Effects of Oseltamivir Treatment on Duration of Clinical Illness and Viral Shedding and Household Transmission of Influenza Virus
Identifieur interne : 002656 ( Main/Exploration ); précédent : 002655; suivant : 002657Effects of Oseltamivir Treatment on Duration of Clinical Illness and Viral Shedding and Household Transmission of Influenza Virus
Auteurs : Sophia Ng [République populaire de Chine] ; Benjamin J. Cowling [République populaire de Chine, Hong Kong] ; Vicky J. Fang [République populaire de Chine] ; Kwok Hung Chan [République populaire de Chine] ; Dennis K. M. Ip [République populaire de Chine] ; Calvin K. Y. Cheng [République populaire de Chine] ; Timothy M. Uyeki [Géorgie (pays)] ; Peter M. Houck [États-Unis] ; J. S. Malik Peiris [République populaire de Chine] ; Gabriel M. Leung [République populaire de Chine]Source :
- Clinical Infectious Diseases [ 1058-4838 ] ; 2010.
Abstract
Background. Large clinical trials have demonstrated the therapeutic efficacy of oseltamivir against influenza. We assessed the indirect effectiveness of oseltamivir in reducing secondary household transmission in an incident cohort of influenza index patients and their household members. Methods. We recruited index outpatients whose rapid test results were positive for influenza from February through September 2007 and January through September 2008. Household contacts were followed up for 7–10 days during 3–4 home visits to monitor symptoms. Nose and throat swabs were collected and tested for influenza by reverse-transcription polymerase chain reaction or viral culture. Results. We followed up 384 index patients and their household contacts. Index patients who took oseltamivir within 24 h of symptom onset halved the time to symptom alleviation (adjusted acceleration factor, 0.56; 95% confidence interval [CI], 0.42–0.76). Oseltamivir treatment was not associated with statistically significant reduction in the duration of viral shedding. Household contacts of index patients who had taken oseltamivir within 24 h of onset had a nonstatistically significant lower risk of developing laboratory-confirmed infection (adjusted odds ratio, 0.54; 95% CI, 0.11–2.57) and a marginally statistically significant lower risk of clinical illness (adjusted odds ratio, 0.52; 95% CI, 0.25–1.08) compared with contacts of index patients who did not take oseltamivir. Conclusions. Oseltamivir treatment is effective in reducing the duration of symptoms, but evidence of household reduction in transmission of influenza virus was inconclusive.
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DOI: 10.1086/650458
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Ip</name></author><author><name sortKey="Cheng, Calvin K Y" sort="Cheng, Calvin K Y" uniqKey="Cheng C" first="Calvin K. Y." last="Cheng">Calvin K. Y. Cheng</name></author><author><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name></author><author><name sortKey="Houck, Peter M" sort="Houck, Peter M" uniqKey="Houck P" first="Peter M." last="Houck">Peter M. Houck</name></author><author><name sortKey="Peiris, J S Malik" sort="Peiris, J S Malik" uniqKey="Peiris J" first="J. S. Malik" last="Peiris">J. S. Malik Peiris</name></author><author><name sortKey="Leung, Gabriel M" sort="Leung, Gabriel M" uniqKey="Leung G" first="Gabriel M." last="Leung">Gabriel M. 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Cowling</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Community Medicine, School of Public Health, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Hong Kong</country></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Hong Kong</country><wicri:regionArea>Reprints or correspondence: Dr Benjamin J. Cowling, School of Public Health, University of Hong Kong, Units 624-7, Cyberport 3, Pokfulam, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Fang, Vicky J" sort="Fang, Vicky J" uniqKey="Fang V" first="Vicky J." last="Fang">Vicky J. Fang</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Community Medicine, School of Public Health, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Chan, Kwok Hung" sort="Chan, Kwok Hung" uniqKey="Chan K" first="Kwok Hung" last="Chan">Kwok Hung Chan</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Microbiology, University of Hong Kong, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Ip, Dennis K M" sort="Ip, Dennis K M" uniqKey="Ip D" first="Dennis K. M." last="Ip">Dennis K. M. Ip</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Community Medicine, School of Public Health, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Cheng, Calvin K Y" sort="Cheng, Calvin K Y" uniqKey="Cheng C" first="Calvin K. Y." last="Cheng">Calvin K. Y. Cheng</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Community Medicine, School of Public Health, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Houck, Peter M" sort="Houck, Peter M" uniqKey="Houck P" first="Peter M." last="Houck">Peter