Most patients who have suspected or confirmed cases of H1N1 infection have a mild, uncomplicated, self-limited illness that may not require antiviral treatment. If infected individuals have a normal immune system, they should be able to recover from the infection with symptomatic treatment only and without antiviral therapy. However, it is the decision of the patient's physician whether to treat or not to treat. The CDC provides this decision tree as a guideline if the illness is mild and uncomplicated:
The CDC suggests that patients with suspected or confirmed influenza should be treated if:
- They are hospitalized as a result of the illness
- They are at risk for severe disease including these patients:
- Patients that have certain medical conditions, such as asthma, diabetes, heart disease, or patients with weakened immune systems that may exacerbate the infection.
- Children younger than 2 years old
- Adults 65 years or older
- Pregnant women or women up to 2 weeks post-partum
- They have a progressive or complicated illness characterized by signs of:
- lower respiratory tract disease such as hypoxia or abnormal chest x-ray
- CNS complications such as encephalitis
- Complications of low blood pressure including shock or organ failure
- Myocarditis
- Invasive secondary bacterial infection
The treatment options indicated for the 2009 H1N1 infection include oseltamivir (brand name Tamiflu®), an oral tablet, and zanamivir (brand name Relenza®), an inhaled antiviral agent.
Reference:
Centers for Disease Control and Prevention. Updated interim recommendations for the use of antiviral medications in the treatment and prevention of influenza for the 2009-2010 season. December 7, 2009. Available at: http://www.cdc.gov/h1n1flu/recommendations.htm. Accessed January 18, 2010.
