What are the treatment issues for children who may have the (H1N1) 2009 virus?
SOME CONFUSION has emerged around the use of Tamiflu to treat children following the publication of research by a team from the University of Oxford.
Based on an analysis of seven trials of the drugs Tamiflu and Relenza involving 1,766 children with seasonal influenza, it found that a course of antivirals given to children after they were exposed to the virus resulted in an 8 per cent decrease in flu transmission.
It suggests 13 children would need to be treated to prevent one additional case of influenza.
The Oxford researchers concluded that using the drug had little or no effect on acute flare-ups in children with asthma. Nor did antivirals reduce secondary ear infections in children or the likelihood of them requiring antibiotic treatment.
Children taking Tamiflu were also more likely to experience vomiting, mirroring research published in July suggesting that more than half of children given Tamiflu reported minor side-effects. However, there are a number of caveats associated with this latest research.
It is an analysis of older trials carried out on seasonal influenza and does not apply directly to swine flu. The number of previous trials analysed is relatively small and it did conclude that if started within 48 hours of symptom onset, Tamiflu could shorten the length of the illness in children by up to 1½ days.
Lead researcher Dr Matthew Thompson said the benefits of using antivirals to manage the disease in children, who do not have underlying health problems, are “fairly small”.
Dr Kevin Kelleher of the Health Service Executive said yesterday: “We have taken the approach [in Ireland] that not everybody who gets the pandemic flu needs to be treated with antivirals, and we have stated clearly that we believe only people who have pre-existing conditions, who are more likely to get complications, and those people who are severely ill with the virus should be treated in this way.”
So what should parents do if they suspect their child has pandemic (H1N1) 2009 virus? If your child is otherwise healthy and has mild symptoms, they are unlikely to benefit from antiviral medication. Rest, fluids and paracetamol is the best initial treatment.
* If the child has an underlying chronic illness, you should contact your family doctor to discuss the need for Tamiflu to prevent further complications.
* For a child with severe flu-like symptoms, you should contact your doctor as they may also benefit from Tamiflu treatment.
* A parent worried about a sick child for any reason should make telephone contact with their local practice or out-of-hours service to discuss their concerns.