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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 avian flu?

Avian flu among birds2

Avian flu is an infection caused by bird flu viruses. These influenza type A viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines but usually do not get sick from them. However, avian flu is very contagious among birds and can make some domesticated birds (including chickens, ducks, and turkeys) very sick and kill them.

Infected birds shed flu virus in their:
  • saliva
  • nasal secretions
  • feces
Susceptible birds become infected when they have contact with contaminated secretions or excretions or with surfaces that are contaminated with secretions or excretions from infected birds.

Domesticated birds may become infected with avian flu virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.

Avian flu among humans2

The risk from avian flu is generally low among most people because the viruses do not usually infect humans. However, confirmed cases of human infection from several subtypes of avian flu infection have been reported.

Most cases of avian flu infection in humans have resulted from contact with infected poultry, such as:
  • domesticated chickens
  • ducks
  • turkeys
  • surfaces contaminated with secretions/excretions from infected birds
The spread of avian flu viruses from one ill person to another has been reported rarely and the cases are still unconfirmed. The transmission of this infection has not been observed to continue beyond one person.

If the virus mutates to allow easy spread from one person to another, thousands, even millions of people can become infected, resulting in a pandemic.

The symptoms of avian flu may depend on which virus caused the infection. Known symptoms in humans have included:
  • typical human flu-like symptoms (fever, cough, sore throat and muscle aches)
  • eye infections
  • pneumonia
  • severe respiratory diseases (such as acute respiratory distress)
  • other severe and life-threatening complications

Find out what the differences are between the avian flu and pandemic flu.

Learn why experts are concerned about the avian flu.

 
FOOTNOTE
2. US Dept of Health and Human Services. Centers for Disease Control and Prevention Web site. Key facts about avian influenza (bird flu) and avian influenza A (H5N1) virus. Available at: http://www.cdc.gov/flu/avian/gen-info/facts.htm. 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.
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