WHO Recommendations for Treating H5N1 Bird Flu

After almost 300 cases of bird flu and more than 270 deaths, the World Health Organization has updated its recommendations on how to treat bird flu caused by the H5N1 virus.

Here are the WHO recommendations for treating bird flu caused by the H5N1 virus, updated April 19, 2007.

• Tamiflu, the brand name for the drug oseltamivir, may be effective against bird flu. Doctors may prescribe up to double the normal dose on a case-by-case basis. Early treatment with Tamiflu is best, but Tamiflu seems to help in preventing death even when the disease is advanced.
• In some cases, and when H5N1 may be susceptible to amantadine, a combination drug therapy of Tamiflu and amantadine is recommended. The earlier bird flu treatment guidelines warned against using amantadine or rimantadine. Relenza, the brand name for zanamivir, was not mentioned in the recommendations.
• In general, corticosteroids should not be given to patients. They could lower the immune system's abilities to find infection, increasing the chance of the patient getting secondary infections called opportunistic infections. The WHO only recommends giving corticosteroids for bird flu patients when there is “persistent septic shock with suspected adrenal insufficiency".
• Antibiotics should not be given to prevent secondary or opportunistic infections unless laboratory tests confirm a bacterial infection is already present. Acquired pneumonia warrants initial antibiotic treatment according to the recommendations.
• When illness with H5N1 bird flu is related to Acute Respiratory Distress Syndrome, ARDS, treatment should be given according to evidence-based results for treating sepsis-associated ARDS. This recommendation has to do with the choice of putting the patient on a mechanical ventilator to breathe in the event the lungs cannot function correctly. This can happen when fluid fills the lungs in some bird flu patients, perhaps due to a phenomenon called a cytokine storm.

  _Sources:

  World Health Organization (WHO). Epidemic and Pandemic Alert Response. Summary of the second WHO consultation on clinical aspects of human infection with avian influenza A (H5N1) virus.

  World Health Organization (WHO). Epidemic and Pandemic Alert Response. Rapid advice on pharmacological management of humans infected with avian influenza A (H5N1) virus.