Press Release
10 January 2018

Antiviral treatment for potentially severe influenza infection

The Advisory Committee on Communicable Diseases made the following recommendations in relation to the clinical management of seasonal influenza.

1. Seasonal influenza may cause severe or even life-threatening diseases, especially among individuals at risk for complications.

2. The initial management of severe or potentially severe influenza infections remains largely clinical. If clinically indicated, empirical antiviral treatment should be started as soon as possible. Laboratory confirmation of influenza virus infection is NOT necessary for the initiation of treatment.

3. Antiviral treatment using neuraminidase inhibitors (NAI) has been shown to reduce the duration of illness and complications of influenza. Empirical antiviral treatment should be considered for any patient with suspected influenza who is hospitalized, has severe or progressive illness, or is at high risk for complications from influenza, including children and pregnant women, irrespective of vaccination history. NAI has a good safety profile but monitoring of possible side effects is generally recommended. The potential benefits generally outweigh the small risks of possible adverse effects for patients with severe influenza infections or at risk for major influenza complications.

4. While there have been a number of innovations in diagnostic tools for influenza, they may still be subject to various limitations e.g. limited access or longer turnover time for laboratory-based tests, often lower sensitivity for point-of-care tests and intrinsic limitations (variable time profile / localization of virus expression) in specimen collection for both types of tests.

5. The sensitivities of available rapid antigenic diagnostic tests for influenza are limited. A negative rapid antigenic diagnostic test does NOT rule out influenza, especially during peak influenza periods.

6. Although some rapid molecular tests have been developed for use nearer the bedside, they may still suffer from varying degrees of limitation in sensitivity as compared to the standard laboratory-based tests.

Notes to editors:
The Hong Kong Medical Association, founded in 1920, aims to bring together Hong Kong's government, institutional, university and private medical practitioners for an effective exchange of views and co-ordination of efforts. The foremost objective of the Association is to safeguard and promote public health. The Association speaks collectively for its members and aims to keep its members abreast of medical ethics, issues and advances around the world. In fulfilling these goals, the association hopes to better serve the people of Hong Kong.

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