Management of Influenza in Households: A Prospective, Randomized Comparison of Oseltamivir Treatment With or Without Postexposure Prophylaxis

• Published in: The Journal of infectious diseases Vol. 189; no. 3; pp. 440 - 449
• Main Authors: Hayden, Frederick G., Belshe, Robert, Villanueva, Catalina, Lanno, Riin, Hughes, Claire, Small, Ian, Dutkowski, Regina, Ward, Penelope, Carr, Jackie
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.02.2004; University of Chicago Press; Oxford University Press
• Subjects: Acetamides - therapeutic use; Administration, Oral; Adolescent; Adult; Adults; Aged; Aged, 80 and over; Antiviral Agents - therapeutic use; Antivirals; Biological and medical sciences; Child; Child, Preschool; Disease transmission; Diseases; Family Characteristics; Female; Fundamental and applied biological sciences. Psychology; Household management; Humans; Infant; Infections; Infectious diseases; Influenza A virus; Influenza virus; Influenza, Human - drug therapy; Influenza, Human - prevention & control; Male; Medical sciences; Microbiology; Middle Aged; Oseltamivir; Post exposure prophylaxis; Prospective Studies; Time Factors; Vaccination; Viruses; Infection; Prevention; Oseltamivir; Treatment; Microbiology; Viral disease; Antiviral; Influenza A
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/381128

We determined the efficacy of postexposure prophylaxis (PEP) and treatment of ill index cases with oseltamivir, in an attempt to prevent influenza transmission in households, in a study conducted in 277 households with 298 index cases (62% with laboratory-confirmed influenza) and 812 contacts aged ⩾1 year. Contacts were randomized by household to receive treatment (5 days; n=402), if illness developed, or PEP for 10 days (n=410), and the number of households with at least 1 contact developing laboratory-confirmed influenza was measured. PEP provided a protective efficacy of 58.5% (95% confidence interval [CI], 15.6%–79.6%; P=.0114) for households against proven influenza and 68.0% (95% CI, 34.9%–84.2%; P=.0017) for individual contacts, compared with treatment of index cases alone. No oseltamivir-resistant variants were detected in treated index cases or contacts. PEP of household contacts of those with influenza reduces the secondary spread of influenza in families when the initial household case is treated