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Clinical judgment is still essential regarding oseltamivir, vaccine product.

Consistent with the American Academy of Pediatrics and the Centers for Disease Control and Prevention guidelines, the authors recommend empiric oseltamivir for a child with influenzalike illness who has a condition that places them at risk for influenza complications, particularly if the suspected agent is the pandemic H1N1 virus.

However, the data highlight the difficulty in identifying all children who may benefit from oseltamivir therapy, especially given that the majority of children with ILI don't have influenza, oseltamivir therapy is best initiated within 48 hours of onset of symptoms, the most readily available test (rapid influenza testing) generally lacks sensitivity to identify those with influenza, and PCR testing is expensive and not available in many hospital emergency rooms.

Approximately half of the study patients had a history of influenza vaccine.

It is unclear whether this history of vaccination represented one or two doses in the younger patients.

The results underscore the importance of influenza vaccine, and this year the AAP has issued a preference for the nasal live attenuated vaccine for any child aged 2-8 years who doesn't have an underlying contraindication--emphasizing that vaccination should not be delayed in order to obtain a specific product for either dose of the influenza vaccine.

Dr. Mary Anne Jackson is director of the division of infectious diseases and associate chair of community and regional pediatric collaboration at Children's Mercy Hospital dr Clinics, and professor of pediatrics at the University of Missouri-Kansas City. She has no disclosures.


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Title Annotation:VIEW ON THE NEWS
Author:Jackson, Mary Anne
Publication:Pediatric News
Date:Sep 1, 2014
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