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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.

How would a pandemic impact the US?
A flu pandemic may strike in waves, each of which could last for 6 to 8 weeks. An especially severe pandemic could lead to widespread illness, a large number of deaths, and economic loss. Everyday life would be disrupted because so many people in so many places would become seriously ill at the same time.
 
Impact could range from school and business closings to the interruption of such basic services as public transportation and food delivery.

Health services overwhelmed

A substantial portion of the world's population would require some form of medical care. Healthcare facilities would be overwhelmed, creating a strain on hospital staff, and a shortage of beds, ventilators, and other supplies.
 
To cope with the demand, "surge capacity" at nontraditional sites, such as schools, may need to be created. The need for vaccine is likely to outstrip supply and the supply of antiviral drugs is also likely to be inadequate early in a pandemic. Difficult decisions would need to be made regarding who gets these vaccines and antivirals.

High mortality rates

Mortality rates are determined by four factors:
  • Number of people who become infected
  • Virulence of the virus
  • Underlying characteristics and vulnerability of affected populations
  • Availability and effectiveness of preventive measures

Number of Deaths in Most Recent Pandemics
Pandemic
US Deaths
Worldwide
Deaths
1918/19 500,000+ 40,000,000+
1957/58 70,000+ 1,000,000-2,000,000
1968/69 34,000 700,000+
 
Learn how the US government is protecting the country in case of a pandemic.
 
Read more about how a pandemic would impact mortality rates.



 
FOOTNOTE
14. US Dept of Health and Human Services. General information. Available at: http://www.pandemicflu.gov/general. Accessed April 13, 2006.
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