M. Houck</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Seattle Quarantine Station, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, National Center for Preparedness, Detection and Control of Infectious Diseases, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Peiris, J S Malik" sort="Peiris, J S Malik" uniqKey="Peiris J" first="J. S. Malik" last="Peiris">J. S. Malik Peiris</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Microbiology, University of Hong Kong, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Leung, Gabriel M" sort="Leung, Gabriel M" uniqKey="Leung G" first="Gabriel M." last="Leung">Gabriel M. Leung</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Community Medicine, School of Public Health, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Clinical Infectious Diseases</title><title level="j" type="abbrev">Clinical Infectious Diseases</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><publisher>The University of Chicago Press</publisher><date type="published">2010</date><biblScope unit="vol">50</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="707">707</biblScope><biblScope unit="page" to="714">714</biblScope></imprint><idno type="ISSN">1058-4838</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1058-4838</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Background. Large clinical trials have demonstrated the therapeutic efficacy of oseltamivir against influenza. We assessed the indirect effectiveness of oseltamivir in reducing secondary household transmission in an incident cohort of influenza index patients and their household members. Methods. We recruited index outpatients whose rapid test results were positive for influenza from February through September 2007 and January through September 2008. Household contacts were followed up for 7–10 days during 3–4 home visits to monitor symptoms. Nose and throat swabs were collected and tested for influenza by reverse-transcription polymerase chain reaction or viral culture. Results. We followed up 384 index patients and their household contacts. Index patients who took oseltamivir within 24 h of symptom onset halved the time to symptom alleviation (adjusted acceleration factor, 0.56; 95% confidence interval [CI], 0.42–0.76). Oseltamivir treatment was not associated with statistically significant reduction in the duration of viral shedding. Household contacts of index patients who had taken oseltamivir within 24 h of onset had a nonstatistically significant lower risk of developing laboratory-confirmed infection (adjusted odds ratio, 0.54; 95% CI, 0.11–2.57) and a marginally statistically significant lower risk of clinical illness (adjusted odds ratio, 0.52; 95% CI, 0.25–1.08) compared with contacts of index patients who did not take oseltamivir. Conclusions. Oseltamivir treatment is effective in reducing the duration of symptoms, but evidence of household reduction in transmission of influenza virus was inconclusive.</div></front></TEI><affiliations><list><country><li>Géorgie (pays)</li><li>Hong Kong</li><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Washington (État)</li></region></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Ng, Sophia" sort="Ng, Sophia" uniqKey="Ng S" first="Sophia" last="Ng">Sophia Ng</name></noRegion><name sortKey="Chan, Kwok Hung" sort="Chan, Kwok Hung" uniqKey="Chan K" first="Kwok Hung" last="Chan">Kwok Hung Chan</name><name sortKey="Cheng, Calvin K Y" sort="Cheng, Calvin K Y" uniqKey="Cheng C" first="Calvin K. Y." last="Cheng">Calvin K. Y. Cheng</name><name sortKey="Cowling, Benjamin J" sort="Cowling, Benjamin J" uniqKey="Cowling B" first="Benjamin J." last="Cowling">Benjamin J. Cowling</name><name sortKey="Fang, Vicky J" sort="Fang, Vicky J" uniqKey="Fang V" first="Vicky J." last="Fang">Vicky J. Fang</name><name sortKey="Ip, Dennis K M" sort="Ip, Dennis K M" uniqKey="Ip D" first="Dennis K. M." last="Ip">Dennis K. M. Ip</name><name sortKey="Leung, Gabriel M" sort="Leung, Gabriel M" uniqKey="Leung G" first="Gabriel M." last="Leung">Gabriel M. Leung</name><name sortKey="Peiris, J S Malik" sort="Peiris, J S Malik" uniqKey="Peiris J" first="J. S. Malik" last="Peiris">J. S. Malik Peiris</name></country><country name="Hong Kong"><noRegion><name sortKey="Cowling, Benjamin J" sort="Cowling, Benjamin J" uniqKey="Cowling B" first="Benjamin J." last="Cowling">Benjamin J. Cowling</name></noRegion><name sortKey="Cowling, Benjamin J" sort="Cowling, Benjamin J" uniqKey="Cowling B" first="Benjamin J." last="Cowling">Benjamin J. Cowling</name></country><country name="Géorgie (pays)"><noRegion><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name></noRegion></country><country name="États-Unis"><region name="Washington (État)"><name sortKey="Houck, Peter M" sort="Houck, Peter M" uniqKey="Houck P" first="Peter M." last="Houck">Peter M. Houck</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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