Wilderness Environ Med

. 2021 Jan 8;S1080-6032(20)30174-5.
doi: 10.1016/j.wem.2020.09.008. Online ahead of print.
Reconstitution of Oseltamivir Capsules for Pediatric Use on a Long-Term Cruise: A Treatment Option

Yoshihiro Aoki 1 , Liliana Del Carmen Amaya Dimas 2 , Katsuhiko Kitazawa 3 , Naoto Mizushiro 4



Influenza is a concerning disease in terms of risk management for cruise passengers during a voyage. Currently, cruise passengers include children in addition to elderly people. Oral oseltamivir can be used to treat pediatric influenza. In addition, early antiviral treatment may reduce the spread of influenza on board. However, the capsule form of oseltamivir is not of the recommended dosage for children. In this report, we describe 2 siblings who acquired influenza during travel on a world cruise ship and were treated with decapsulated oseltamivir. The siblings' mother was instructed to decapsulate a 75 mg oseltamivir capsule, suspend the powder in 15 mL of water (5 mg·mL-1), stir well, and administer the required amount of medicine orally to each patient using a syringe. Both patients recovered successfully with no complications. The presented case suggests that suspending decapsulated oseltamivir in water and measuring the required amount with a syringe for orally administration to children with influenza can be a safe treatment strategy in resource-limited settings.

Keywords: emergency medicine; extreme environments; influenza; pediatrics; suspensions; travel medicine.