With this latest evidence WHO recommends:

Standardising care and promptly sharing clinical and treatment information to improve understanding of the disease and identify appropriate therapy.

Tamiflu remaining the primary antiviral treatment both early and late in the infection as there is evidence of prolonged replication with H5N1.

Modified Tamiflu treatment regimens - higher and longer dosing may be necessary given the virulence of some forms of H5N1 seen recently.

Possible combination therapy with adamantanes (case by case basis), particularly in patients with pneumonia or progressive disease.

The guidance also states that inhaled zanamivir has not been studied in human H5N1 illness and that the adequacy of inhaled zanamivir delivery in patients with serious lower respiratory tract or extra pulmonary disease is a major concern. Ongoing modifications will be made to the WHO guidance based on continual research findings.

During the clinical development programme Roche carried out studies looking at higher doses of Tamiflu. The safety profile at these higher doses was supportive of further investigation A high versus standard dosage study has recently started in patients with severe influenza, both H5N1 and seasonal, in conjunction with the National Institutes of Health (NIH), to determine which is the most effective dose in severe disease.

WHO coordinates the global response to human cases of H5N1 avian influenza and tracks the corresponding threat of an influenza pandemic, providing access to both technical guidelines and information useful for the general public.

Tamiflu is an oral neuraminidase inhibitor that is active against all strains of influenza A and B tested. More than 80 governments worldwide are now stockpiling Tamiflu in preparation for a pandemic and many global businesses are in discussions with Roche and are now stockpiling for their employees and their families in line with local laws and regulations.

Source: Eurekalert
LIN/B