Tamiflu and antiviral drugs not the answer to flu in children say researchers

Some researchers are warning governments that antiviral drugs have limited effectiveness against both seasonal flu and swine flu and may increase risks rather than benefits, especially in children.

While many countries in the northern hemisphere are stockpiling antiviral drugs such as Tamiflu and Relenza for widespread use against seasonal and pandemic flu some researchers are questioning this approach citing a lack of evidence that use of the drugs has significant benefits.

Research published in the British Medical Journal (BMJ) back in August found that Tamiflu and Relenza rarely prevented complications of the flu in children such as asthma flare-ups and secondary infections requiring antibiotics. Tamiflu is also associated with side-effects such as vomiting and widespread antiviral use may lead to viruses becoming resistant to them according to the paper.

The research was a systematic review and meta-analysis of previous studies which looked at the use of antivirals. Scientists at the University of Oxford, England, led by Dr Matthew Thompson, looked at the results of four trials on the treatment of seasonal flu in 1,766 children between one and 12 and three trials involving the use of antiviral to limit the spread of seasonal flu in 863 children in the same age group.

What Thompson and colleagues found was that while the antiviral drugs reduced the length of time children suffered symptoms of flu by around one day, complications were not reduced and side-effects meant children were often no better off.

The second part of the study revealed that 13 people need to be treated to prevent one additional flu case, meaning antivirals reduce transmission of the influenza virus by only 8%.

Thompson reported that: "Our research is finding for most children these antiviral drugs are probably not going to have much of an effect."

Co-author Dr Carl Heneghan, a GP and clinical lecturer at Oxford University, added that “The strategy of giving out this treatment in a mild infection is inappropriate”.

This study is certainly not the first to urge caution and restraint in the use of these antiviral drugs. In an editorial in 2007, again in the BMJ, it was reported that Japanese authorities had advised against prescribing Tamiflu to adolescents aged 10-19 years. This measure resulted from the suicides of two 14 year olds who jumped to their deaths while taking the drug. Another 52 other deaths (14 in children or adolescents) had been associated with Tamiflu at the time of writing. So there is also concern that the drug causes neuropsychiatric disturbances.

Although the University of Oxford researchers did not look at antiviral effects in the current H1N1 swine flu, they say these drugs are unlikely to help children infected with the virus.

In the BMJ they say “While morbidity and mortality in the current pandemic remain low, a more conservative strategy might be considered prudent, given the limited data, side effects such as vomiting, and the potential for developing resistant strains of influenza.”

They add that parents with sick children should make sure they get plenty of rest and fluids and that they should contact their doctor if the child's condition gets worse.

Natural health experts meanwhile say there are many proven means by which to reduce the risk of contracting flu of any kind and dealing with it if you or your children do. Dr. Joseph Mercola, who runs one of the most popular natural medicine websites on the web, has frequently discussed the importance of vitamin D from sunlight exposure, diet and supplements for maintaining the body's innate immune responses which help us fight off viral infections.

Other sensible measures include using good hygiene, washing hands after being out in public places or around those infected with the flu, getting eight hours of sleep every night, avoiding stress, eating a healthy diet with plenty of whole foods, fruits and vegetables and taking supplements of immune boosting nutrients such as vitamin C and zinc if you know you often catch the flu and are therefore susceptible.

Primary Source: Shun-Shin M Thompson M Heneghan C Perera R Harnden A Mant D (2009) Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomised controlled trials (Online) last accessed 29.10.09 at http://www.bmj.com/cgi/content/full/339/aug10_1/b3172?q=w_pandemic_flu