PURPOSE: Children with lung disease are at a significantly increased risk of complications of H1N1 influenza. Oseltamivir, administered within 48 hours of the onset of symptoms, is indicated for the treatment of high-risk children over the age of 1 year with influenza-like illness. The H1N1 Assessment Tool was developed by physicians at our institution with the goal of facilitating access to oseltamivir to pediatric patients with chronic lung disease. This study examines the efficacy of the tool.
METHODS: Between October 10 and December 30, 2009, the H1N1 Assessment Tool was used to assess patients in the Division of Respiratory Medicine with influenza-like symptoms who telephoned for medical advice. The tool was administered by telephone and consisted of three questionnaires (initial, 48-hour and 2-week), which allowed for standardized data collection.
RESULTS: The H1N1 Assessment Tool was used to assess 33 symptomatic children (20 with cystic fibrosis, 6 with asthma, 2 with spinal muscular atrophy, 1 with neonatal chronic lung disease, 1 on home oxygen, 1 with congenital diaphragmatic hernia and 2 with tracheostomy). The most frequently reported symptoms were fever (85%), cough (82%) and lethargy (67%). 55% of patients had a nasopharyngeal swab for viruses, of which 60% were positive for H1N1. 82% of patients were prescribed oseltamivir. Of these, 87% took the first dose within 24 hours of it being prescribed. Of the 9 patients for whom we have complete data, 6 (67%) took the first dose of oseltamivir with the the recommended 48 hours of the onset of symptoms.
CONCLUSION: Our study shows that the H1N1 Assessment Tool allowed children with chronic lung disease to access oseltamivir within 24 hours of the initial call for medical advice, and for the most part, within the recommended 48 hours of symptom onset.
CLINICAL IMPLICATIONS: This tool allowed providers to treat ill and potentially infectious patients in a timely manner and without exposing other patients to the virus.
DISCLOSURE: Joanna Massam, No Financial Disclosure Information; No Product/Research Disclosure Information