CDC Guidance on the Use of Influenza Antiviral Agents and Rapid Influenza Diagnostic Tests
During the 2010-2011 Influenza Season
To: Health Care Providers
From: Patsy Kelso, PhD, State Epidemiologist for Infectious Disease
Date: Jan. 19, 2011
– Please Distribute Widely –
Influenza activity in Vermont has just increased from sporadic to regional, and is widespread in New York. As flu is spreading, we urge clinicians to consult CDC guidance on the use of influenza antiviral agents and rapid influenza diagnostic tests.
Interim recommendations on the use of antiviral medications are currently available on CDC’s website at: http://www.cdc.gov/flu/professionals/antivirals/index.htm
Updated guidance on the use of rapid influenza diagnostic tests is available at: http://www.cdc.gov/flu/professionals/diagnosis/clinician_guidance_ridt.htm
Antiviral Agents Guidance – Highlights:
1) Use early empiric antiviral treatment for suspected or confirmed influenza among people with severe, complicated, or progressive illness, or those hospitalized for influenza.
2) Use early empiric antiviral treatment for suspected or confirmed influenza among people at higher risk for influenza complications.
3) Use either oseltamivir or zanamivir for influenza A and B treatment or chemoprophylaxis – and do not use rimantadine or amantadine as influenza antiviral medications due to high levels of resistance to these medications among circulating influenza A viruses.
4) Use antiviral medications for children younger than 1 year of age with suspected or confirmed influenza.
5) Use local data on influenza activity to guide diagnosis and treatment decisions for patients with influenza-like illness.
6) Consider antiviral treatment for any previously healthy, non high-risk symptomatic outpatient with confirmed or suspected influenza, based upon clinical judgment, if treatment can be initiated within 48 hours of illness onset.
Rapid Influenza Diagnostic Tests Guidance – Highlights:
1) Use rapid influenza diagnostic tests when a positive result will change the clinical management of patients or change outbreak control strategies in a population, especially if the setting includes hospitalized patients or persons at high risk for influenza-associated complications.
2) Avoid using negative rapid test results to guide decisions regarding treating patients with influenza antiviral medications due to the suboptimal sensitivity of rapid tests.
3) Evaluate rapid diagnostic test results in the context of other available clinical and epidemiological information.
4) Consider further influenza laboratory testing in the following circumstances:
- when a patient tests negative by rapid test during periods of high influenza activity
- when a patient tests positive by rapid test during periods of low influenza activity
- when a patient has had recent close exposure to pigs, poultry, or other animals and novel influenza A virus infection is possible