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Published on: January 30, 2017
Postexposure prophylaxis for influenza in pediatric wards oseltamivir or zanamivir after rapid antigen detection
Masayoshi Shinjoh1, Yaoko Takano, Takao Takahashi
1Department of Pediatrics, School of Medicine, Keio University, Japan. m-shinjo@z2.keio.jp
Insights
Postexposure prophylaxis (PEP) with oseltamivir or zanamivir effectively prevents nosocomial influenza in pediatric wards. This study found PEP significantly reduced secondary infections with no reported adverse events.
Area of Science:
- Infectious Diseases
- Pediatric Medicine
- Hospital Epidemiology
Background:
- Postexposure prophylaxis (PEP) for influenza is established in households but understudied in pediatric hospital settings.
- Nosocomial influenza presents a unique challenge in pediatric wards, requiring effective prevention strategies.
Purpose of the Study:
- To evaluate the safety and efficacy of neuraminidase inhibitor PEP for nosocomial influenza in pediatric wards.
- To assess the utility of rapid influenza diagnostic tests in identifying hospital-acquired infections.
Main Methods:
- Oseltamivir or zanamivir was administered as PEP to contacts of nosocomial influenza cases in pediatric wards.
- Influenza diagnosis was confirmed using rapid diagnostic tests.
- Secondary infection rates were compared between contacts who received PEP and those who did not.
Main Results:
- Twenty nosocomial influenza introductions occurred between 2003 and 2011.
- The secondary infection rate among contacts receiving PEP was significantly lower (3%) compared to those not receiving PEP (29%).
- No adverse events were reported during the study period.
Conclusions:
- Postexposure prophylaxis with oseltamivir or zanamivir is a safe and effective strategy against nosocomial influenza in pediatric wards.
- Rapid influenza diagnostic tests aid in the timely detection of hospital-acquired influenza in children.
Background:
Postexposure prophylaxis (PEP) using neuraminidase inhibitors against exposure to influenza virus has been well studied in household settings but not in nosocomial settings in pediatric wards.
Methods:
We used oseltamivir or zanamivir as PEP in our pediatric wards. All influenza cases were diagnosed by the influenza rapid diagnostic test.
Results:
Between 2003 and 2011, there were 20 nosocomial introductions of influenza (10 were A, 9 were B and 1 was undetermined). The index cases consisted of 17 inpatients, 2 parents and 1 medical staff member. The 17 inpatients had been admitted to the hospital for reasons other than infectious disease and they developed influenza after hospitalization. Among the 81 contacts, 28 (35%) were exposed to influenza A, and 52 (64%) were exposed to influenza B. The rate of secondary infection among contacts not given PEP was 29% (5/17), and the rate among contacts given PEP was significantly lower, 3% (2/63; P = 0.004). The 2 infected contacts who had been given PEP were both influenza B cases, and both had received oseltamivir. The contacts who received PEP within 24 hours (59), for influenza A (23) and those who received zanamivir (15) did not develop influenza. No adverse events were reported.
Conclusions:
PEP using oseltamivir or zanamivir for unexpected occurrences of nosocomial influenza in pediatric wards is safe and effective. The influenza rapid diagnostic test that we used was helpful for detecting nosocomial influenza in children.
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