it is not worth treating • It cannot stop you getting another dose of flu at a later date What are the side effects of antiviral treatment?
Tamiflu is a relatively new drug. This means that its safety outside of clinical trials is still being carefully monitored. The side effects of tamiflu include nausea, vomiting, abdominal pain, diarrhoea, headache, conjunctivitis and rash. Less commonly, hepatitis (inflammation of the liver), irregular heart rhythms, neuropsychiatric disorders in children and adolescents (fits and delirium, altered level of consciousness, confusion, abnormal behaviour, delusions, hallucinations, agitation, anxiety, nightmares and in a very few cases accidental injury and death), visual disturbances and severe skin reactions have been reported. Relenza can cause chest tightness, respiratory problems, acute allergic reactions, rashes and also neuropsychiatric disorders as described above. OK, so I take the antiviral treatment. What if I get flu again? What if I didn’t have swine flu the first time?
Swine flu may mutate into a more virulent (dangerous) strain of flu or it may combine with normal seasonal flu to form a new strain. So you could catch flu again. Unfortunately, you are only allowed to have one course of treatment. So should I take antiviral treatment or not?
Unfortunately, the case for antiviral treatment is not as clear cut as both the government or the media would make out. As doctors we have a duty to always balance the potential risk of doing harm to patients against the benefits of the treatment, rather than make blanket recommendations or blindly follow guidance and regulations to issue medications and expect our patients to take them, regardless of the consequences. Your doctor will discuss these issues with you, but ultimately the decision for your doctor to issue antiviral treatment and for you to take it will have to be a shared one based on your individual circumstances and opinion and the information we have on swine flu at the current time.



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