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Pandemic Planning Toolkit A resource to assist your organization in preparing for pandemic influenza

TAMIFLU® (oseltamivir phosphate) has been studied only in strains of influenza that were circulating at the time. The magnitude of effect of TAMIFLU in treating and preventing novel strains of influenza, such as those that may be involved in a pandemic, cannot be predicted.

What is the likelihood of a flu pandemic?
The evolution of flu viruses cannot be predicted. This makes it difficult to know if or when a virus might mutate to become easily transmittable among humans. Therefore, it is impossible to say when another pandemic will arise, or whether it will be mild or severe.
 
However, the World Health Organization (WHO) asserts that once a virus allows for efficient human-to-human transmission, a pandemic can occur. Because of high global mobility and interconnection, illness could spread quickly and, if the virus has a high fatality rate, threaten millions of lives around the world.10

A lesson from the past

Pandemics are a reality. Health records show at least 10 influenza pandemics over the past 300 years.11
 
1732-1733
1781-1782
1800-1802
1830-1833
1847-1848
1857-1858
1889-1900
1918-1919
1957-1958
1968-1969
  12

 
A monitoring system has been created showing the levels of severity of a flu pandemic, learn what the levels are.



 
FOOTNOTE
10. The Avian Flu Working Group. The global economic and financial impact of an avian flu pandemic and the role of the IMF. February 28, 2006. Available at: http://www.imf.org/external/pubs/ft/afp/2006/eng/022806.htm. Accessed April 13, 2006.
11. Osterholm MT. Preparing for the next pandemic. N Engl J Med [serial online]. May 2005; 352:1839-1842. Accessed March 31, 2006.
12. Osterholm MT. Understanding pandemic influenza in the modern world. Paper presented at: Business Planning for Pandemic Influenza: A National Summit; February 14, 2006; Minneapolis, Minn.
Indications

TAMIFLU is indicated for the treatment of uncomplicated influenza caused by viruses types A and B in patients 1 year and older who have been symptomatic for no more than 2 days.

TAMIFLU is also indicated for the prophylaxis of influenza in patients 1 year and older.

TAMIFLU is not a substitute for early and annual vaccination as recommended by the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP).

Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use TAMIFLU.

Safety Information

There is no evidence for efficacy against any illness caused by agents other than influenza types A and B.

Treatment efficacy in subjects with chronic cardiac and/or respiratory disease has not been established. No difference in the incidence of complications was observed between the treatment and placebo groups in this population.

No information is available regarding treatment of influenza in patients at imminent risk of requiring hospitalization.

Efficacy of TAMIFLU has not been established in immunocompromised patients.

Safety and efficacy of repeated treatment or prophylaxis courses have not been studied.

Influenza can be associated with a variety of neurologic and behavioral symptoms, which can include events such as hallucinations, delirium and abnormal behavior, in some cases resulting in fatal outcomes. These events may occur in the setting of encephalitis or encephalopathy but can occur without obvious severe disease. There have been postmarketing reports (mostly from Japan) of delirium and abnormal behavior leading to injury, and in some cases resulting in fatal outcomes, in patients with influenza who were receiving TAMIFLU. Because these events were reported voluntarily during clinical practice, estimates of frequency cannot be made but they appear to be uncommon based on TAMIFLU usage data. These events were reported primarily among pediatric patients and often had an abrupt onset and rapid resolution. The contribution of TAMIFLU to these events has not been established. Patients with influenza should be closely monitored for signs of abnormal behavior. If neuropsychiatric symptoms occur, the risks and benefits of continuing treatment should be evaluated for each patient.

In postmarketing experience, rare cases of anaphylaxis and serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme, have been reported with TAMIFLU.

The most common adverse events reported >1% of patients treated with TAMIFLU and more commonly than in patients treated with placebo are:

  • Treatment of adult and pediatric patients - nausea, vomiting.
  • Prophylaxis of adult and pediatric patients - nausea, vomiting, abdominal pain.

Vaccination is considered the first line of defense against influenza.

Please see TAMIFLU full Prescribing Information for additional safety information.

 

Roche