Should children be given Tamiflu?

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Wed 9 September 2009

The pros and cons explained

If we do get a second wave of swine flu this winter, children and young people are at high risk of catching the virus. In the first week of the launch of the National Flu Pandemic Service, over 150,000 doses of the anti-viral drug Tamiflu were prescribed to the British public.

Since then, whether or not to use Tamiflu on people who catch swine flu has been hotly debated in the media. So what are the risks and benefits in taking Tamiflu?

Side effects

All drugs have the potential to cause adverse drug reactions (i.e. side effects). Two separate studies carried out by the UK Health Protection Agency specifically monitored the side effects of Tamiflu in healthy school age children.

In both studies, primary and secondary school children had been given Tamiflu to prevent them catching swine flu after a classmate fell ill. The studies both showed that just over 50% of children reported experiencing at least one side effect. These included:

• Nausea
• Headaches
• Abdominal pain
• Tiredness
• Vomiting
• “Neuropsychiatric effects” e.g. sleep problems, difficulty concentrating, nightmares

The scientists who carried out the studies also reported that these occurred at a higher rate than was expected.

Another highly publicised report, published in the British Medical Journal suggested there was “no clear evidence” that anti-viral drugs prevented complications in children with seasonal flu, but found that they shorten the duration of illness by up to a day and a half.

Benefits

If taken within 48 hours of being infected with the H1N1 virus, anti-viral drugs can reduce the duration of illness, and according to the WHO are “associated with better clinical outcomes.”

Currently both the UK government, WHO and Centres for Disease Control in the US agree that anti-viral drugs should be used:

• when there are any signs of severe disease developing;
• for adults in high risk groups who become infected;
• for children with serious disease or who are in the high risk groups.

Although the WHO advises that healthy adults and children over the age of 5 need not be treated as most will experience mild illness, the UK government has left that decision up to us.