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Effects of early oseltamivir therapy on viral shedding in 2009 pandemic influenza A (H1N1) virus infection.
Clin Infect Dis 2010; 50(7):963-9CI

Abstract

BACKGROUND

Pandemic influenza (H1N1) 2009 is susceptible to oseltamivir. There are few reports on its clinical and virologic response to oseltamivir.

METHODS

During the pandemic containment response in Singapore, all patients with positive polymerase chain reaction (PCR) results for pandemic influenza (H1N1) 2009 were hospitalized, given oseltamivir for 5 days, and discharged when daily PCR results for combined nasal and throat swab samples became negative. Six patients had concurrent positive viral culture and PCR results.

RESULTS

The median age of the first 70 consecutive patients was 26 years (interquartile range, 21-38 years); 60% were men, and 29% had comorbidity. The mean time (+/-SD) from illness onset to hospital admission was 3+/-2 days. Influenza-like illness was noted in 63% of patients. Fever occurred in 91%, cough in 88%, sore throat in 66%, and rhinorrhea in 53% of patients. The mean duration (+/-SD) of viral shedding from illness onset was day 6+/-2 days. Viral shedding persisted beyond 7 days in 37% of patients. Clinical features and viral shedding were similar between those with and without comorbidity, except the former had more cough and lower oxygen saturation. Patients receiving oseltamivir on days 1 to 3 of illness had significantly shorter viral shedding duration, compared with those treated from day 4 onwards (P < .05). The mean durations (+/-SD) of positive PCR and viral culture results were 5+/-8 and 4+/-18 days, respectively, for 6 patients with concurrent positive viral culture and PCR results.

CONCLUSIONS

Prolonged viral shedding was noted in young immunocompetent adults with mild pandemic influenza (H1N1) 2009 despite receipt of oseltamivir. When prescribed during the first 3 days of illness, oseltamivir shortened the duration of viral shedding.

Authors+Show Affiliations

Departments of Infectious Diseases, Tan Tock Seng Hospital, Singapore.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20180701

Citation

Ling, Li M., et al. "Effects of Early Oseltamivir Therapy On Viral Shedding in 2009 Pandemic Influenza a (H1N1) Virus Infection." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 50, no. 7, 2010, pp. 963-9.
Ling LM, Chow AL, Lye DC, et al. Effects of early oseltamivir therapy on viral shedding in 2009 pandemic influenza A (H1N1) virus infection. Clin Infect Dis. 2010;50(7):963-9.
Ling, L. M., Chow, A. L., Lye, D. C., Tan, A. S., Krishnan, P., Cui, L., ... Leo, Y. S. (2010). Effects of early oseltamivir therapy on viral shedding in 2009 pandemic influenza A (H1N1) virus infection. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 50(7), pp. 963-9. doi:10.1086/651083.
Ling LM, et al. Effects of Early Oseltamivir Therapy On Viral Shedding in 2009 Pandemic Influenza a (H1N1) Virus Infection. Clin Infect Dis. 2010 Apr 1;50(7):963-9. PubMed PMID: 20180701.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of early oseltamivir therapy on viral shedding in 2009 pandemic influenza A (H1N1) virus infection. AU - Ling,Li M, AU - Chow,Angela L, AU - Lye,David C, AU - Tan,Adriana S, AU - Krishnan,Prabha, AU - Cui,Lin, AU - Win,Nwe N, AU - Chan,Monica, AU - Lim,Poh L, AU - Lee,Cheng C, AU - Leo,Yee S, PY - 2010/2/26/entrez PY - 2010/2/26/pubmed PY - 2010/6/2/medline SP - 963 EP - 9 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 50 IS - 7 N2 - BACKGROUND: Pandemic influenza (H1N1) 2009 is susceptible to oseltamivir. There are few reports on its clinical and virologic response to oseltamivir. METHODS: During the pandemic containment response in Singapore, all patients with positive polymerase chain reaction (PCR) results for pandemic influenza (H1N1) 2009 were hospitalized, given oseltamivir for 5 days, and discharged when daily PCR results for combined nasal and throat swab samples became negative. Six patients had concurrent positive viral culture and PCR results. RESULTS: The median age of the first 70 consecutive patients was 26 years (interquartile range, 21-38 years); 60% were men, and 29% had comorbidity. The mean time (+/-SD) from illness onset to hospital admission was 3+/-2 days. Influenza-like illness was noted in 63% of patients. Fever occurred in 91%, cough in 88%, sore throat in 66%, and rhinorrhea in 53% of patients. The mean duration (+/-SD) of viral shedding from illness onset was day 6+/-2 days. Viral shedding persisted beyond 7 days in 37% of patients. Clinical features and viral shedding were similar between those with and without comorbidity, except the former had more cough and lower oxygen saturation. Patients receiving oseltamivir on days 1 to 3 of illness had significantly shorter viral shedding duration, compared with those treated from day 4 onwards (P < .05). The mean durations (+/-SD) of positive PCR and viral culture results were 5+/-8 and 4+/-18 days, respectively, for 6 patients with concurrent positive viral culture and PCR results. CONCLUSIONS: Prolonged viral shedding was noted in young immunocompetent adults with mild pandemic influenza (H1N1) 2009 despite receipt of oseltamivir. When prescribed during the first 3 days of illness, oseltamivir shortened the duration of viral shedding. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/20180701/Effects_of_early_oseltamivir_therapy_on_viral_shedding_in_2009_pandemic_influenza_A__H1N1__virus_infection_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/651083 DB - PRIME DP - Unbound Medicine ER -