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Early H1N1 treatment can save lives: WHO
Sharon Kirkey , Canwest News Service: Thursday, November 12, 2009 9:02 AM
Early medical treatment for H1N1 can mean the difference between life and death for people with underlying conditions as well as otherwise healthy people whose symptoms do not improve within three days, World Health Organization officials said Thursday in releasing updated clinical guidelines on the treatment of the pandemic virus.
The vast majority of people infected with H1N1 have mild symptoms and recover fully, even without any medical treatment, Dr. Nikki Shindo, a medical officer with WHO's Global Influenza Programme, said in a press briefing from Geneva Thursday.
But H1N1 can cause severe pneumonia, even in healthy young people, and the virus can take lives within a week.
"The window of opportunity is very narrow to reverse the progression of the disease," Shindo said. "The medicine needs to be administered before the virus destroys the lungs."
"We have heard that doctors involved in caring for very sick patients in intensive care units regretted that the patient arrived too late, and even the most sophisticated medical procedures could not save their lives.
"We asked the doctors, what could have been done differently to avoid the tragic outcomes? All of them answered, without exception, that things may have been very different if they had been treated with anti-viral medicine early."
When WHO first published guidelines earlier this year for doctors treating H1N1 patients, the focus was on how to treat severe cases. The guidelines took a more conservative approach with the use of ant-virals, because there was virtually no experience in how effective the drugs were in treating H1N1, and access in some countries was limited.
"Now, with more data and experience with the disease we have better information on how to prevent severe disease," Shindo said.
The updated guidelines are based on "what we know now about the virus, and how it affects people."
In countries such as Canada where the virus is circulating, the three main updated recommendations are as follows:
?People in at risk groups need to be treated with anti-virals as soon as possible when they have flu symptoms. This includes pregnant women, children under two and people with underlying conditions such as respiratory problems.
?People who are not from an at-risk groups but who have persistent or rapidly worsening symptoms should also be treated with anti-virals. These symptoms include difficulty breathing and a high fever that lasts beyond three days.
?People who have already developed pneumonia should be given both anti-virals and antibiotics. Shindo said that, in many severe cases of H1N1 caused illness, bacterial infections develop.
"These medicines, anti-virals and antibiotics, if used in a timely manner can help save lives," Shindo said.
"We are not recommending anti-virals if otherwise healthy people are experiencing only mild illness or as a preventive measure in healthy people."
Anti-virals are considered most effective when used within 48 hours of the onset of symptoms. But Shindo said that, in severe cases, treatment should be given regardless of how long people waited before seeking medical care.
Canada has a national antiviral stockpile of 55 million doses of two anti-viral medicines, Tamiflu and Relenza.
Shindo said countries should de-centralize the distribution of anti-virals and ensure family doctors have access to the medicines.
"Patients should not need to visit hospitals in order to get anti-virals prescribed," she said. "This should ensure that individuals get the care they need faster" and leave hospitals to treat the most severe cases.
Shindo said it's still not completely known what are the risk factors for severe disease in otherwise healthy people, but that obesity, especially morbid obesity, meaning those with a body mass index greater than 40, "could play a role."
http://www.globalnational.com/sitemap/Early+H1N1+treatment+save+lives/2214277/story.html
Sharon Kirkey , Canwest News Service: Thursday, November 12, 2009 9:02 AM
Early medical treatment for H1N1 can mean the difference between life and death for people with underlying conditions as well as otherwise healthy people whose symptoms do not improve within three days, World Health Organization officials said Thursday in releasing updated clinical guidelines on the treatment of the pandemic virus.
The vast majority of people infected with H1N1 have mild symptoms and recover fully, even without any medical treatment, Dr. Nikki Shindo, a medical officer with WHO's Global Influenza Programme, said in a press briefing from Geneva Thursday.
But H1N1 can cause severe pneumonia, even in healthy young people, and the virus can take lives within a week.
"The window of opportunity is very narrow to reverse the progression of the disease," Shindo said. "The medicine needs to be administered before the virus destroys the lungs."
"We have heard that doctors involved in caring for very sick patients in intensive care units regretted that the patient arrived too late, and even the most sophisticated medical procedures could not save their lives.
"We asked the doctors, what could have been done differently to avoid the tragic outcomes? All of them answered, without exception, that things may have been very different if they had been treated with anti-viral medicine early."
When WHO first published guidelines earlier this year for doctors treating H1N1 patients, the focus was on how to treat severe cases. The guidelines took a more conservative approach with the use of ant-virals, because there was virtually no experience in how effective the drugs were in treating H1N1, and access in some countries was limited.
"Now, with more data and experience with the disease we have better information on how to prevent severe disease," Shindo said.
The updated guidelines are based on "what we know now about the virus, and how it affects people."
In countries such as Canada where the virus is circulating, the three main updated recommendations are as follows:
?People in at risk groups need to be treated with anti-virals as soon as possible when they have flu symptoms. This includes pregnant women, children under two and people with underlying conditions such as respiratory problems.
?People who are not from an at-risk groups but who have persistent or rapidly worsening symptoms should also be treated with anti-virals. These symptoms include difficulty breathing and a high fever that lasts beyond three days.
?People who have already developed pneumonia should be given both anti-virals and antibiotics. Shindo said that, in many severe cases of H1N1 caused illness, bacterial infections develop.
"These medicines, anti-virals and antibiotics, if used in a timely manner can help save lives," Shindo said.
"We are not recommending anti-virals if otherwise healthy people are experiencing only mild illness or as a preventive measure in healthy people."
Anti-virals are considered most effective when used within 48 hours of the onset of symptoms. But Shindo said that, in severe cases, treatment should be given regardless of how long people waited before seeking medical care.
Canada has a national antiviral stockpile of 55 million doses of two anti-viral medicines, Tamiflu and Relenza.
Shindo said countries should de-centralize the distribution of anti-virals and ensure family doctors have access to the medicines.
"Patients should not need to visit hospitals in order to get anti-virals prescribed," she said. "This should ensure that individuals get the care they need faster" and leave hospitals to treat the most severe cases.
Shindo said it's still not completely known what are the risk factors for severe disease in otherwise healthy people, but that obesity, especially morbid obesity, meaning those with a body mass index greater than 40, "could play a role."
http://www.globalnational.com/sitemap/Early+H1N1+treatment+save+lives/2214277/story.html
