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Influenza Treatment Pathway

Rob Orman, MD, Cameron Berg, MD FAAEM, and Mel Herbert, MD MBBS FAAEM
00:00
20:33

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Do you ever feel confused as to whom should be tested and/or treated for influenza? Rest assured, you’re not the only one. Cam Berg simplifies the process with a seasonally topical ‘influenza clinical pathway

Daniel B. -

At what point do you stop testing in an otherwise healthy patient that appears to clearly have the flu and simply call it an influenza-like illness?

Ian L., Dr -

Post Exposure and Pre Exposure Chemoprophylaxis in high risk contacts or high risk persons eg nursing homes has not been discussed here .
The CDC in its statement Jan 21 2001 by Fiora et al stated the evidence that Post Exposure Prophylaxis reduced influence effects whatever that means by 68- 89% with osteltamavir .
Pre exposure prophylaxis for high risk patients such as in nursing homes and by projection other high at risk patient also showed considerable significant benefit .
Bowles SK LeeW Simon ER reported this in J Infectious Diseases 2002 186 : 1582-1588 .Vaccines being at best usually 50% efficacious means for considerably high risk persons post exposure or in a pandemic the antivirals have not been proven only slightly useful.

James M., D.O. -

The attached Influenza pathway is not in complete agreement with the podcast. If you are relying on the elisa test result in your high risk group, you are wrong half the time. The podcast stated that gestalt was as good or better than the elisa test. Shouldn't the pathway reflect that. The pathway suggests testing all high risk patients with less than 48 hrs of symptoms. I personally treat those patients if I think they have it.

Jonah S., RN -

The CDC has come under fire for potential financial conflicts of interest as it relates to the makers of Tamiflu (oseltamivir). The FDA does not agree with the CDCs findings when using the same trials. Australia does not include oseltamivir in its national formulary because the makers will not release the data from the additional trials it has conducted (required to be on their formulary). There are a limited number of reasons why you wouldn't want to submit additional trial data and I can tell you that positive results supporting the product you're trying to sell isn't one of them.

Stephen T. -

Thank you for Dr. Berg's influenza insights, ADP-style -- I'd be curious to hear if either of our two national EM-ID thought leaders, Greg Moran or Dave Talan, have any differing views and/or style points...

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Influenza Treatment Pathway Full episode audio for MD edition 20:33 min - 16 MB - M4AInfluenza Treatment Pathway 329 KB - PDF