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What role could Antivirals play in a pandemic


Antivirals to play dual role: Prevention and Treatment

Influenza - Prevention 

Antivirals could play two principal roles in the management of seasonal flu:

Research has demonstrated the effectiveness of Antivirals when used for both purposes. When used for treatment purposes, these drugs need to be administered within 48 hours after the onset of symptoms. 1,2

Experts recommend Antivirals for pandemic flu management

  1. The Australian federal pandemic plan makes it clear that antivirals are an important part of a comprehensive public health intervention to reduce illness and death 5
  2. The World Health Organisation (WHO) recommends Antivirals for the prevention of pandemic influenza disease in household contacts. This recommendation is based on the effectiveness of Antivirals in preventing ordinary influenza in healthy and elderly patients and children ages 1 year and older. 29
  3. Recent studies, based on mathematical modelling, suggest that Antivirals could be used prophylactically near the start of a pandemic to reduce the risk that a fully transmissible virus will emerge (or at least to delay its spread internationally), thus gaining time to augment vaccine supplies. 26,27

The success of this strategy, which has never been tested, depends on several assumptions about the early behavior of a pandemic virus, which cannot be known in advance. Success also depends on excellent surveillance and logistics capacity in the initially affected areas, combined with an ability to enforce movement restrictions in and out of the affected area. To increase the likelihood that early intervention using the WHO rapid-intervention stockpile of antiviral drugs will be successful, surveillance in affected countries needs to improve, particularly concerning the capacity to detect clusters of cases closely related in time and place.29

Experts look to neuraminidase inhibitors for pandemic flu

The Antivirals belong to a drug class known as neuraminidase inhibitors. In laboratory studies, the neuraminidase inhibitors have been shown to reduce the duration of illness caused by seasonal influenza.28 The efficacy of the neuraminidase inhibitors depends on their administration within 48 hours after symptom onset. Studies are currently underway to examine the efficacy of Antivirals against potential pandemic strains of influenza.29